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https://www.readbyqxmd.com/read/28103289/cost-effectiveness-analysis-of-five-competing-strategies-for-the-management-of-multiple-recurrent-community-onset-clostridium-difficile-infection-in-france
#1
Emilie Baro, Tatiana Galperine, Fanette Denies, Damien Lannoy, Xavier Lenne, Pascal Odou, Benoit Guery, Benoit Dervaux
BACKGROUND: Clostridium difficile infection (CDI) is characterized by high rates of recurrence, resulting in substantial health care costs. The aim of this study was to analyze the cost-effectiveness of treatments for the management of second recurrence of community-onset CDI in France. METHODS: We developed a decision-analytic simulation model to compare 5 treatments for the management of second recurrence of community-onset CDI: pulsed-tapered vancomycin, fidaxomicin, fecal microbiota transplantation (FMT) via colonoscopy, FMT via duodenal infusion, and FMT via enema...
2017: PloS One
https://www.readbyqxmd.com/read/28103249/the-green-tea-catechin-epigallocatechin-gallate-ameliorates-graft-versus-host-disease
#2
Sabine Westphal, Aleixandria McGeary, Sandra Rudloff, Andrea Wilke, Olaf Penack
Allogeneic hematopoetic stem cell transplantation (allo-HSCT) is a standard treatment for leukemia and other hematologic malignancies. The major complication of allo-HSCT is graft-versus-host-disease (GVHD), a progressive inflammatory illness characterized by donor immune cells attacking the organs of the recipient. Current GVHD prevention and treatment strategies use immune suppressive drugs and/or anti-T cell reagents these can lead to increased risk of infections and tumor relapse. Recent research demonstrated that epigallocatechin gallate (EGCG), a component found in green tea leaves at a level of 25-35% at dry weight, may be useful in the inhibition of GVHD due to its immune modulatory, anti-oxidative and anti-angiogenic capacities...
2017: PloS One
https://www.readbyqxmd.com/read/28102756/treatment-of-recurrent-clostridium-difficile-infection-using-fecal-microbiota-transplantation-in-patients-with-inflammatory-bowel-disease
#3
Krista M Newman, Kevin M Rank, Byron P Vaughn, Alexander Khoruts
We recently compared results of fecal microbiota transplantation (FMT) in patients with refractory, recurrent Clostridium difficile infection (rCDI), with and without underlying inflammatory bowel disease (IBD). Here we extend this cohort and analyze outcomes in greater detail by subtype of IBD. We find that FMT is generally effective in breaking the cycle of CDI recurrence, but its effects on overall IBD progression are much less predictable. We discuss a number of challenges intrinsic to this complex clinical situation and outline the next steps that can address these challenges going forward...
January 19, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28101308/antibacterial-resistance-in-patients-with-hematopoietic-stem-cell-transplantation
#4
REVIEW
Sehnaz Alp, Murat Akova
Recipients of hematopoietic stem cell transplantation (HSCT) are at substantial risk of bacterial, fungal, viral, and parasitic infections depending on the time elapsed since transplantation, presence of graft-versus-host disease (GVHD), and the degree of immunosuppression. Infectious complications in HSCT recipients are associated with high morbidity and mortality. Bacterial infections constitute the major cause of infectious complications, especially in the early post-transplant period. The emergence of antibacterial resistance complicates the management of bacterial infections in this patient group...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28100834/soft-robotic-sleeve-supports-heart-function
#5
Ellen T Roche, Markus A Horvath, Isaac Wamala, Ali Alazmani, Sang-Eun Song, William Whyte, Zurab Machaidze, Christopher J Payne, James C Weaver, Gregory Fishbein, Joseph Kuebler, Nikolay V Vasilyev, David J Mooney, Frank A Pigula, Conor J Walsh
There is much interest in form-fitting, low-modulus, implantable devices or soft robots that can mimic or assist in complex biological functions such as the contraction of heart muscle. We present a soft robotic sleeve that is implanted around the heart and actively compresses and twists to act as a cardiac ventricular assist device. The sleeve does not contact blood, obviating the need for anticoagulation therapy or blood thinners, and reduces complications with current ventricular assist devices, such as clotting and infection...
