... institution review board in accordance with the Declaration of Helsinki, and informed consent was obtained from all participating patients The treatment algorithm was shown in Figure Monitoring ... analyzed on an intention-to-treat basis Progression was defined as ≥25% paraprotein increase in two consecutive tests four weeks apart Relapse was defined as reappearance of the paraprotein on immunofixation ... OS, including methylation of Death-associated Protein Kinase (DAPK) and the development of oligoclonal reconstitution, were analysed Methods Treatment The study started in early 2005 and ended in...
... transplants T gondii usually causes disease in the brain In hematopoietic stem cell transplant recipients, acute pulmonary disease may also occur Heart transplant recipients develop disease in ... columns and monoclonal-antibody depletion procedures results in a higher incidence of contamination In one series of patients receiving contaminated products, 14% had fever or bacteremia, but none ... thawing were helpful in guiding therapy for the recipient Table 126-1 Organisms Transmitted by Organ Transplantation and Their Primary Sites of Reactivation Disease a Bl ood L ungs H eart B rain...
... mature in an old host who has several latent infections already Nevertheless, most infections occur in a predictable time frame after transplantation (Table 126-2) Table 126-2 Common Sources of Infections ... resulting from chemotherapy or underlying chronic disease, however, direct testing of the recipient may prove less reliable This chapter considers aspects of infection unique to various transplantation ... aspects of infection unique to various transplantation settings Infections in Hematopoietic Stem Cell Transplant (HSCT) Recipients Transplantation of hematopoietic stem cells from bone marrow...
... ulcerations occur in both the lower and the upper gastrointestinal tract, and it may be difficult to distinguish diarrhea due to GVHD from that due to CMV infection The finding of CMV in the liver ... granulocytopenia, thrombocytopenia, or gastrointestinal disease, the foremost cause of death from CMV infection in the setting of hematopoietic stem cell transplantation is pneumonia With the standard ... strain from the donor is also common in CMVpositive recipients, and most seropositive patients who undergo hematopoietic stem cell transplantation excrete CMV, with or without clinical findings...
... combat disease Treatment of CMV pneumonia in HSCT recipients (unlike that in other clinical settings) involves both IV immune globulin (IVIg) and ganciclovir In patients who cannot tolerate ganciclovir, ... Although encephalitis developing after transplantation has been associated with HHV-6 in cerebrospinal fluid (CSF), the causality of the association is not well defined In several cases, plasma viremia ... infection of B cells leads to several interesting phenomena in HSCT recipients The marrow ablation that occurs as part of the HSCT procedure may sometimes eliminate latent EBV from the host Infection...
... of influenza Amantadine and rimantadine have limited effects, primarily reducing symptoms and shortening the duration of illness caused by sensitive strains of influenza A virus The neuraminidase ... Aerosolized ribavirin is difficult to administer Antibody in particular may prove more active in immunocompromised hosts, but relevant evaluation is lacking Influenza also occurs in HSCT recipients ... (accounting for
... glomerulopathy in kidney transplant recipients, bronchiolitis obliterans in lung transplant recipients, vasculopathy in heart transplant recipients, and the vanishing bile duct syndrome in liver transplant ... which often originate in surgical wound or anastomotic sites The type of transplant largely determines the spectrum of infection In subsequent weeks, the consequences of the administration of ... the transplanted organ) can occur CMV infection is often a problem, particularly in the first months after transplantation and may present as severe systemic disease or as infection of the transplanted...
... cephalosporins to decrease the risk of postoperative complications Urinary tract infections developing soon after transplantation are usually related to anatomic alterations resulting from surgery ... Cryptococcus gondii (meningitis); Nocardia Note: CMV, cytomegalovirus Early Infections Bacteria often cause infections that develop in the period immediately after kidney transplantation There ... Bacteria CMV (Legionella in endemic disease; settings) Nocardia; invasive fungi Pneumocystis; Legionella Central nervous system Listeria CMV disease; (meningitis); Listeria (meningitis); Toxoplasma...
... predisposing to bacterial infection VZV may cause fatal disseminated infection in nonimmune kidney transplant recipients, but in immune patients reactivation zoster usually does not disseminate ... cells that invade the CNS, nasopharynx, liver, small bowel, heart, and other organs, including the transplanted kidney The disease is diagnosed by the finding of a mass of proliferating EBV-positive ... to prevent and treat CMV infection in renal transplant recipients An immune globulin preparation enriched with antibodies to CMV was used by many centers in the past in an effort to protect the...
... hominis infection is suspected M hominis mediastinitis has been cured with a combination of surgical debridement (sometimes requiring muscle-flap placement) and the administration of clindamycin ... blastomycosis may cause pulmonary infiltrates or disseminated disease Late Infections Late infections (>6 months after kidney transplantation) may involve the CNS and include CMV retinitis as well as other ... (see "Middle-Period Infections," above) Heart Transplantation Early Infections Sternal wound infection and mediastinitis are early complications of heart transplantation An indolent course is...
