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1.
Transfusion ; 61 Suppl 1: S22-S31, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34269432

RESUMO

BACKGROUND: Civilian and military guidelines recommend early balanced transfusion to patients with life-threatening bleeding. Low titer group O whole blood was introduced as the primary blood product for resuscitation of massive hemorrhage at Haukeland University Hospital, Bergen, Norway, in December 2017. In this report, we describe the whole blood program and present results from the first years of routine use. STUDY DESIGN AND METHODS: Patients who received whole blood from December 2017 to April 2020 were included in our quality registry for massive transfusions. Post-transfusion blood samples were collected to analyze isohemagglutinin (anti-A/-B) and hemolysis markers. Administration of other blood products, transfusion reactions, and patient survival (days 1 and 30) were recorded. User experiences were surveyed for both clinical and laboratory staff. RESULTS: Two hundred and five patients (64% male and 36% female) received 836 units in 226 transfusion episodes. Patients received a mean of 3.7 units (range 1-35) in each transfusion episode. The main indications for transfusion were trauma (26%), gastrointestinal (22%), cardiothoracic/vascular (18%), surgical (18%), obstetric (11%), and medical (5%) bleeding. There was no difference in survival between patients with blood type O when compared with non-group O. Haptoglobin level was lower in the transfusion episodes for non-O group patients, however no clinical hemolysis was reported. No patients had conclusive transfusion-associated adverse events. Both clinical and laboratory staff preferred whole blood to component therapy for massive transfusion. DISCUSSION: The experience from Haukeland University Hospital indicates that whole blood is feasible, safe, and effective for in-hospital treatment of bleeding.


Assuntos
Transfusão de Sangue , Ressuscitação , Reação Transfusional/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transfusão de Sangue/métodos , Criança , Pré-Escolar , Feminino , Hemólise , Hospitais , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Ressuscitação/métodos , Reação Transfusional/sangue , Reação Transfusional/patologia , Adulto Jovem
2.
Anesthesiology ; 133(6): 1173-1183, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32902572

RESUMO

BACKGROUND: This pilot trial focused on feasibility and safety to provide preliminary data to evaluate the hemostatic potential of cold-stored platelets (2° to 6°C) compared with standard room temperature-stored platelets (20° to 24°C) in adult patients undergoing complex cardiothoracic surgery. This study aimed to assess feasibility and to provide information for future pivotal trials. METHODS: A single center two-stage exploratory pilot study was performed on adult patients undergoing elective or semiurgent complex cardiothoracic surgery. In stage I, a two-armed randomized trial, platelets stored up to 7 days in the cold were compared with those stored at room temperature. In the subsequent single-arm stage II, cold storage time was extended to 8 to 14 days. The primary outcome was clinical effect measured by chest drain output. Secondary outcomes were platelet function measured by multiple electrode impedance aggregometry, total blood usage, immediate and long-term (28 days) adverse events, length of stay in intensive care, and mortality. RESULTS: In stage I, the median chest drain output was 720 ml (quartiles 485 to 1,170, n = 25) in patients transfused with room temperature-stored platelets and 645 ml (quartiles 460 to 800, n = 25) in patients transfused with cold-stored platelets. No significant difference was observed. The difference in medians between the room temperature- and cold-stored up to 7 days arm was 75 ml (95% CI, -220, 425). In stage II, the median chest drain output was 690 ml (500 to 1,880, n = 15). The difference in medians between the room temperature arm and the nonconcurrent cold-stored 8 to 14 days arm was 30 ml (95% CI, -1,040, 355). Platelet aggregation in vitro increased after transfusion in both the room temperature- and cold-stored platelet study arms. Total blood usage, number of adverse events, length of stay in intensive care, and mortality were comparable among patients receiving cold-stored and room temperature-stored platelets. CONCLUSIONS: This pilot trial supports the feasibility of platelets stored cold for up to 14 days and provides critical guidance for future pivotal trials in high-risk cardiothoracic bleeding patients.


