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https://www.readbyqxmd.com/read/28213046/splenectomy-as-a-destination-improving-quality-of-care-among-asplenic-veterans-through-a-travel-clinic
#1
Aaron P Mitchell, Joel C Boggan, Karen Lau, David L Simel
BACKGROUND: Asplenic patients are at risk for severe infections, but adherence to recommended preventive education and vaccination is poor. The goal of this study was to demonstrate that a targeted intervention can improve vaccination rates in a population of asplenic veterans. METHODS: Surgically asplenic patients actively receiving care in our health care system were identified via a database search. Patients were contacted via mailed letters and encouraged to attend an existing travel clinic with a new process designed for asplenic patients...
February 14, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28128749/comparative-erythrocyte-deformability-investigations-by-filtrometry-slit-flow-and%C3%A2-rotational-ektacytometry-in-a-long-term-follow-up-animal-study-on-splenectomy-and%C3%A2-different-spleen-preserving-operative-techniques-partial-or-subtotal-spleen-resection-and-spleen
#2
Iren Miko, Norbert Nemeth, Viktoria Sogor, Ferenc Kiss, Eniko Toth, Katalin Peto, Andrea Furka, Erzsebet Vanyolos, Laszlo Toth, Jozsef Varga, Krisztian Szigeti, Ilona Benkő, Anna V Olah, Istvan Furka
BACKGROUND: Partial or subtotal spleen resection or spleen autotransplantation can partly preserve/restore the splenic filtration function, as previous studies demonstrated. OBJECTIVE: For better evaluation and follow-up of the various spleen-preserving operative techniques' effectiveness versus splenectomy, a composite methodological approach was applied in a canine experimental model. METHODS: Beagle dogs were subjected to control (n = 6), splenectomy (SE, n = 4), partial and subtotal spleen resection (n = 4/each) or spleen autotransplantation groups (AU, Furka's spleen-chip method, n = 8)...
January 27, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27994385/exchange-transfusion-for-babesiosis-when-how-and-how-long
#3
Pramod K Guru, John C O Horo, Heidi D Lehrke, Jeffrey L Winters, John W Wilson
Babesiosis is a zoonotic disease transmitted by Ixodes ticks seen in the United States and parts of Europe. Because of the typically mild course of most infections, the disease is uncommonly seen in clinical practice. However, asplenic patients can develop a life-threatening infection. The first line of therapy for Babesia infections is antiparasitic medications; however, red blood cell (RBC) exchange transfusion has been described as an adjunct therapy. We describe a severe case of babesiosis in an asplenic patient and review the evidence, indications, and protocols for RBC exchange transfusion in this setting...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27929751/recommended-vaccinations-for-asplenic-and-hyposplenic-adult-patients
#4
Paolo Bonanni, Maddalena Grazzini, Giuditta Niccolai, Diana Paolini, Ornella Varone, Alessandro Bartoloni, Filippo Bartalesi, Maria Grazia Santini, Simonetta Baretti, Carlo Bonito, Paola Zini, Maria Teresa Mechi, Fabrizio Niccolini, Lea Magistri, Maria Beatrice Pulci, Sara Boccalini, Angela Bechini
Asplenic or hyposplenic (AH) individuals are particularly vulnerable to invasive infections caused by encapsulated bacteria. Such infections have often a sudden onset and a fulminant course. Infectious diseases (IDs) incidence in AH subjects can be reduced by preventive measures such as vaccination. The aim of our work is to provide updated recommendations on prevention of infectious diseases in AH adult patients, and to supply a useful and practical tool to healthcare workers for the management of these subjects, in hospital setting and in outpatients consultation...
