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https://www.readbyqxmd.com/read/28091392/the-impact-of-viral-load-and-time-to-onset-of-cytomegalovirus-replication-on-long-term-graft-survival-after-kidney-transplantation
#1
Tomas Reischig, Martin Kacer, Petra Hruba, Pavel Jindra, Ondrej Hes, Daniel Lysak, Mirko Bouda, Ondrej Viklicky
BACKGROUND: Asymptomatic cytomegalovirus (CMV) infection is associated with graft dysfunction and failure. However, no study assessed CMV viral load in terms of the risk for graft failure. METHODS: In prospective cohort of kidney transplant recipients, we assessed the impact of CMV DNAemia on the overall graft survival and the incidence of moderate-to-severe interstitial fibrosis and tubular atrophy (IF/TA) in protocol biopsy at 36 months. CMV DNAemia was stratified by viral load in whole blood...
January 16, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/27990673/trichodysplasia-spinulosa-in-a-7-year-old-boy-managed-using-physical-extraction-of-keratin-spicules
#2
Michael Barton, Suing Lockhart, Robert Sidbury, Richard Wang, Heather Brandling-Bennett
Trichodysplasia spinulosa (TS) is an uncommon skin disease characterized by a folliculocentric papular eruption and keratin spine formation, classically appearing on the central face and ears. It occurs in immunosuppressed patients and is linked to a viral etiology. Diagnostic tests including polymerase chain reaction (PCR) are available for detection of the TS-associated polyomavirus. Effective treatment options include topical cidofovir and oral valganciclovir. We present a case diagnosed using PCR with skin scrapings and treated using physical extraction of the keratin spicules...
December 19, 2016: Pediatric Dermatology
https://www.readbyqxmd.com/read/27938774/a-48-year-old-man-with-leukopenia-jaundice-and-skin-rash-after-lung%C3%A2-transplantation
#3
Ali Ataya, Abhishek Biswas, Satish Chandrashekaran, Juan C Salgado, Steven S Goldstein, Amir M Emtiazjoo
A 48-year-old African-American male subject presented with progressive fatigue, jaundice, and new-onset leukopenia 12 weeks after undergoing bilateral lung transplantation for advanced pulmonary sarcoidosis. His transplant surgery and immediate posttransplantation course were uneventful. Induction immunosuppression included methylprednisolone 500 mg intraoperatively and basiliximab (anti-IL-2 monoclonal antibody) on days 0 and 4 after transplantation. His maintenance immunosuppression posttransplantation was prednisone 20 mg daily, tacrolimus with target tacrolimus levels 10 to 15 ng/mL, and mycophenolate mofetil 750 mg twice daily...
December 2016: Chest
https://www.readbyqxmd.com/read/27932110/effect-of-cytomegalovirus-infection-on-survival-of-older-kidney-transplant-patients-d-r-impact-of-valganciclovir-prophylaxis-versus-preemptive-therapy
#4
E Luna, F Caravaca, F Ferreira, N Fernandez, P Martín, M L Vargas, J Saenz de Santamaría, G Garcia Pino, L Azevedo, A Muñoz Sanz
BACKGROUND: Kidney transplant patients with D+/R+ serology can be treated with either prophylaxis or preemptive valganciclovir. The older transplant population suffers severe immunosenescence, especially patients with latent cytomegalovirus (CMV) infection (R+). They are more likely to develop indirect CMV effects. Likewise, many patients have significant cardiovascular comorbidity, which makes them more sensitive to these indirect effects. The aim of this study was to evaluate the incidence of CMV viremia and indirect effects on survival, comparing prophylaxis (V) against preemptive (P) valganciclovir in an older kidney transplant population...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27917735/top-1-of-inpatients-administered-antimicrobial-agents-comprising-50-of-expenditures-a-descriptive-study-and-opportunities-for-stewardship-intervention
#5
Jennifer Dela-Pena, Luiza Kerstenetzky, Lucas Schulz, Ron Kendall, Alexander Lepak, Barry Fox
OBJECTIVE To characterize the top 1% of inpatients who contributed to the 6-month antimicrobial budget in a tertiary, academic medical center and identify cost-effective intervention opportunities targeting high-cost antimicrobial utilization. DESIGN Retrospective cohort study. PATIENTS Top 1% of the antimicrobial budget from July 1 through December 31, 2014. METHODS Patients were identified through a pharmacy billing database. Baseline characteristics were collected through a retrospective medical chart review...
December 5, 2016: Infection Control and Hospital Epidemiology
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...
