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1.
Medicine (Baltimore) ; 102(34): e34819, 2023 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-37653752

RESUMO

INTRODUCTION: The lentiform fork sign (LFS) is a unique magnetic resonance imaging (MRI) finding characterized by a bright hyperintense rim delineating the lentiform nucleus as a fork associated with metabolic acidosis in end-stage renal disease. PATIENT CONCERNS: We report 3 cases of LFS in diabetic uremic patients. In one case of uremia, intensive hemodialysis treatment was not effective. Given our poor understanding of LFS, it was regarded as bilateral basal ganglia pathology, and pulse hormone and gamma globulins therapy was initiated. The patient neurological symptoms improved, and the pathological signs on imaging subsided. Based on our experience with the first LFS case, 2 diabetic uremic cases presenting with LFS were successfully treated with hormone or gamma globulin pulse therapy in addition to intensive hemodialysis. DIAGNOSIS: Based on the clinical manifestations, past medical history and MRI imaging changes of the 3 cases reported here, the diagnosis of LFS was established. INTERVENTIONS: Our experience from these 3 cases suggests that hormone supplementation and gamma globulin therapy may be indicated for treating LFS. LESSONS: Our findings highlight that in diabetic uremic dialysis patients with neurological symptoms, LFS should be suspected. The clinical manifestations, past medical history and MRI imaging findings are essential for diagnosing LFS. Hormone supplementation and gamma globulin therapy may be the effective treatment for LFS.


Assuntos
Diabetes Mellitus , Falência Renal Crônica , Humanos , gama-Globulinas/uso terapêutico , Diálise Renal , Pesquisa , Imunoglobulinas Intravenosas , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia
2.
Pediatr Pulmonol ; 58(10): 2769-2776, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37469295

RESUMO

INTRODUCTION: Bronchiolitis obliterans is characterized by partial or total occlusion of the bronchioles due to inflammation and fibrosis, and the most common form is postinfectious bronchiolitis obliterans (PIBO). This study aimed to retrospectively present our intravenous immunoglobulin (IVIG) treatment experience in PIBO patients with a clinically severe course despite receiving commonly used treatment protocols. MATERIALS AND METHODS: The study included patients aged 0-18 with subtle immunological abnormalities who were followed up in our center for PIBO between 2010 and 2021. Clinical evaluation, body mass index (BMI), computerized tomography (CT) image scoring, and immunological parameters were recorded before and after IVIG treatment. RESULTS: Of the 11 patients included in the study, 90% were male, the mean age at diagnosis was 27.1 months (range: 5-68 months) and the mean current age was 81.4 months (range: 15-188 months). The number of hospital visits due to infection and the frequency of hospitalizations decreased markedly in the patients who underwent IVIG therapy. Oxygen therapy was discontinued in all patients, and improvements in radiological severity scores were observed. BMI z-scores improved over the baseline values after IVIG therapy. CONCLUSION: Corticosteroids are considered the best first-line treatment to control inflammation in PIBO. In our study group, PIBO patients showed favorable clinical and radiological responses to regular IVIG treatment, possibly due to minor immune deficiency secondary to steroids or as a result of undetected adaptive and innate immune defects involved in the etiology of severe PIBO.


Assuntos
Bronquiolite Obliterante , gama-Globulinas , Humanos , Masculino , Feminino , Estudos Retrospectivos , gama-Globulinas/uso terapêutico , Imunoglobulinas Intravenosas/uso terapêutico , Testes de Função Respiratória , Bronquiolite Obliterante/diagnóstico por imagem , Bronquiolite Obliterante/tratamento farmacológico , Bronquiolite Obliterante/etiologia , Inflamação/complicações
3.
Comput Math Methods Med ; 2022: 5162768, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35912143

RESUMO

Objective: To investigate the efficacy of gamma globulin combined with azithromycin sequential therapy in the treatment of children with refractory mycoplasma pneumonia and its effect on Th1/Th2 cytokine levels. Method: From January 2021 to January 2022, 100 children diagnosed with refractory mycoplasma pneumonia were randomly divided into 2 groups (50 cases in each one), the control group was treated with azithromycin plus comprehensive basic treatment, and the treatment group was treated with combined treatment on the basis of the control group, gamma globulin therapy; the treatment effect and cytokine levels of the two groups were compared. Results: Th1, Th2, and Th1/Th2 before treatment were not significantly different between the two groups. Th1, Th2, and Th1/Th2 in the treatment group were significantly downregulated compared with those in the control group after treatment. The levels of IgG, IgA, and IgM in the treatment group were not significantly different from those in the control group before treatment but were significantly upregulated after treatment. IL-10, IL-6, and IL-2 levels were also significantly increased in the treatment group. The disappearance time of clinical symptoms such as fever, cough, and pulmonary rales in the treatment group was significantly shorter than that in the control group, and the cure rate in the treatment group was significantly better than that in the control group. Conclusion: The clinical effect of gamma globulin combined with azithromycin sequential therapy in the treatment of children with refractory mycoplasma pneumonia is remarkable, which can reduce inflammatory factors, improve patients' immunity, and promote disease recovery.