February 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27859047/human-b-cell-memory-is-shaped-by-age-and-tissue-specific-t-independent-and-gc-dependent-events
#5
Alaitz Aranburu, Eva Piano Mortari, Anwar Baban, Ezio Giorda, Simona Cascioli, Valentina Marcellini, Marco Scarsella, Sara Ceccarelli, Sandro Corbelli, Nicoletta Cantarutti, Rita De Vito, Alessandro Inserra, Luciana Nicolosi, Arnalda Lanfranchi, Fulvio Porta, Caterina Cancrini, Andrea Finocchi, Rita Carsetti
Switched and IgM memory B cells execute different and noninterchangeable functions. We studied memory B cells in children of different ages, in peripheral blood and spleen and compared them with those of children born asplenic or unable to build germinal centers. We show that, whereas switched memory B cells are mostly generated in the germinal centers at all ages, IgM memory B cells can be distinct in three types with different developmental history. Innate IgM memory B cells, the largest pool in infants, are generated in the spleen by a germinal center-independent mechanism...
November 16, 2016: European Journal of Immunology
https://www.readbyqxmd.com/read/27819637/patients-after-splenectomy-old-risks-and-new-perspectives
#6
REVIEW
Mihnea Dragomir, Dragoş George Emil Petrescu, Graţiela Elena Manga, George A Călin, Cătălin Vasilescu
The risks that arise after splenectomy can be divided in infectious and non-infectious. The link between splenectomy and these hazards remains partially unknown. Host defense against infection is altered after splenectomy and such individuals develop sepsis more easily and the infection has a fulminant course. Splenectomy is also a potential risk factor for several vascular complications that result from partial or total obstruction of an arterial or venous blood vessel. Furthermore, pulmonary hypertensioncan be a severe and sometimes fatal complication following splenectomy...
2016: Chirurgia
https://www.readbyqxmd.com/read/27776576/overwhelming-post-splenectomy-sepsis-in-patients-with-asplenia-and-hyposplenia-a-retrospective-cohort-study
#7
J Chong, P Jones, D Spelman, K Leder, A C Cheng
Overwhelming post-splenectomy infection (OPSI) is a serious complication of asplenia and is associated with encapsulated organisms, most commonly Streptococcus pneumoniae, but also Haemophilus influenzae and Neisseria meningitidis. We aimed to estimate the risk of infection in this patient group. We reviewed data collected by the Victorian Spleen Registry in Australia. On registration, all patients are asked about significant infections requiring admission to hospital for intravenous antibiotics; those requiring admission to ICU were defined as OPSI...
January 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/27650028/-prevention-of-severe-infections-in-asplenic-patients
#8
Th J M Verheij
The lifetime risk of dying from sepsis is approximately 2-3% in persons with (functional) asplenia. Both patients and their physicians are not always fully aware of these risks and the implementation of preventive measures is insufficient. Physicians should inform both patients and colleagues on the consequences of lost splenic function. Primary care physicians should screen their lists for patients with (functional) asplenia and offer these patient adequate preventive measures when needed.
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27613607/intravascular-haemolysis-with-haemoglobinuria-in-a-splenectomized-patient-with-severe-plasmodium-knowlesi-malaria
#9
Bridget E Barber, Matthew J Grigg, Timothy William, Tsin W Yeo, Nicholas M Anstey
BACKGROUND: Haemoglobinuria is an uncommon complication of severe malaria, reflecting acute intravascular haemolysis and potentially leading to acute kidney injury. It can occur early in the course of infection as a consequence of a high parasite burden, or may occur following commencement of anti-malarial treatment. Treatment with quinine has been described as a risk factor; however the syndrome may also occur following treatment with intravenous artesunate. In Malaysia, Plasmodium knowlesi is the most common cause of severe malaria, often associated with high parasitaemia...
2016: Malaria Journal
https://www.readbyqxmd.com/read/27590561/asplenic-patients-and-invasive-pneumococcal-disease-how-bad-is-it-these-days
#10
Thomas J Marrie, Gregory J Tyrrell, Sumit R Majumdar, Dean T Eurich
OBJECTIVES: Most are aware of pneumococcal infection as a complication of splenectomy and the increased risk of severe invasive pneumococcal disease (IPD) in asplenic patients. However little is known of the current status of this entity in a population with an active pneumococcal conjugate vaccine program for children. METHODS: All IPD cases reported from 2000 to 2014 in Northern Alberta, Canada were collected prospectively. Socio-demographic variables, clinical characteristics, and IPD-related outcomes were compared between patients with and without a spleen using the Student t-test, Chi-square test, or Fisher's exact test, as appropriate...
