scholarly journals A másodlagos hypogammaglobulinaemia, a fertőzések és a halálozás összefüggései és a preventív immunglobulin-pótlás szükségessége krónikus lymphoid leukaemiás betegekben

2019 ◽  
Vol 160 (38) ◽  
pp. 1487-1494
Author(s):  
Hajna Losonczy ◽  
Ágnes Nagy ◽  
Szabolcs Kosztolányi ◽  
Orsolya Tóth ◽  
Renáta Csalódi ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Immunoglobulin Therapy ◽  
Upper Respiratory Tract ◽  
Lymphoid Leukaemia ◽  
Replacement Treatment ◽  
Immunoglobulin Treatment ◽  
Immunoglobulin Prophylaxis ◽  
Disease Stages ◽  
Immunoglobulin Levels ◽  
Chronic Lymphoid Leukaemia

Abstract: Immune status was investigated in 186 patients with chronic lymphoid leukaemia between January 2012 and March 2015. Incidences of infections and mortality were analysed in patients who did not receive prophylactic immunoglobulin therapy. Immunoglobulin G (IgG) levels were normal (7–17.8 g/L) or decreased in 62.37% and 35.48% of patients, respectively. We measured high immunoglobulin levels only in a few cases (2.15%). Immunoglobulin levels became increasingly lower in more advanced disease stages (Rai stages). The number of infections was inversely proportional to that. Hypogammaglobulinaemia proved to be more important than disease progression in terms of the development of infections. The most common infections were upper respiratory tract (33.07%) and sepsis (18.90%). Two months after chemotherapy, initially normal immunoglobulin levels decreased by an average of 21%, and at the same time the incidence of infections increased. The most common cause of death was sepsis: 30% occurred at low immunoglobulin levels, while 20% at normal immunoglobulin levels. According to literature, prophylactic immunoglobulin treatment is indicated in patients with chronic lymphoid leukaemia and immunodeficiency for decreasing both morbidity and mortality. According to recommendations in literature, replacement treatment must be administered in severe or moderately severe recurrent bacterial infections. Immunoglobulin prophylaxis may be provided as low dose (10 g), fix dose (18 g) or individually customized higher dose (300–400 mg/kg body weight) treatment. According to recommendations, higher dose immunoglobulin prophylaxis, administered every three weeks on six occasions, is more efficient when customized. With this dose, infection-free condition may be achieved in 50% of patients. Orv Hetil. 2019; 160(38): 1487–1494.

scholarly journals Possibilities of tropical treatment of bacterial ENT infections

2021 ◽  
pp. 44-54
Author(s):  
P. A. Shamkina ◽  
A. A. Krivopalov ◽  
P. I. Panchenko ◽  
S. V. Ryazantsev
Keyword(s):  
Antibiotic Resistance ◽  
Otitis Media ◽  
Primary Care Physicians ◽  
Bacterial Infections ◽  
Acute Otitis Media ◽  
Medical Community ◽  
Antibacterial Drug ◽  
Upper Respiratory Tract ◽  
Inappropriate Use ◽  
Acute Rhinosinusitis

The overuse and inappropriate use of systemic antibiotics is the most serious cause of problems associated with the increasing resistance of bacterial pathogens. What served as the basis for WHO to call the XXI century “The era of antibiotic resistance”. The wide spread of resistant strains of microorganisms, the growth of severe and complicated forms of diseases leads to an increase in the frequency of unfavorable treatment outcomes. In the Russian Federation, an increase in the incidence of acute rhinosinusitis from 4.6 to 12.7 cases per 1000 population has been noted in the last decade. The incidence of acute rhinosinusitis in Europe is recorded in 6.4 ± 3.6 of all cases of visits to primary care physicians. Up to 38% of outpatients in the ENT profile suffer from various forms of otitis media, including up to 30% of acute otitis media. The most important way to overcome the global problem of antibiotic resistance, along with the delayed use of systemic antibacterial drugs initiated by the world medical community, is to switch to the active use of topical drugs with antimicrobial activity. The article provides an overview of the data of domestic and foreign literature on the properties of a topical antibacterial drug with the active ingredient hydroxymethylquinoxaline dioxide. The results of experimental work and clinical studies, proving the high efficacy and safety of the drug in the complex treatment of bacterial infections of the upper respiratory tract, have been analyzed.

Bacterial Infections of the Adult Upper Respiratory Tract

2019 ◽  
Author(s):  
Laura K Certain ◽  
Miriam B Barshak
Keyword(s):  
Respiratory Tract ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Group A Streptococcus ◽  
The United States ◽  
Controlled Study ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Upper respiratory tract infections are the most common maladies experienced by humankind.1 The majority are caused by respiratory viruses. A Dutch case-controlled study of primary care patients with acute respiratory tract infections found that viruses accounted for 58% of cases; rhinovirus was the most common (24%), followed by influenza virus type A (11%) and corona­viruses (7%). Group A streptococcus (GAS) was responsible for 11%, and 3% of patients had mixed infections. Potential pathogens were detected in 30% of control patients who were free of acute respiratory symptoms; rhinovirus was the most common.2 Given the increasing problem of antibiotic resistance and the increasing awareness of the importance of a healthy microbiome, antibiotic use for upper respiratory infections should be reserved for those patients with clear indications for treatment. A recent study of adult outpatient visits in the United States found that respiratory complaints accounted for 150 antibiotic prescriptions per 1,000 population annually, yet the expected “appropriate” rate would be 45.3 In other words, most antibiotic prescriptions for these complaints are unnecessary. Similarly, a study in the United Kingdom found that general practitioners prescribed antibiotics to about half of all patients presenting with an upper respiratory infection, even though most of these infections are viral.4 This review contains 5 figures, 16 tables, and 82 references. Keywords: infection, airway, sinusitis, otitis media, otitis externa, pharyngitis, epiglottitis, abscess