Assuntos
Plaquetas/fisiologia , Preservação de Sangue/métodos , Procedimentos Cirúrgicos Cardíacos , Criopreservação/métodos , Transfusão de Plaquetas , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Agregação Plaquetária/fisiologia , Temperatura , Fatores de Tempo
3.
Int J Pediatr Otorhinolaryngol ; 130: 109795, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31786522

RESUMO

OBJECTIVES: Tonsillectomy (TE) or adenotonsillectomy (ATE) may have a beneficial effect on the clinical course in children with the periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome. However, an immunological reason for this effect remains unknown. This literature review summarizes the current knowledge regarding the immunological role of the tonsils in the PFAPA syndrome. METHODS: We searched PubMed, Medline, EMBASE and Cochrane for papers written in English dated from 1 January 1987 to 30 April 2019. The search included all studies reporting histological, immunological or microbiological workup of tonsil specimens from children aged 0-18 years with PFAPA. RESULTS: Thirteen articles reported histological, immunological or microbiological workup of tonsil specimens in children with PFAPA. The histology of tonsil specimens from children with PFAPA displayed chronic tonsillar inflammation with lymphoid hyperplasia. No uniform immunological pattern was identified, but some studies found fewer B-lymphocytes and smaller germinal centers in PFAPA compared to controls. A difference in tonsillar microbiota between PFAPA and controls was found in one study. CONCLUSION: A uniform immunological or microbiological pattern explaining the clinical effect of TE in children with PFAPA has not been revealed. Future targeted immunological studies of tonsils in PFAPA patients could possibly illuminate the understanding of the immunology in this disease.


Assuntos
Febre Familiar do Mediterrâneo/imunologia , Linfadenite/imunologia , Tonsila Palatina/patologia , Faringite/imunologia , Estomatite Aftosa/imunologia , Tonsilectomia , Adenoidectomia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Linfadenite/cirurgia , Masculino , Microbiota , Faringite/cirurgia , Síndrome
4.
Cancers (Basel) ; 11(7)2019 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-31319548

RESUMO

Background: Natural killer (NK) cells are potential effectors in anti-cancer immunotherapy; however only a subset potently kills cancer cells. Here, we examined whether pretreatment of glioblastoma (GBM) with the proteasome inhibitor, bortezomib (BTZ), might sensitize tumour cells to NK cell lysis by inducing stress antigens recognized by NK-activating receptors. Methods: Combination immunotherapy of NK cells with BTZ was studied in vitro against GBM cells and in a GBM-bearing mouse model. Tumour cells were derived from primary GBMs and NK cells from donors or patients. Flow cytometry was used for viability/cytotoxicity evaluation as well as in vitro and ex vivo phenotyping. We performed a Seahorse assay to assess oxygen consumption rates and mitochondrial function, Luminex ELISA to determine NK cell secretion, protein chemistry and LC-MS/MS to detect BTZ in brain tissue. MRI was used to monitor therapeutic efficacy in mice orthotopically implanted with GBM spheroids. Results: NK cells released IFNγ, perforin and granzyme A cytolytic granules upon recognition of stress-ligand expressing GBM cells, disrupted mitochondrial function and killed 24-46% of cells by apoptosis. Pretreatment with BTZ further increased stress-ligands, induced TRAIL-R2 expression and enhanced GBM lysis to 33-76% through augmented IFNγ release (p < 0.05). Blocking NKG2D, TRAIL and TRAIL-R2 rescued GBM cells treated with BTZ from NK cells, p = 0.01. Adoptively transferred autologous NK-cells persisted in vivo (p < 0.05), diminished tumour proliferation and prolonged survival alone (Log Rank10.19, p = 0.0014, 95%CI 0.252-0.523) or when combined with BTZ (Log Rank5.25, p = 0.0219, 95%CI 0.295-0.408), or either compared to vehicle controls (median 98 vs. 68 days and 80 vs. 68 days, respectively). BTZ crossed the blood-brain barrier, attenuated proteasomal activity in vivo (p < 0.0001; p < 0.01 compared to vehicle control or NK cells only, respectively) and diminished tumour angiogenesis to promote survival compared to vehicle-treated controls (Log Rank6.57, p = 0.0104, 95%CI 0.284-0.424, median 83 vs. 68 days). However, NK ablation with anti-asialo-GM1 abrogated the therapeutic efficacy. Conclusions: NK cells alone or in combination with BTZ inhibit tumour growth, but the scheduling of BTZ in vivo requires further investigation to maximize its contribution to the efficacy of the combination regimen.