Assuntos
Azitromicina , Pneumonia por Mycoplasma , Azitromicina/farmacologia , Azitromicina/uso terapêutico , Criança , Terapia Combinada , Citocinas/uso terapêutico , Humanos , Pneumonia por Mycoplasma/tratamento farmacológico , gama-Globulinas/uso terapêutico
4.
Comput Math Methods Med ; 2022: 5137874, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35941893

RESUMO

Purpose: To explore and analyze the therapeutic effect of gamma globulins (GG) on Kawasaki disease (KD) in children and the influencing factors of short-term prognosis. Methods: First, 90 pediatric KD patients admitted between January 2019 and January 2021 were selected and divided into a control group (n = 40) and a research group (n = 50) according to the difference in treatment. In addition to routine treatment and nursing given to both groups, control group was given aspirin (ASA), based on which research group was supplemented with GG therapy. The treatment outcome and adverse events (AEs) of the two cohorts of patients were analyzed and compared, and the influencing factors of children's short-term prognosis were analyzed by logistics multivariate analysis. Results: Research group had a statistical higher overall response rate than control group, with significantly fewer cases suffering from AEs such as nausea and vomiting, diarrhea, rash, dizziness and headache, and coronary artery injury. On the other hand, logistics multivariate analysis identified that gender, body mass index (BMI), onset time, platelet (PLT), and treatment mode all independently influence the short-term prognosis of children with KD. Conclusions: GG therapy is effective in treating pediatric KD patients and can effectively prevent AEs. In addition, gender, BMI, onset-to-treatment time, PLT, C-reactive protein (CRP), and treatment methods are independent risk factors for short-term prognosis of children with KD.


Assuntos
Doença da Artéria Coronariana , Síndrome de Linfonodos Mucocutâneos , Proteína C-Reativa/metabolismo , Criança , Doença da Artéria Coronariana/tratamento farmacológico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/tratamento farmacológico , Prognóstico , Estudos Retrospectivos , gama-Globulinas/uso terapêutico
5.
Viruses ; 14(8)2022 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-35893661

RESUMO

HIV-HCV co-infected subjects are at risk of liver fibrosis which may be linked to immune imbalances. Direct-acting antivirals (DAAs) represent the mainstay of HCV treatment in co-infected individuals, yet their effects on immune cell populations playing a role in fibrogenesis is unknown. We assessed γδ T-cell phenotype and function, Treg and Th17 frequencies, as well as γ-globulins and B-cell activation in 47 HIV-HCV co-infected and 35 HCV mono-infected individuals prior to and following DAA treatment (SVR12). Γδ T-cell activation decreased in both groups yet persisted at higher levels in the HIV-HCV co-infected subjects. No differences were registered in terms of γδT-cell function. Of note, the Vδ2/Th17 ratio, inversely linked to liver damage, increased significantly in the two groups upon treatment, yet a negative correlation between the Vδ2/Th17 ratio and liver function enzymes was found in the co-infected subjects alone. B-cell activation and γ-globulin levels decreased in both settings, yet B-cell activation remained higher in the HIV-HCV co-infected individuals. In HIV-HCV co-infected and HCV mono-infected participants, the effect of DAA was limited to γδ T- and B-cell activation as well as γ-globulin concentrations and the Vδ2/Th17 ratio, with no changes in γδ T-cell function and Treg frequencies. Importantly, γδ T- and B-cell activation remained at higher levels in the co-infected individuals than in those with HCV mono-infection alone. The persistence of such alterations within these cell subsets may be associated with the risk of hepatic and extrahepatic complications.