October 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27583208/fatal-purpura-fulminans-and-waterhouse-friderichsen-syndrome-from-fulminant-streptococcus-pneumoniae-sepsis-in-an-asplenic-young-adult
#11
Andrew J Hale, Mary LaSalvia, James E Kirby, Allison Kimball, Rachel Baden
Asplenic patients are at increased risk for sepsis and fulminant infection. Sepsis in these patients is typically secondary to encapsulated bacteria, with Streptococcus pneumoniae being the most frequent pathogen. Rare complications of severe sepsis include purpura fulminans and bilateral adrenal hemorrhage (Waterhouse-Friderichsen syndrome). We present the case of a 36-year-old woman, healthy except for splenectomy years prior for idiopathic thrombocytopenic purpura treatment, who presented with fever. Upon presentation to our hospital, three hours after symptoms onset, she had purpura fulminans and shock...
2016: IDCases
https://www.readbyqxmd.com/read/27581861/-pets-are-a-risk-for-asplenic-patients-capnocytophaga-canimorsus-infection-in-an-asplenic-patient
#12
R I Claassen, C Savelkoul, M A Schouten, D H T Tjan
Post-splenectomy sepsis is a serious condition with high mortality rates. We present a case of a 64-year-old patient with a medical history of splenectomy who was referred to the Emergency Department with a fever, shivers, and an altered mental state. The symptoms had started twelve hours before. Upon arrival in the hospital the patient was tachypnoeic, hypotensive and febrile. Blood cultures were taken and broad-spectrum antibiotics were started. He was directly admitted to the Intensive Care Unit with severe sepsis of unknown aetiology...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27572973/a-global-map-of-genetic-diversity-in-babesia-microti-reveals-strong-population-structure-and-identifies-variants-associated-with-clinical-relapse
#13
Jacob E Lemieux, Alice D Tran, Lisa Freimark, Stephen F Schaffner, Heidi Goethert, Kristian G Andersen, Suzane Bazner, Amy Li, Graham McGrath, Lynne Sloan, Edouard Vannier, Dan Milner, Bobbi Pritt, Eric Rosenberg, Sam Telford, Jeffrey A Bailey, Pardis C Sabeti
Human babesiosis caused by Babesia microti is an emerging tick-borne zoonosis of increasing importance due to its rising incidence and expanding geographic range(1). Infection with this organism, an intraerythrocytic parasite of the phylum Apicomplexa, causes a febrile syndrome similar to malaria(2). Relapsing disease is common among immunocompromised and asplenic individuals(3,4) and drug resistance has recently been reported(5). To investigate the origin and genetic diversity of this parasite, we sequenced the complete genomes of 42 B...
June 13, 2016: Nature Microbiology
https://www.readbyqxmd.com/read/27403772/a-rare-case-of-primary-myelofibrosis-in-a-14-year-old-patient-with-congenital-asplenia
#14
Maliha Khan, Cheng C Yin, Amber Yates, Kate J Newberry, Srdan Verstovsek
Primary myelofibrosis (PMF) is rarely diagnosed in children, and in most cases in children younger than 3 years old. Pediatric PMF generally follows a benign course and is usually managed supportively with blood transfusions and prophylactic antibiotics for infections. We present a case of a 17-year-old girl diagnosed with PMF at the age of 14 years. A computed tomography scan performed at the time of an appendectomy showed congenital asplenism. To our knowledge, this is only the third case of myelofibrosis and congenital asplenism to be reported in the literature...
July 11, 2016: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/27367636/risk-benefit-assessment-for-antibiotic-prophylaxis-in-asplenic-dental-patients
#15
Heba Hussein, Ronald S Brown
A review of the published literature revealed that discourse on the topic of antibiotic prophylaxis guidelines for the asplenic dental patient is limited and that guidelines regarding this issue have not been updated for years. The review determined that the professional protocol for the treatment of asplenic dental patients has changed over the last 30 years, particularly with reference to adult patients. Furthermore, as dentists and physicians now understand that blood-borne bacteremias are produced from everyday occurrences such as chewing and toothbrushing, bacteremias secondary to dental procedures are no longer viewed as seriously as in the past; therefore, the guidelines for antibiotic prophylaxis have changed...