5.
Transfusion ; 59(8): 2652-2661, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31150571

RESUMO

BACKGROUND: Cold storage of platelets may extend shelf life compared to room temperature storage. This study aimed to investigate in vitro platelet quality and function in cold-stored and delayed-cold-stored nonagitated apheresis platelets in platelet additive solution during storage for 21 days. STUDY DESIGN AND METHODS: Ten double apheresis platelet concentrates in 37% plasma/63% PAS-IIIM were split into two groups; nonagitated 2 to 6°C storage (CSPs) and delayed cold storage (DCSPs) with 7 days agitated storage at 20-24°C followed by nonagitated cold storage for 14 additional days. Platelet count, metabolism, viscoelastic properties, and aggregation ability were measured on Days 1, 7, 14, and 21. RESULTS: All platelet units, both CSPs and DCSPs, complied with the EU guidelines throughout storage for 21 days. Swirling was not detectable after cold storage. Cold storage improved platelet function; however, DCSP on Day 7 showed poorer results compared to CSP. Cold storage slowed down metabolism, with lower lactate and higher glucose concentrations in the CSP compared to the DCSP throughout storage for 21 days. CONCLUSION: Cold storage of platelets improved platelet function in in vitro assays, even though delayed cold storage on Day 7 showed poorer results compared to continuous cold storage. This difference could be explained by accelerated metabolism and higher glucose consumption during the period of room temperature storage. Cold storage and delayed cold storage could ease inventory management. Further studies investigating the in vitro and clinical effects of cold-stored and delayed-cold-stored platelets are encouraged.


Assuntos
Plaquetas/metabolismo , Preservação de Sangue , Temperatura Baixa , Plaquetoferese , Plaquetas/citologia , Feminino , Humanos , Masculino , Testes de Função Plaquetária , Estudos Prospectivos , Fatores de Tempo
6.
Transfusion ; 59(S2): 1446-1452, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30980744

RESUMO

The shift toward using a transfusion strategy in a ratio to mimic whole blood (WB) functionality has revitalized WB as a viable option to replace severe blood loss in civilian health care. A military-civilian collaboration has contributed to the reintroduction of WB at Haukeland University Hospital in Bergen, Norway. WB has logistical and hemostatic advantages in both the pre- and in-hospital settings where the goal is a perfectly timed balanced transfusion strategy. In this paper, we describe an event leading to activation of our emergency WB collection strategy for the first time. We evaluate the feasibility of our civilian walking blood bank (WBB) to cover the need of a massive amount of blood in an emergency situation. The challenges are discussed in relation to the different stages of the event with the recommendations for improvement in practice. We conclude that the use of pre-screened donors as a WBB in a civilian setting is feasible. The WBB can provide platelet containing blood components for balanced blood resuscitation in a clinically relevant time frame.


Assuntos
Bancos de Sangue , Doadores de Sangue , Segurança do Sangue , Seleção do Doador , Hospitais Militares , Medicina Militar , Bancos de Sangue/organização & administração , Bancos de Sangue/normas , Segurança do Sangue/métodos , Segurança do Sangue/normas , Seleção do Doador/organização & administração , Seleção do Doador/normas , Feminino , Hospitais Militares/organização & administração , Hospitais Militares/normas , Humanos , Masculino , Medicina Militar/métodos , Medicina Militar/organização & administração , Medicina Militar/normas , Noruega
7.
Pediatr Rheumatol Online J ; 11(1): 38, 2013 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-24134207