Assuntos
Coinfecção , Infecções por HIV , Hepatite C Crônica , Hepatite C , Antivirais/uso terapêutico , Coinfecção/complicações , Coinfecção/tratamento farmacológico , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Humanos , Fenótipo , Linfócitos T Reguladores , gama-Globulinas/uso terapêutico
6.
Swiss Med Wkly ; 152: w30143, 2022 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-35704942

RESUMO

OBJECTIVE: Diffuse large B-cell lymphoma can complicate the course of B-cell primary immunodeficiencies or induce lowering of total gamma globulin levels, whose clinical status as an effective secondary immunodeficiency remains unspecified. This study aimed to assess the frequency, and clinical and prognostic relevance of the low total gamma-globulin levels discovered at diagnosis of diffuse large B-cell lymphoma. RESULTS: In a 2-year monocentric retrospective study, 96 patients diagnosed with diffuse large B-cell lymphoma who had a serum electrophoresis were included. Patients were divided into those with lower (L-TGL and higher (H-TGL) total gamma-globulin levels (total gamma-globulin levels ≤5.5 g/l and >5.5 g/l) and compared for outcomes, including fatal infectious events. Twelve (12.5%; 8 males; age median 68 years, range 55-82 years) exhibited L-TGL. There was no difference between the both groups regarding demographics, Ann Arbor lymphoma stage, inflammatory parameters or chemotherapy regimen. However, overall death rates (10/12, 83.3% versus 22/96, 26.2%; p = 0.03) and infection-related death rates (10/12, 83% versus 6/96, 6.2%; p <0.001) were significantly higher in the L-TGL group. CONCLUSION: We demonstrate for the first time the strong negative impact of L-TGL on overall and infection-related mortality in diffuse large B-cell lymphoma. Prospective studies should distinguish immunodeficiencies secondary to the lymphoma from pre-existing humoral primary immunodeficiencies, using biomolecular testing and post-treatment total gamma-globulin level monitoring, to determine the best management strategy for infectious risk during diffuse large B-cell lymphoma treatment in the context of L-TGL.


Assuntos
Linfoma Difuso de Grandes Células B , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/uso terapêutico , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , gama-Globulinas/uso terapêutico
7.
J Thromb Haemost ; 20(8): 1859-1867, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35557490

RESUMO

BACKGROUND: Venous thromboembolism (VTE) is a concern for patients with newly diagnosed multiple myeloma. OBJECTIVES: We aimed to evaluate VTE incidence, risk factors, and risk score. PATIENTS/METHODS: We performed a substudy of the "Intergroupe Francophone du Myelome 2009" randomized controlled trial. RESULTS: We assessed 700 patients receiving lenalidomide/bortezomib/dexamethasone, followed or not by autologous hematopoietic stem cell transplantation. VTE incidence at 6 months was 4.8% (95% confidence interval [CI]: 3.3-6.9%) and 1.5% (95% CI: 0.8-2.9%) from 6 to 12 months. Using multivariate analysis we confirmed history of VTE (odds ratio 5.1 [1.6-16.7], P = .007) as a strong VTE-related risk factor, invalidated erythropoietin exposure (0.6 [0.2-1.7], P = .3) as risk factor, and added two new risk factors: fracture at diagnosis (2.6 [1.3-5.5], P = .01), and serum gamma globulin level > 27 g/L (2.8 [1.2-6.8,] P = .02). Moreover, we noticed that VTE occurred earlier in patients with gamma globulin levels >27 g/L, suggesting a need to revisit the thromboprophylaxis timeframe. Heparin administration was associated with a decreased risk (0.3 [0.1-0.7], P = .005) but failed to erase the risk regardless of dose. The area under the receiver operating characteristic curve of the IMPEDE VTE score was 0.67, as previously reported, confirming our cohort was well representative. CONCLUSIONS: Prospective studies are warranted in light of these results to improve VTE risk stratification and to design adapted thromboprophylaxis in terms of timing and dose.


Assuntos
Mieloma Múltiplo , Tromboembolia Venosa , Anticoagulantes/uso terapêutico , Bortezomib/efeitos adversos , Dexametasona/efeitos adversos , Humanos , Lenalidomida/efeitos adversos , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/tratamento farmacológico , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/prevenção & controle , gama-Globulinas/uso terapêutico
8.
Int J Antimicrob Agents ; 59(1): 106486, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34839007