November 4, 2016: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/27795766/-role-of-oral-antiviral-therapy-in-the-treatment-of-acute-retinal-necrosis
#7
Samia El Haouzi, Amina Jait, Omar Lezrek, Tachfouti Samira, Laghmari Amina, Ouafa Cherkaoui, Karman Abdellouahed, Rajae Daoudi
: Acute retinal necrosis syndrome (ARNS) is a rare but devastating uveitic syndrome with devastating visual outcome (visual prognosis ++). It should be diagnosed as early as possible because of its severity and its risk of bilateralization. This is a rare entity caused by the group of herpes viruses. In immunocompromised patients the complications of RNA syndrome often lead to loss of visual acuity. After the discovery of this disease using polymerase chain reaction (PCR) and immune load coefficient (ILC) usually by puncturing the cornea to evacuate the aqueous humour, the confirmation of this diagnosis allows for faster optimization of disease management decreasing the time required to confirm the diagnosis...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27790727/durable-remission-of-both-multicentric-castleman-s-disease-and-kaposi-s-sarcoma-with-valganciclovir-rituximab-and-liposomal-doxorubicin-in-an-hhv-8-positive-hiv-negative-patient
#8
C Murphy, E Hawkes, F Chionh, G Chong
WHAT IS KNOWN AND OBJECTIVE: Human herpesvirus-8 (HHV-8)-positive, HIV-negative multicentric Castleman's disease is a rare lymphoproliferative disorder with no standardized treatment. Concurrent Kaposi's sarcoma, another HHV-8-related disease, is uncommon in HIV-negative patients. The role of antiviral therapy and rituximab in HIV-negative patients is not well established. CASE DESCRIPTION: We report a case of a 5-year, durable remission of HHV-8-positive, HIV-negative comorbid multicentric Castleman's disease and Kaposi's sarcoma treated with long-term valganciclovir, following initial rituximab and liposomal doxorubicin...
February 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27772620/cytomegalovirus-and-other-%C3%AE-herpesviruses
#9
REVIEW
Carlos A Q Santos
Cytomegalovirus (CMV), human herpes virus (HHV)-6, and HHV-7 are ubiquitous β-herpesviruses that can cause opportunistic infection and disease in kidney transplant recipients. Active CMV infection and disease are associated with acute allograft failure and death, and HHV-6 and HHV-7 replication are associated with CMV disease. CMV prevention strategies are used commonly after kidney transplantation, and include prophylaxis with antiviral medications and preemptive treatment upon the detection of asymptomatic viral replication in blood...
September 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27760756/how-i-treat-resistant-cytomegalovirus-infection-in-hematopoietic-cell-transplantation-recipients
#10
REVIEW
Firas El Chaer, Dimpy P Shah, Roy F Chemaly
Cytomegalovirus (CMV) infection is a significant complication in hematopoietic cell transplantation (HCT) recipients. Four antiviral drugs are used for preventing or treating CMV: ganciclovir, valganciclovir, foscarnet, and cidofovir. With prolonged and repeated use of these drugs, CMV can become resistant to standard therapy, resulting in increased morbidity and mortality, especially in HCT recipients. Antiviral drug resistance should be suspected when CMV viremia (DNAemia or antigenemia) fails to improve or continue to increase after 2 weeks of appropriately dosed and delivered antiviral therapy...
December 8, 2016: Blood
https://www.readbyqxmd.com/read/27759493/experimental-and-computational-studies-on-the-effects-of-valganciclovir-as-an-antiviral-drug-on-calf-thymus-dna
#11
Nahid Shahabadi, Mehdi Pourfoulad, Neda Hosseinpour Moghadam
DNA-binding properties of an antiviral drug, valganciclovir (valcyte) was studied by using emission, absorption, circular dichroism, viscosity, differential pulse voltammetry, fluorescence techniques, and computational studies. The drug bound to calf thymus DNA (ct-DNA) in a groove-binding mode. The calculated binding constant of UV-vis, Ka, is comparable to groove-binding drugs. Competitive fluorimetric studies with Hoechst 33258 showed that valcyte could displace the DNA-bound Hoechst 33258. The drug could not displace intercalated methylene blue from DNA double helix...
January 2, 2017: Nucleosides, Nucleotides & Nucleic Acids
https://www.readbyqxmd.com/read/27753183/tolerability-of-up-to-200%C3%A2-days-of-prophylaxis-with-valganciclovir-oral-solution-and-or-film-coated-tablets-in-pediatric-kidney-transplant-recipients-at-risk-of-cytomegalovirus-disease
#12
G Varela-Fascinetto, C Benchimol, R Reyes-Acevedo, M Genevray, D Bradley, J Ives, H T Silva
This multicenter, open-label study evaluated the tolerability of extended prophylaxis with valganciclovir in pediatric kidney transplant recipients at risk of CMV disease. Fifty-six patients aged 4 months to 16 years received once-daily valganciclovir oral solution and/or tablets, dosed by BSA and renal function, for up to 200 days. The most common AEs on treatment were upper respiratory tract infection (33.9%), urinary tract infection (33.9%), diarrhea (32.1%), leukopenia (25.0%), neutropenia (23.2%), and headache (21...