RESUMO

BACKGROUND: The Periodic Fever, Aphthous stomatitis, Pharyngitis and cervical Adenitis syndrome (PFAPA) is the most common periodic fever syndrome in childhood. Clinically, PFAPA may resemble autoinflammatory diseases, but the etiology is not fully understood. METHODS: We measured inflammatory proteins in plasma and hematologic parameters in children with PFAPA during and between febrile episodes, and in a control group with suspected bacterial pneumonia. In children with PFAPA, a first blood sample was taken within 24 hours of a febrile episode and a second sample between episodes. In children with pneumonia, the first sample was taken shortly after admission and a second sample after full recovery. RESULTS: A total of 22 children with PFAPA and 14 children with pneumonia were included. In children with PFAPA, levels of interleukin (IL) 6, CXCL10 and CCL4 were significantly increased during febrile episodes. The levels of IL-6 and CXCL10 were higher in children with PFAPA during febrile episodes than in children with pneumonia. The levels of CXCL10 remained higher in children with PFAPA between febrile episodes compared to children with pneumonia after recovery. Children with PFAPA had a relative eosinopenia and lymphocytopenia with reduced numbers of both CD4+ and CD8+ T cells during febrile episodes. This pattern was not observed in the children with pneumonia. CONCLUSIONS: The results indicate an innate immune response as the initial step in PFAPA, and a subsequent adaptive response with activation and redistribution of T cells. Moreover, an activation of the innate immune system involving CXCL10 may persist between febrile episodes. CXCL10 may be a possibly clinical marker in children with PFAPA.

8.
Acta Paediatr ; 102(2): 187-92, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23106338

RESUMO

AIM: To describe the incidence, epidemiology, clinical presentation and clinical outcome of children with the syndrome of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) in a population-based study. METHODS: In a prospective population-based study, all children in South Rogaland, Norway, diagnosed with PFAPA during 2004-2010 were evaluated clinically, and parents were interviewed systematically. A follow-up interview was performed for all patients. RESULTS: A total of 46 children (32 boys; p = 0.011) were diagnosed with PFAPA. We calculated an incidence of 2.3 per 10 000 children up to 5 years of age. The median age of onset was 11.0 months (quartiles: 5.0, 14.8). Nearly 37 children were followed until resolution. In 17 of these, a tonsillectomy was performed with prompt resolution of PFAPA in all. The median age of spontaneous resolution was 60.2 months (range 24-120) and in children with tonsillectomy 50.9 months (range 15-128). CONCLUSION: The incidence of PFAPA was 2.3 per 10 000 children up to 5 years of age. In the majority of cases, onset of symptoms may be during the first year of life.


Assuntos
Febre , Linfadenite , Faringite , Estomatite Aftosa , Idade de Início , Pré-Escolar , Feminino , Febre/diagnóstico , Febre/epidemiologia , Febre/cirurgia , Seguimentos , Humanos , Incidência , Lactente , Linfadenite/diagnóstico , Linfadenite/epidemiologia , Linfadenite/cirurgia , Masculino , Pescoço , Noruega/epidemiologia , Faringite/diagnóstico , Faringite/epidemiologia , Faringite/cirurgia , Estudos Prospectivos , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/epidemiologia , Estomatite Aftosa/cirurgia , Síndrome , Tonsilectomia , Resultado do Tratamento
9.
Br J Haematol ; 145(6): 761-74, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19388934

RESUMO

Acute myeloid leukaemia (AML) cells show constitutive release of several chemokines that occurs in three major clusters: (I) chemokine (C-C motif) ligand (CCL)2-4/chemokine (C-X-C motif) ligand (CXCL)1/8, (II) CCL5/CXCL9-11 and (III) CCL13/17/22/24/CXCL5. Ingenol-3-angelate (PEP005) is an activator of protein kinase C and has antileukaemic and immunostimulatory effects in AML. We investigated primary AML cells derived from 35 unselected patients and determined that PEP005 caused a dose-dependent increase in the release of chemokines from clusters I and II, including several T cell chemotactic chemokines. The release of granulocyte-macrophage colony-stimulating factor and hepatocyte growth factor was also increased. CCL2-4/CXCL1/8 release correlated with nuclear factor (NF)-kappaB expression in untreated AML cells, and PEP005-induced chemokine production was associated with further increases in the expression of the NF-kappaB subunits p50, p52 and p65. Increased DNA binding of NF-kappaB was observed during exposure to PEP005, and the specific NF-kappaB inhibitor BMS-345541 reduced constitutive chemokine release even in the presence of PEP005. Finally, PEP005 decreased expression of stem cell markers (CD117, CXCR4) and increased lineage-associated CD11b and CD14 expression. To conclude, PEP005 has a unique functional pharmacological profile in human AML. Previous studies have described proapoptotic and T cell stimulatory effects and the present study describes additional T cell chemotactic and differentiation-inducing effects.