RESUMO

Optimal therapy for methicillin-susceptible Staphylococcus aureus (MSSA) infections is unclear. Current standard of care consists of antistaphylococcal antibiotics (ASAs) such as nafcillin, oxacillin and cefazolin. Ceftriaxone has been evaluated due to its advantage as a once-daily outpatient regimen. However, questions remain regarding its efficacy compared with ASAs. We aimed to conduct a review and synthesis of available literature for outcomes of patients treated with ceftriaxone or ASAs for MSSA infections. We searched Cochrane Central Register of Controlled Trials, Embase Ovid, MEDLINE Ovid, Scopus and Web of Science (1990 to June 2021). Risk of bias for cohort studies was assessed by the Newcastle-Ottawa scale. We pooled risk ratios (RRs) using the DerSimonian-Laird random-effects model for outcomes of those receiving ceftriaxone versus ASAs. Heterogeneity was assessed by the I2 index. From 459 identified studies, 7 were included in the quantitative synthesis totalling 1640 patients. Definitive therapy with ceftriaxone was associated with a lower risk of toxicity requiring therapy alteration (RR 0.49, 95% CI 0.27-0.88; I2 = 0%). There was no difference in terms of 90-day all-cause mortality (RR 0.93, 95% CI 0.46-1.88; I2 = 9%), hospital readmission (RR 0.96, 95% CI 0.57-1.64; I2 = 0%) or infection recurrence (RR 1.04, 95% CI 0.63-1.72; I2 =0%). Current evidence suggests there is no difference in efficacy between ceftriaxone and ASAs for MSSA infection, with a lower risk of toxicity with ceftriaxone. Within the limitations of available retrospective studies, ceftriaxone is a consideration for definitive therapy of MSSA infection. [Trial registration: PROSPERO ID: CRD42021259086].


Assuntos
Antibacterianos/uso terapêutico , Anticorpos Anti-Idiotípicos/uso terapêutico , Ceftriaxona/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos , gama-Globulinas/uso terapêutico , Humanos , Estudos Retrospectivos
10.
CNS Neurosci Ther ; 27(6): 694-701, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33683811

RESUMO

AIMS: Seizure outcome of autoimmune encephalitis (AE) varies from seizure-free to refractory epilepsy, and the associated factors remain unclear. We aimed to describe seizure characteristics, identify seizure outcome-related factors, and discuss the medication strategy of antiepileptic drugs (AEDs) at the first onset of AE. METHODS: We retrospectively studied the data of 86 patients with clinically diagnosed AE. The clinical characteristics were described using a chi-square test. Seizure outcome-related factors were assessed using multivariable logistic regression analysis. RESULTS: 56 patients were finally enrolled, with antibodies to N-methyl-D-aspartate receptor found in 29, to γ-aminobutyric acid receptor B found in 13, and to leucine-rich glioma-inactivated protein 1 found in 14. Status epilepticus occurrence and onset with seizure lead to a poor seizure outcome, while administration of human gamma globulin and a low antibody titer contributed to a good seizure outcome. CONCLUSIONS: In the acute phase, seizure characteristics may be considered in the utilization of AEDs. For patients with seizure-free status in the acute phase, clinical manifestation (onset with seizure or not, whether status epilepticus occurs or not), therapy regimen (human gamma globulin administered or not), and antibody titer may be considered when formulating the strategy for withdrawal of AEDs post-acute phase.


Assuntos
Doenças Autoimunes/complicações , Encefalite/complicações , Convulsões/etiologia , Adolescente , Adulto , Anticonvulsivantes/uso terapêutico , Doenças Autoimunes/tratamento farmacológico , Criança , Pré-Escolar , Encefalite/tratamento farmacológico , Encefalite/imunologia , Feminino , Humanos , Imunoterapia , Lactente , Recém-Nascido , Masculino , Receptores de GABA-A/imunologia , Receptores de N-Metil-D-Aspartato/imunologia , Estudos Retrospectivos , Convulsões/tratamento farmacológico , Estado Epiléptico , Resultado do Tratamento , gama-Globulinas/uso terapêutico
11.
Med Sci Monit ; 27: e926751, 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33571171