October 17, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27704725/the-efficacy-of-valganciclovir-for-prevention-of-infections-with-cytomegalovirus-and-epstein-barr-virus-after-kidney-transplant-in-children
#13
Bernadette M Cameron, Sean E Kennedy, William D Rawlinson, Fiona E Mackie
This study evaluated the efficacy of prophylactic ValGCV in preventing CMV and EBV infections in a single-center pediatric kidney transplant population (2008-2014). Therapy duration was determined according to donor/recipient serostatus. EBV monitoring was performed using monthly plasma PCR for 18 months post-transplant and for CMV, monthly for 6 months after prophylaxis cessation. Data were collected on 35 children, median age 10.6 years. There were 15 (42.9%) and 11 (31.4%) recipients seronegative for CMV or EBV, respectively, who received a kidney from a seropositive donor...
October 4, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27673425/treatment-of-perinatal-viral-infections-to-improve-neurologic-outcomes
#14
REVIEW
William J Muller
Viral infections in the fetus or newborn often involve the central nervous system (CNS) and can lead to significant morbidity and mortality. Substantial progress has been made in identifying interventions decreasing adverse neurodevelopmental outcomes in this population. This review highlights progress in treatment of important viruses affecting the CNS in these susceptible hosts, focusing on herpes simplex virus (HSV), cytomegalovirus (CMV), human immunodeficiency virus (HIV), and enteroviruses. The observation that high-dose acyclovir improves mortality in neonatal HSV disease culminated decades of antiviral research for this disease...
October 26, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27661068/descemet-stripping-automated-endothelial-keratoplasty-outcomes-in-patients-with-cytomegalovirus-endotheliitis
#15
Ester Fernández López, Elsie Chan
PURPOSE: There is currently limited information regarding the outcomes of endothelial keratoplasty in eyes with cytomegalovirus (CMV) endotheliitis. We report the results of Descemet stripping automated endothelial keratoplasty (DSAEK) for endothelial failure secondary to CMV. METHODS: This is a retrospective review of 4 eyes of 4 patients with CMV endotheliitis and DSAEK. CMV was confirmed in each case by a positive aqueous tap on qualitative polymerase chain reaction...
January 2017: Cornea
https://www.readbyqxmd.com/read/27640117/a-questionnaire-based-assessment-of-numbers-motivation-and-medical-care-of-uk-patients-undergoing-liver-transplant-abroad
#16
Ben Kerr Winter, Anand Odedra, Steve Green
BACKGROUND: Medical tourism, where patients travel abroad intentionally to access medical treatment, is a growing trend. Some of these patients travel to undergo organ transplantation. This study aims to quantify the number of UK patients who undergo liver transplantation abroad, assessing their motivations and management. METHODS: Questionnaires were sent to all seven UK liver transplant units enquiring about liver patients receiving transplant abroad. Included were questions on destination, motivation, and pre and post-transplant care...
November 2016: Travel Medicine and Infectious Disease
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
#17
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/27607910/update-on-treatment-of-cytomegalovirus-infection-in-pregnancy-and-of-the-newborn-with-congenital-cytomegalovirus
#18
William D Rawlinson, Stuart T Hamilton, Wendy J van Zuylen
PURPOSE OF REVIEW: The purpose of this review is to assess the recent studies of therapy of pregnant women and neonates, aimed at preventing the consequences of congenital cytomegalovirus (CMV) infection. RECENT FINDINGS: A recent randomized controlled trial of treatment of CMV during pregnancy with hyperimmune globulin did not show significant efficacy in prevention of foetal infection and morbidity, although there was a trend towards improvement with treatment...
December 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27583207/cytomegalic-hepatitis-in-a-patient-receiving-omalizumab
#19
R Gonçalves, C Valente, E Ferreira, J E Serra, J Saraiva da Cunha
Cytomegalovirus is a double stranded DNA virus that can be present in nearly all organs and body fluids. The primary infection is usually asymptomatic in the immunocompetent host and it is common among adolescents and young adults. The symptomatic form appears, in the majority of cases, as a mononucleosis syndrome with full recovery without specific treatment. We report a case of a 25 years old woman who presented with hepatitis due to CMV infection and history of omalizumab administration one month earlier...
2016: IDCases
https://www.readbyqxmd.com/read/27580058/pharmacokinetics-and-safety-of-valganciclovir-in-pediatric-heart-transplant-recipients-4-months-of-age-and-younger
#20
Denise Bradley, Sebastian Moreira, Vishak Subramoney, Clifford Chin, Jane Ives, Ka Wang
BACKGROUND: Valganciclovir (VGCV) effectively prevents cytomegalovirus disease in adult and pediatric solid organ transplant (SOT) recipients. A dosing algorithm for VGCV for pediatric patients, based on body surface area and renal function, provides a personalized dose using age-appropriate formulations. The suitability of this dosing algorithm has not been assessed specifically in infants and neonates 4 months of age and younger receiving a SOT. METHODS: This multicenter prospective study evaluated the pharmacokinetics (PK) and safety of VGCV oral solution in 17 heart transplant recipients 4 months of age and younger who received two doses of VGCV on consecutive days using the pediatric dosing algorithm...
August 30, 2016: Pediatric Infectious Disease Journal
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