Assuntos
Antineoplásicos/uso terapêutico , Diterpenos/uso terapêutico , Leucemia Mieloide Aguda/tratamento farmacológico , NF-kappa B/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Diferenciação Celular , Quimiocinas/imunologia , Feminino , Citometria de Fluxo , Humanos , Leucemia Mieloide Aguda/imunologia , Leucemia Mieloide Aguda/metabolismo , Masculino , Pessoa de Meia-Idade , NF-kappa B/análise , NF-kappa B/genética , Proteína Quinase C/metabolismo , Interferência de RNA , RNA Interferente Pequeno/farmacologia , Estatísticas não Paramétricas , Células Tumorais Cultivadas
10.
Tidsskr Nor Laegeforen ; 127(12): 1651-3, 2007 Jun 14.
Artigo em Norueguês | MEDLINE | ID: mdl-17571105

RESUMO

BACKGROUND: In children with recurrent episodes of fever, the cause may be the periodic fever syndrome (PFAPA-syndrome). The condition is not uncommon, and awareness of the syndrome is important for avoiding unnecessary investigations and treatment. The article presents an overview of the PFAPA-syndrome. MATERIAL AND METHODS: The overview was based on Pubmed and Medline searches and data from 22 children with PFAPA-syndrome diagnosed at Stavanger University Hospital. RESULTS AND INTERPRETATION: In children with PFAPA-syndrome the fever occurs regularly, appears abruptly and lasts for three to five days. Typical symptoms are cervical adenitis, tonsillitis/pharyngitis or aphthous stomatitis, often accompanied by headache, abdominal pain, nausea and reduced general condition. Of the 22 children, 17 were boys. The median age of debut was 12 months, median duration of fever four days, and median time between episodes 25 days. The most common symptoms were cervical adenitis (n = 18) and tonsillitis/pharyngitis (n = 16). During episodes, all children had high fever, reduced general condition, no proved infection but typical high levels of C-reactive protein. More than half of the children had been given antibiotics on at least five occasions before the diagnosis of PFAPA-syndrome. With a typical history and clinical investigation, the need for further investigations is limited. The diagnosis must be considered in children younger than five years of age with periodic fever without signs of airway infection. When PFAPA-syndrome is suspected, the child should be referred to a paediatrician. There is no evidence-based treatment for PFAPA-syndrome, but tonsillectomy is considered to have an effect.


Assuntos
Febre , Periodicidade , Pré-Escolar , Diagnóstico Diferencial , Feminino , Febre/diagnóstico , Febre de Causa Desconhecida/diagnóstico , Humanos , Lactente , Linfadenite/diagnóstico , Masculino , Faringite/diagnóstico , Prognóstico , Recidiva , Estomatite Aftosa/diagnóstico , Síndrome , Tonsilite/diagnóstico
11.
APMIS ; 114(6): 453-7, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16856968

RESUMO

Russian children between 7 and 10 years of age have been shown to have significantly higher seroprotection against diphtheria compared to Norwegian children. That was due to a reinforcing dose given on entering school to Russian but not to Norwegian children. The next booster was given at the age of 11-12 years in both countries. We have compared diphtheria and tetanus antitoxin levels among 13- to 14- and 15- to 16-year-old teenagers to see if the difference was maintained among the older age group. Serum samples obtained from 106 Russian and 117 Norwegian teenagers were tested by enzyme immunoassay. The Russian and Norwegian adolescents exhibited adequate rates of protection against diphtheria with similar geometric mean antitoxin concentrations of 1.26 and 1.15 IU/ml, respectively, at 13-14 years, and 0.33 and 0.29 IU/ml at 15-16 years. Differences within the age groups were not significant. However, at 13-14 years the Norwegians were much better protected 2 years after a reinforcing dose of tetanus toxoid than the Russians who had not been boosted for 7 years. At the age of 15-16 the difference diminished and became statistically not significant.