... heart transplantation, particularly in patients maintained on intense immunosuppressive therapy A subset of heart and heart-lung transplant recipients may develop early fulminant EBV-LPD (within ... disease may occur In fact, because of the expanded use of prophylaxis, this scenario is increasingly common, particularly in patients with ongoing GVHD Late Infections EBV infection usually presents ... for Pneumocystis infection is required for these patients (see "Lung Transplantation, Late Infections," below) Lung Transplantation Early Infections It is not surprising that lung transplant recipients...
... cholangitis, including abdominal pain and jaundice Although these findings may suggest graft rejection, rejection is typically accompanied by marked elevation of liver function enzymes In contrast, in ... controversial Success in preventing reinfection with hepatitis B virus has increased in recent years; in contrast, reinfection of the graft with hepatitis C virus occurs in all patients, with ... rapid intervention may therefore become necessary The approach to EBV-LPD is similar to that described in other sections Liver Transplantation Early Infections As in other transplantation settings,...
... bacterial and yeast infections Most pancreatic transplants are drained into the bowel, whereas the remaining transplants (~20%) are drained into the bladder A cuff of duodenum is used in the anastomosis ... Organ Transplantation Indwelling IV Catheter Infections The prolonged use of indwelling IV catheters for administration of medications, blood products, and nutrition is common in diverse transplantation ... of CMV infection, EBV-LPD, and infections with opportunistic pathogens in patients receiving a pancreatic transplant are similar to those in other SOT recipients Miscellaneous Infections in Solid...
... vaccine H influenzae conjugate vaccine is safe and should be efficacious in this population; therefore, its administration before transplantation is recommended Booster doses of this vaccine ... vaccine should also be used in the appropriate setting (Chap 116) A combined vaccine is now available that provides dual protection against hepatitis A and hepatitis B If hepatitis A vaccine ... 116 and 117) In general, these patients should receive any killed or inactivated vaccine preparation appropriate to the area they are visiting; this recommendation includes the vaccines for Japanese...
... recommendations Seasonal influenza Vaccinate in the fall Vaccinate in the fall Vaccinate close Vaccinate close contacts Poliomyelitis contacts Administer Administer inactivated vaccine Measles/mumps/rubella ... different transplant populations are being evaluated Yearly immunization of household and other contacts (including health care personnel) against influenza benefits the patient by preventing local ... renal transplant recipients, rates of melanoma are modestly increased and rates of cancers of the kidney and bladder are increased Vaccination of Transplant Recipients In addition to receiving...
... drug Finally, clinical infections with MRSA strains exhibiting high-level vancomycin resistance due to VRE-derived plasmids have been reported in several patients in the United States, often in ... community-acquired "staph infections" in some U.S cities now caused by strains resistant to β-lactam antibiotics (Chap 129) The potential incursion of these strains into hospitals and the resulting impact on ... provide cohort nursing for colonized/infected patients Control device-related infections Enlist administrative support proactively Source: Adapted from: RA Weinstein, Emerg Infect Dis 7:188, 2001;...
... screen for cryoglobulins, cryofibrinogens, ANCA (antineutrophilic cytoplasmic antibodies), cold agglutinin, ANA (antineuclear antibodies), lupus anticoagulant and anticardiolipin were all negative ... PT (prothrombin time) of 19 seconds, PC (prothrombin concentration) of 56% INR (international normalized ratio) as 1.7 and a PTT (partial thromboplastin time) of 35 seconds Fibrinogen repeatedly ... vasculitis in a patient with chronic lymphatic leukemia following granulocyte colony stimulating factor injection: a case report Journal of Medical Case Reports 2011 5:88 Competing interests The...
... link between clinical skin scoring and epidermal changes Apart from the increased mean epidermal thickness in biopsies with local clinical skin involvement, we also found parakeratosis in a minority ... scoring was independent of the skin site, our data indicate that in patients with dcSSc, biopsies from the upper inner arm may be used to study histological parameters One interesting finding ... of SSc skin has recently regained interest because it may be integrated as an outcome measure in clinical trials on skin disease, whereby skin biopsies are obtained before and after administration...
... and interpreted the patient’s data and was involved in writing the manuscript CSJ was involved in drafting the manuscript Competing interests The author declares that they have no competing interests ... any signs of disseminated infection At the last follow-up appointment, he had no symptoms of any disseminated fungemia Amphotericin Conclusion Opportunistic infections intransplant recipients ... Opportunistic fungal infection by Fusarium oxysporum in a renal transplant patient Sabouraudia 1979, 17:219-223 Guarro J, Gené J: Opportunistic fusarial infections in humans Eur J Clin Microbiol Infect Dis...