January 18, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28100577/late-spontaneous-decapsulation-of-the-kidney-graft-in-a-patient-with-hepatitis-c-and-treated-with-sirolimus-possible-pathophysiological-association-in-a-rare-complication
#6
Rita Leal, Helena Pinto, Rui Alves, Arnaldo Figueiredo
Late decapsulation with fluid collection is a rare complication of renal transplantation with deleterious effects on kidney function. Its physiopathology is unclear but there might be an association with mammalian target of rapamycin (m-TOR) inhibitors, especially in patients with chronic hepatitis C. We report a case of late spontaneous decapsulation 12 years after kidney transplant in a patient infected with hepatitis C under treatment with sirolimus. He underwent marsupialisation of the collection, sirolimus was converted to cyclosporine and hepatitis C treatment was performed with success...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28100279/severe-community-acquired-adenovirus-pneumonia-treated-with-oral-ribavirin-a-case-report
#7
Byung Woo Yoon, Yong Geon Song, Seung Hyeun Lee
BACKGROUND: Adenovirus is a common pathogen of acute upper respiratory infection in children and is generally self-limiting. Severe adenovirus infections have been reported in immunocompromised hosts especially bone marrow transplantation recipients due to hematologic malignancy. Severe adenovirus pneumonia in immunocompetent hosts has rarely been reported and optimal treatment has not been established. We report a case of community-acquired severe adenovirus pneumonia which was successfully treated with early administration of oral ribavirin...
January 18, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28099778/pseudozyma-and-other-non-candida-opportunistic-yeast-bloodstream-infections-in-a-large-stem-cell-transplant-center
#8
Anupam Pande, Lemuel R Non, Rizwan Romee, Carlos A Q Santos
INTRODUCTION: Non-Candida opportunistic yeasts are emerging causes of bloodstream infection (BSI) in immunocompromised hosts. However, their clinical presentation, management, and outcomes in stem cell transplant (SCT) recipients are not well described. CASE REPORT AND REVIEW: We report the first case to our knowledge of Pseudozyma BSI in a SCT recipient. He had evidence of cutaneous involvement, which has not been previously described in the literature. He became infected while neutropenic and receiving empiric micafungin, which is notable because Pseudozyma is reported to be resistant to echinocandins...
January 18, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28098552/hepatitis-e-virus-infection-in-solid-organ-transplant-recipients-france
#9
Sebastien Lhomme, Laurent Bardiaux, Florence Abravanel, Pierre Gallian, Nassim Kamar, Jacques Izopet
The rate of transfusion-transmitted hepatitis E virus (HEV) in transplant recipients is unknown. We identified 60 HEV-positive solid organ transplant patients and retrospectively assessed their blood transfusions for HEV. Seven of 60 patients received transfusions; 3 received HEV-positive blood products. Transfusion is not the major route of infection in this population.
February 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28098544/fatal-emmonsia-sp-infection-and-fungemia-after-orthotopic-liver-transplantation
#10
Shanthi Kappagoda, Jason Y Adams, Robert Luo, Niaz Banaei, Waldo Concepcion, Dora Y Ho
We report a fatal case of disseminated Emmonsia sp. infection in a 55-year-old man who received an orthotopic liver transplant. The patient had pneumonia and fungemia, and multisystem organ failure developed. As human habitats and the number of immunocompromised patients increase, physicians must be aware of this emerging fungal infection.