RESUMO

BACKGROUND Coronavirus disease 2019 (COVID-19) is spreading rapidly worldwide, and scientists are trying to find a way to overcome the disease. We explored the risk factors that influence patient outcomes, including treatment regimens, which can provide a reference for further treatment. MATERIAL AND METHODS A retrospective cohort study analysis was performed using data from 97 patients with COVID-19 who visited Wuhan Union Hospital from February 2020 to March 2020. We collected data on demographics, comorbidities, clinical manifestations, laboratory tests, treatment methods, outcomes, and complications. Patients were divided into a recovered group and a deceased group. We compared the differences between the 2 groups and analyzed risk factors influencing the treatment effect. RESULTS Seventy-six patients recovered and 21 died. The average age and body mass index (BMI) of the deceased group were significantly higher than those of the recovered group (69.81±6.80 years vs 60.79±11.28 years, P<0.001 and 24.95±3.14 kg/m² vs 23.09±2.97 kg/m², P=0.014, respectively). The combination of antiviral drugs and supportive therapy appears to be associated with the lowest mortality (P<0.05). Multivariate Cox regression analysis revealed that age, BMI, H-CRP, shock, and acute respiratory distress syndrome (ARDS) were independent risk factors for patients with COVID-19 (P<0.05). CONCLUSIONS Elderly patients and those with a high BMI, as well as patients who experience shock and ARDS, may have a higher risk of death from COVID-19. The combination of antiviral drugs and supportive therapy appears to be associated with lower mortality, although further research is needed.


Assuntos
Tratamento Farmacológico da COVID-19 , COVID-19/mortalidade , Síndrome do Desconforto Respiratório/mortalidade , Choque/mortalidade , Fatores Etários , Idoso , Antivirais/uso terapêutico , COVID-19/complicações , COVID-19/virologia , China/epidemiologia , Quimioterapia Combinada/métodos , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Mortalidade Hospitalar , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/terapia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/patogenicidade , Choque/etiologia , Choque/terapia , Resultado do Tratamento , gama-Globulinas/uso terapêutico
12.
J Clin Lab Anal ; 35(1): e23580, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33174652

RESUMO

BACKGROUND: Henoch-Schonlein purpura nephritis (HSPN) is a serious complication of Henoch-Schonlein purpura (HSP), which is usually treated with immunosuppressant and glucocorticoid. This study was designed to explore the effect of dexamethasone and gamma globulin combined with prednisone in the treatment of pediatric HSPN. METHODS: According to the treatment plan, 60 children treated with dexamethasone and gamma globulin were included in the control group, and the rest 55 children treated with dexamethasone and gamma globulin combined with prednisone were selected as the research group. The clinical manifestations, therapeutic effect, immune function, serum inflammatory factors, blood coagulation function, urine routine, renal function, and adverse reactions were compared between the two groups. RESULTS: The clinical manifestations of children in the research group were significantly better than those in the control group after treatment (P < .05). The total effective rate in the research group (94.55%) was markedly higher than that in the control group (76.67%) (P < .05). CD3+, CD4+, CD8+, IL-10, PT, and APTT increased while CD4+/CD8+, IgA, IL-8, TNF-α, FIB, urine protein, urine red blood cell, Scr, and BUN decreased in both groups after treatment, and the changes of all the above indexes in the research group were significant than those in the control group (P < .05). The incidence of adverse reactions in the research group was remarkably superior to that in the control group (P < .05). CONCLUSION: Dexamethasone and gamma globulin combined with prednisone can improve the immune function of children with HSPN and promote the recovery of renal function.


Assuntos
Dexametasona/uso terapêutico , Vasculite por IgA/tratamento farmacológico , Imunossupressores/uso terapêutico , Nefrite/tratamento farmacológico , Prednisona/uso terapêutico , gama-Globulinas/uso terapêutico , Criança , Pré-Escolar , Citocinas/sangue , Feminino , Humanos , Vasculite por IgA/complicações , Vasculite por IgA/epidemiologia , Masculino , Nefrite/epidemiologia , Nefrite/etiologia , Resultado do Tratamento
13.
BMJ Case Rep ; 13(12)2020 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334773

RESUMO

The aetiology of febrile exanthems in children is often difficult to distinguish clinically. A diagnosis of Kawasaki disease (KD) should be considered in infants with exanthematous fever. More perplexing is the increasing incidence of an atypical form of KD. Pathogenesis of KD remains unclear even though an aberrant response of the immune system to an unidentified pathogen is often hypothesised. A 30-fold increase in the incidence of KD in Italy during the SARS-CoV-2 pandemic suggests an immune response to a viral trigger. We report an infant clinically diagnosed with high probability as incomplete KD, who presented with reactivation of the BCG injection site even though fever with rash was only less than 3 days duration. Echocardiography confirmed coronary artery abnormalities and prompt treatment with intravenous immunoglobulin facilitated rapid recovery. Physicians should consider a diagnosis of KD if BCG site reactivation is noted in children presenting with febrile exanthema.