Presence of Chronic Lymphoid Leukaemia Associated Antigen in Other Malignant Haematological Diseases

Vox Sanguinis ◽  
1974 ◽  
Vol 26 (2) ◽  
pp. 141-146
Author(s):  
Do Trung Phan ◽  
G.G. Petrányi ◽  
Susan R. Hollán
Keyword(s):  
Lymphoid Leukaemia ◽  
Chronic Lymphoid Leukaemia

scholarly journals Treatment-related fluctuation in Guillain-Barre syndrome

2011 ◽  
Vol 02 (02) ◽  
pp. 168-170 ◽  
Author(s):  
Thirunavukkarasu Thivakaran ◽  
Ranjanie Gamage ◽  
Inuka Kishara Gooneratne
Keyword(s):  
Immune Activation ◽  
Early Treatment ◽  
Disease Onset ◽  
Immunoglobulin Therapy ◽  
Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽  
Guillain Barre Syndrome ◽  
Disability Scale ◽  
Guillain Barré Syndrome ◽  
Immunoglobulin Treatment ◽  
Guillain Barré

ABSTRACTGuillain-Barre syndrome (GBS) is usually a monophasic illness but relapses occur. A 55-year-old female with hypertension and vitiligo presented with acute inflammatory demyelinating polyradiculoneuropathy. She improved with immunoglobulin treatment started on day 6 of illness, but relapsed on day 14 warranting repeat immunoglobulin therapy. Thereafter recovery was complete. Her relapse was due to treatment-related fluctuation (TRF). TRF is improvement in the GBS disability scale of at least one grade after completion of immunotherapy followed by worsening of the disability scale of at least one grade within the first 2 months after disease onset. Recurrent GBS and chronic inflammatory demyelinating polyradiculoneuropathy were excluded. During the peak of the illness ANA titres were transiently high. The presence of other medical conditions, predominant proximal weakness and the absence of preceding diarrhea are predictors for TRF seen in this patient. Early treatment and evidence of ongoing immune activation have contributed toward TRF.

scholarly journals Community-Acquired Pneumonia in Children: Myths and Facts

2019 ◽  
Vol 36 (S 02) ◽  
pp. S54-S57 ◽  
Author(s):  
Ki Wook Yun ◽  
Rebecca Wallihan ◽  
Alexis Juergensen ◽  
Asuncion Mejias ◽  
Octavio Ramilo
Keyword(s):  
Respiratory Tract ◽  
Bacterial Infections ◽  
Pathogenic Bacteria ◽  
Bacterial Pathogen ◽  
Transcriptome Profiling ◽  
Antibiotic Use ◽  
Respiratory Viruses ◽  
Community Acquired Pneumonia ◽  
Prognostic Indicators ◽  
Upper Respiratory Tract

AbstractCommunity-acquired pneumonia (CAP) is the leading cause of death in children < 5 years of age worldwide. It is also one of the most frequent infectious diseases in children, leading to large antibiotic use and hospitalization even in the industrialized countries. However, the optimal management of CAP in children is still not well defined. Currently, respiratory viruses are considered the most frequent etiologic agents, but detection of viruses in the upper respiratory tract does not guarantee causation of pneumonia, nor precludes the presence of a bacterial pathogen. In both the upper and lower respiratory tract, respiratory viruses and pathogenic bacteria interact. Emerging evidence indicates that dual viral–bacterial infections function synergistically in many cases and together likely enhance the severity of CAP. Therefore, new and advanced technologies capable of sensitively and specifically discriminating viral, bacterial, and viral–bacterial coinfections are needed. Instead of focusing on the pathogen, analysis of host immune transcriptome profiles from children with CAP can potentially offer diagnostic signatures, help to assess disease severity, and eventually, prognostic indicators. An optimized management strategy by using molecular pathogen testing and transcriptome profiling will facilitate prompt, more appropriate, and targeted therapies, which in turn will lead to improved clinical outcomes in children with CAP.

scholarly journals Congenital Parvovirus B19 Infection: Persistent Viremia and Red Blood Cell Aplasia

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Sruti S. Nadimpalli ◽  
Russell S. Miller ◽  
Vasudeva M. Kamath ◽  
Christiana R. Farkouh ◽  
Chia-Ling Nhan-Chang ◽  
...  
Keyword(s):  
Viral Load ◽  
Preterm Birth ◽  
Blood Cell ◽  
Parvovirus B19 ◽  
Immunoglobulin Therapy ◽  
Intravenous Immunoglobulin Therapy ◽  
Serum Viral Load ◽  
Persistent Viremia ◽  
Parvovirus B19 Infection ◽  
Immunoglobulin Treatment

Abstract We describe a case of fetal parvovirus B19 infection resulting in preterm birth and leading to hydrops fetalis requiring multiple in utero transfusions. The infant developed chronic postnatal anemia responsive to intravenous immunoglobulin therapy. Serum viral load decreased after immunoglobulin treatment but remained detectable for over 1 year.

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