July 2016: General Dentistry
https://www.readbyqxmd.com/read/27099328/vaccinations-in-asplenic-adults
#16
REVIEW
Rhonda J Hammerquist, Kimberly A Messerschmidt, April A Pottebaum, Thaddaus R Hellwig
PURPOSE: The recommended immunizations for adult asplenic patients are reviewed. SUMMARY: Patients without a spleen are at risk of developing overwhelming postsplenectomy infections due to encapsulated organisms, mainly pneumococcal, meningococcal, and Haemophilus influenzae type b (Hib). Due to the high mortality rates associated with these infections, vaccinations are recommended as a preventive measure. It is challenging to ensure optimal immunizations in these high-risk patients due to the number of recommended vaccines, the availability of multiple formulations, and the inability to administer specific formulations at the same time, as well as differences in subsequent vaccine administration schedules...
May 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27068019/critical-illness-in-patients-with-asplenia
#17
REVIEW
Hollis R O'Neal, Alexander S Niven, George H Karam
The critically ill, asplenic patient presents a variety of management challenges. Historically, the focus of the care of the asplenic population has been the prevention and management of infection, including the often-fatal overwhelming postsplenectomy infection with encapsulated organisms such as Streptococcus pneumoniae. Recently, however, there has been increasing recognition of the spleen's function in areas outside of immunity because the asplenic state has been identified as a risk factor for such vascular complications as thrombosis and pulmonary hypertension resulting from dysregulated inflammation and coagulation...
December 2016: Chest
https://www.readbyqxmd.com/read/26939227/human-babesiosis-a-general-review-with-special-reference-to-egypt
#18
Ahmad Megahed Ahmad Saleh, Samia Mohammad Adam Adam, Amr M El-Sayed Abdel-Motagaly, Abeer Mohammad, Abdallah Ibrahim, Tosson Aly Morsy
Babesiosis is a tick-borne malaria-like illness caused by species of the intra-erythrocytic protozoan Babesia. Humans are opportunistic hosts for Babesia when bitten by nymph or adult ticks. Currently, Babesia infection is transmitted by various tick vectors in Europe, Asia, Africa and the northwestern and northeastern United States. Human babesiosis was first described in 1957 but is now known to have worldwide distribution. The increase in reported cases is likely due to increases in actual incidence as well as increased awareness of the disease...
December 2015: Journal of the Egyptian Society of Parasitology
https://www.readbyqxmd.com/read/26682076/severe-legionnaires-disease-complicated-by-rhabdomyolysis-and-clinically-resistant-to-moxifloxacin-in-a-splenectomised-patient-too-much-of-a-coincidence
#19
Theocharis Koufakis, Ioannis Gabranis, Marianneta Chatzopoulou, Anastasios Margaritis, Maria Tsiakalou
We here report a case of Legionnaires' disease in a splenectomised patient, complicated by rhabdomyolysis and acute renal failure and characterized by a poor clinical response to moxifloxacin. Splenectomy is not included among the factors, typically associated with higher risk or mortality in patients with Legionellosis. However, our report is consistent with previous case reports describing severe Legionella infections in asplenic subjects. The possibility that functional or anatomic asplenia may be a factor predisposing to severe clinical course or poor response to therapy in patients with Legionella infection cannot be excluded, deserving further investigation in the future...
2015: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/26655213/antenatally-diagnosed-right-sided-stomach-dextrogastria-a-rare-rotational-anomaly
#20
Hendt P Versteegh, Stephen D Adams, Sally Boxall, David M Burge, Michael P Stanton
AIM: Antenatal detection of right-sided stomach (dextrogastria) is rare, and its significance in regards to intestinal rotation is unclear. We aimed to review all cases of antenatally-diagnosed dextrogastria in our regional fetal medicine unit over 10years. METHODS: A retrospective case-note review of patients identified from a prospectively-maintained database was performed. RESULTS: Twenty cases of antenatally-diagnosed dextrogastria were identified from 2004 to 2014...
February 2016: Journal of Pediatric Surgery
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