Assuntos
Vacina contra Difteria e Tétano/administração & dosagem , Difteria/prevenção & controle , Tétano/prevenção & controle , Adolescente , Difteria/sangue , Difteria/epidemiologia , Antitoxina Diftérica/sangue , Humanos , Esquemas de Imunização , Noruega/epidemiologia , Federação Russa/epidemiologia , Estudos Soroepidemiológicos , Tétano/sangue , Tétano/epidemiologia , Antitoxina Tetânica/sangue
12.
Vaccine ; 23(42): 4980-3, 2005 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-15985319

RESUMO

Tetanus booster is a routine procedure of tetanus prevention in populations with high risk of injury, independent of the levels of protection. But the immune response in already protected individuals is not well studied. We describe the kinetics of booster response in individuals by measuring tetanus antitoxin levels by indirect ELISA. A 6-month follow up was performed on 60 boosted individuals tested before, 1 week, 1, 2, 3 and 6 months after the booster. High initial protection (mean titer 1.08 IU/ml) and less than 3-fold increase after 1 month were observed. After 1 month of stable antitoxin levels, the levels slowly decreased and reached a mean titer of 1.78 IU/ml after 6 months. Individuals with initial levels <1 IU/ml had booster response after the first month twice as high compared to those with initial level >or=1 IU/ml. However, in both groups, the decline from 1 to 6 months was about 2-fold. Individuals already protected against tetanus exhibited an attenuated, short-lasting booster response to tetanus toxoid. This was more pronounced in individuals with pre-booster levels >or=1 IU/ml, who did not improve immune protection after the booster.


Assuntos
Imunização Secundária , Toxoide Tetânico/imunologia , Tétano/imunologia , Adolescente , Adulto , Ensaio de Imunoadsorção Enzimática , Humanos , Masculino , Tétano/prevenção & controle , Antitoxina Tetânica/sangue , Toxoide Tetânico/administração & dosagem
13.
Vaccine ; 23(12): 1446-50, 2005 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-15670879

RESUMO

The main objective of this study was to investigate the booster antibody response in individuals with initially high levels of diphtheria antitoxin. Sixty individuals eligible for the routine booster by the age of 18 years each received a single dose of 5 Lf of diphtheria toxoid in diphtheria-tetanus vaccine. A double antigen ELISA was used for the assessment of the antibody levels. Chaotropic disruption in paired ELISA was used to test antibody avidity. The ratio between initial and maximum antibody concentrations after 1 month was >10 times higher and after 6 months still four times higher in those with initial antibody levels <1 IU/ml. In individuals with initial antibody levels >/=1 IU/ml a two-fold decrease was observed after 6 months compared to the initial levels. Thus, vaccination of individuals with initial long-term protection against diphtheria (antibody levels >/=1 IU/ml) is unnecessary and should be avoided.


Assuntos
Toxoide Diftérico/administração & dosagem , Toxoide Diftérico/imunologia , Difteria/prevenção & controle , Imunização Secundária , Adolescente , Adulto , Anticorpos Antibacterianos/sangue , Difteria/imunologia , Ensaio de Imunoadsorção Enzimática , Humanos , Masculino , Federação Russa
14.
Scand J Infect Dis ; 36(3): 232-4, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15119374

RESUMO

We present a young woman with a rare association of Epstein-Barr virus (EBV) infection, sarcoidosis and massive ascites. The temporal relationship between the EBV infection and ascites strongly suggests a pathophysiological relationship, and other causes of ascites were not identified. The prognosis of ascites is excellent in acute EBV infection.


Assuntos
Ascite/complicações , Infecções por Vírus Epstein-Barr/complicações , Herpesvirus Humano 4/isolamento & purificação , Sarcoidose/complicações , Doença Aguda , Adolescente , Ascite/diagnóstico , Ascite/terapia , Terapia Combinada , DNA Viral , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/tratamento farmacológico , Feminino , Seguimentos , Humanos , Reação em Cadeia da Polimerase , Medição de Risco , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológico , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler
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