February 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28098109/visceral-leishmaniasis-in-adults-with-nephropathy
#11
H Kaaroud El Jeri, A Harzallah, S Barbouch, M M Bacha, R Kheder, S Turki, S Trabelsi, E Abderrahim, F Ben Hamida, T Ben Abdallah
The aim of this study is to evaluate the features of visceral leishmaniasis (VL) in adults with nephropathy, who were not infected with the human immunodeficiency virus. This is a retrospective study of 14 adults hospitalized between 2000 and 2014, with VL and renal involvement. Clinical, biological, and therapeutic data were collected from the patients' medical files. Eleven women and three men, most of whom were from the North of the country, with a mean age of 40.5 years were studied. Lupus was present in five cases, the Sicca syndrome in three cases, diabetes in one case, renal failure on dialysis in two cases, and there were three renal transplant recipients...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28095796/a-severe-case-of-visceral-leishmaniasis-and-liposomal-amphotericin-b-treatment-failure-in-an-immunosuppressed-patient-15%C3%A2-years-after-exposure
#12
Anna Eichenberger, Annina E Buechi, Andreas Neumayr, Chistroph Hatz, Andri Rauch, Marc Huguenot, Eva Diamantis-Karamitopoulou, Cornelia Staehelin
BACKGROUND: Visceral leishmaniasis (VL) is a protozoan disease, which is responsible for 200.000-400.000 yearly infections worldwide. If left untreated, the fatality rate can be as high as 100% within 2 years. 90% of cases occur in just six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. It is thus a disease rarely seen by physicians in Europe or North America. We report on the fatal case of VL in an 80-year-old immunosuppressed patient who presented with a latency of over 15 years after having visited an endemic region...
January 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28095438/vh1-family-immunoglobulin-repertoire-sequencing-after-allogeneic-hematopoietic-stem-cell-transplantation
#13
Maya K Sethi, Felicitas Thol, Michael Stadler, Michael Heuser, Arnold Ganser, Christian Koenecke, Oliver Pabst
After allogeneic hematopoietic stem cell transplantation (HSCT), recovery of humoral immunity is essential to protect from life-threatening infections. However, monitoring the humoral immune system after transplantation with standard techniques in the clinical routine is imprecise. Here, we performed sequencing of mononuclear bone marrow cells to characterize the VH1-repertoire of switched B cells of healthy volunteers and patients undergoing HSCT. Analysis of healthy bone marrow donors and patients showed virtually no clonally related sequences between individuals...
2017: PloS One
https://www.readbyqxmd.com/read/28094327/rapid-adaptation-drives-invasion-of-airway-donor-microbiota-by-pseudomonas-after-lung-transplantation
#14
M Beaume, T Köhler, G Greub, O Manuel, J-D Aubert, L Baerlocher, L Farinelli, A Buckling, C van Delden
In cystic fibrosis (CF) patients, chronic airway infection by Pseudomonas leads to progressive lung destruction ultimately requiring lung transplantation (LT). Following LT, CF-adapted Pseudomonas strains, potentially originating from the sinuses, may seed the allograft leading to infections and reduced allograft survival. We investigated whether CF-adapted Pseudomonas populations invade the donor microbiota and adapt to the non-CF allograft. We collected sequential Pseudomonas isolates and airway samples from a CF-lung transplant recipient during two years, and followed the dynamics of the microbiota and Pseudomonas populations...
January 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28093721/application-of-autologous-hematopoietic-stem-cell-transplantation-for-pemphigus
#15
Menglei Wang, Can Cao, Jing Sun, Xuebiao Peng, Qifa Liu, Liang Huang, Yanyan Chai, Kuan Lai, Pingjiao Chen, Qingxiu Liu, Qian Li, Yusheng Peng, Hao Xiong, Jing Zhang, Minghua Chen, Kang Zeng
BACKGROUND: Pemphigus is a rare and fatal autoimmune disease for which the treatment options are limited. This study aimed to evaluate the efficacy of autologous peripheral hematopoietic stem cell transplantation (APHSCT) for pemphigus. METHODS: We conducted APHSCT for 12 pemphigus patients (seven males and five females, mean age 23.8 years) with life-threatening complications or who responded poorly to conventional therapy. Peripheral blood stem cells were mobilized with cyclophosphamide, granulocyte colony-stimulating factor, and rituximab, and purified autologous CD34(+) stem cells were infused...
January 17, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28093535/hepatitis-e-in-singapore-a-case-series-and-viral-phylodynamics-study
#16
Esmeralda Chi-Yuan Teo, Boon-Huan Tan, Michael A Purdy, Pui-San Wong, Pei-Jun Ting, Pik-Eu Jason Chang, Lynette Lin-Ean Oon, Amanda Sue, Chong-Gee Teo, Chee-Kiat Tan
The incidence of hepatitis E in Singapore appears to be increasing. A retrospective case-series study of patients diagnosed with hepatitis E in a tertiary hospital from 2009 to 2013 was conducted. Of 16 cases, eight (50%) were solid-organ transplant recipients (SOTRs), and 14 (88%) were found infected by genotype 3 hepatitis E virus (HEV-3). Bayesian inferences based on HEV subgenomic sequences from seven cases suggest that HEV-3 strains were introduced to Singapore as two principal lineages. Within limitations of the study, it can be inferred that one lineage, in the 3efg clade, emerged about 83 years ago, probably originating from Japan, whereas the other, in the 3abchij clade, emerged about 40 years ago, from the United States...
January 16, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28093339/short-term-clinical-safety-profile-of-brincidofovir-a-favorable-benefit-risk-proposition-in-the-treatment-of-smallpox
#17
Greg Chittick, Marion Morrison, Thomas Brundage, W Garrett Nichols
Brincidofovir (BCV, CMX001) is an orally available, long-acting, broad-spectrum antiviral that has been evaluated in healthy subjects in Phase I studies and in hematopoietic cell transplant recipients and other immunocompromised patients in Phase II/III clinical trials for the prevention and treatment of cytomegalovirus and adenovirus infections. BCV has also shown in vitro activity against orthopoxviruses such as variola (smallpox) virus, and is under advanced development as a treatment for smallpox under the US FDA's 'Animal Rule'...
January 13, 2017: Antiviral Research
https://www.readbyqxmd.com/read/28093134/management-of-clostridium-difficile-infection-in-inflammatory-bowel-disease-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#18
REVIEW
Sahil Khanna, Andrea Shin, Ciarán P Kelly
The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a formal systematic review of evidence. Best Practice Advice 1: Clinicians should test patients who present with a flare of underlying inflammatory bowel disease for Clostridium difficile infection...
February 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28092420/immune-modulation-by-the-hepatitis-c-virus-core-protein
#19
Cecilia Fernández-Ponce, Juan Pedro Muñoz-Miranda, Mikel M Arbulo-Echevarria, Rocío Litrán, Enrique Aguado, Francisco García-Cozar
Hepatitis C virus (HCV) infection is currently the most important cause of chronic viral hepatitis in the world and one of the most frequent indications for liver transplantation. HCV uses different strategies to evade the innate and adaptive immune response, and this evasion plays a key role in determining viral persistence. Several HCV viral proteins have been described as immune modulators. In this review, we will focus on the effect of HCV nucleocapsid core protein in the function of immune cells and its correlation with the findings observed in HCV chronically infected patients...
January 16, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28092353/non-myeloablative-conditioning-for-second-hematopoietic-cell-transplantation-for-graft-failure-in-patients-with-non-malignant-disorders-a-prospective-study-and-review-of-the-literature
#20
K Mallhi, P J Orchard, W P Miller, Q Cao, J Tolar, T C Lund
Allogeneic hematopoietic cell transplantation (HCT) effectively treats several non-malignant disorders such as selected lysosomal disorders, cerebral adrenoleukodystrophy and hemoglobinopathies. However, rates of graft failure (GF) in non-malignant populations exceed those of patients with malignant indications for HCT. Salvage conditioning regimens and outcomes for second HCT for GF vary immensely in the literature. We report 17 consecutive pediatric patients with non-malignant disorders who underwent a second allogenic HCT for GF using a non-myeloablative, low-dose busulfan-based regimen...
January 16, 2017: Bone Marrow Transplantation
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