Assuntos
Exantema/etiologia , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Vacina BCG/administração & dosagem , Febre , Humanos , Fatores Imunológicos/uso terapêutico , Lactente , Masculino , Síndrome de Linfonodos Mucocutâneos/tratamento farmacológico , Vacinação/efeitos adversos , gama-Globulinas/uso terapêutico
14.
J Pak Med Assoc ; 70(10): 1679-1683, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33159732

RESUMO

OBJECTIVE: To determine the curative effect of gamma globulin combined with methylprednisolone sodium succinate on paediatric patients with severe hand-foot-mouth disease and analyse its influence on cardio-pulmonary functions. METHODOLOGY: Eighty paediatric patients with severe hand-foot-mouth diseases (HFMD) treated in Baoding Children's Hospital, Key Laboratory of Clinical Research on Respiratory Digestive Disease from January 2015 to January 2017 were selected. This study was designed as a case control study with equally dividing patients into test and control groups through random digital method. Patients in the control group accepted methylprednisolone sodium succinate treatment based on conventional therapy. Those in the test group accepted gamma globulin combined with methylprednisolone sodium succinate. The efficacy of the two groups were observed and compared and the improvement of cardiac function index was detected after 3 days of treatment. RESULTS: The time for symptom remission and hospitalisation of children in the test group were significantly shorter than those in the control group (P<0.05). The differences between the two groups had no statistical significance in terms of PaO2, PaCO2, OI, HR, EF% and CO before treatment. After the treatment, patients in the test group had significant improvement compared with the control group (P<0.05). CONCLUSIONS: Curative effect of gamma globulin combined with methylprednisolone sodium succinate on paediatric patients showed significance and this treatment could be effectively improve clinical symptoms and cardio-pulmonary functions of paediatric patients.


Assuntos
Doença de Mão, Pé e Boca , Doenças da Boca , gama-Globulinas , Estudos de Casos e Controles , Criança , China , Doença de Mão, Pé e Boca/tratamento farmacológico , Hospitais , Humanos , Metilprednisolona/uso terapêutico , Hemissuccinato de Metilprednisolona/uso terapêutico , gama-Globulinas/uso terapêutico
15.
Pan Afr Med J ; 37: 47, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33209174

RESUMO

SARS-CoV-2 has created a global public health emergency with significant mortality and morbidity for people living with HIV (PLWH). Preliminary data reveals persons with immune-compromised status are at risk of developing adverse clinical outcomes from SARS-CoV-2. We aimed to characterise clinical outcomes of HIV patients co-infected with SARS-CoV-2 infection in Nasarawa State, North Central Nigeria. We followed four (4) hospitalised HIV patients that tested positive to SARS-CoV-2 in Nasarawa State and characterised their laboratory findings and clinical outcomes. The consent of the cases was sought and they agreed that their clinical data be published. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 nucleic acid were performed using nasopharyngeal swabs (novel coronavirus PCR fluorescence diagnostic kit, BioGerm medical biotechnology) at the Nigeria Centre for Disease Control (NCDC) in Abuja, Nigeria. Our study reveals mild clinical outcome among HIV patients with SARS-CoV-2 co-infection. There is need for a syndemic framework to be used to conceptualise SARS-CoV-2 impact among HIV patients and an urgent need to strengthen healthcare programmes within Nigeria.


Assuntos
Antirretrovirais/uso terapêutico , Betacoronavirus , Coinfecção/tratamento farmacológico , Infecções por Coronavirus/tratamento farmacológico , Infecções por HIV/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Síndrome Respiratória Aguda Grave , Profissionais do Sexo , Antivirais/uso terapêutico , COVID-19 , Teste para COVID-19 , Vacinas contra COVID-19 , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Metilprednisolona/uso terapêutico , Nigéria , Norfloxacino/uso terapêutico , Pandemias , Pneumonia Viral/diagnóstico , Reação em Cadeia da Polimerase em Tempo Real , SARS-CoV-2 , gama-Globulinas/uso terapêutico
17.
J Int Med Res ; 48(10): 300060520964009, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33100064

RESUMO

BACKGROUND: The causative virus of coronavirus disease 2019 (COVID-19) may cause severe fatal pneumonia. The clinical presentation includes asymptomatic infection, severe pneumonia, and acute respiratory failure. Data pertaining to acute renal injury due to COVID-19 in patients who have undergone renal transplantation are scarce. We herein report two cases of COVID-19 along with acute kidney injury following kidney transplantation.Case presentation: Two patients with COVID-19 underwent renal transplantation and were subsequently diagnosed with acute kidney injury. The first patient presented with progressive respiratory symptoms and acute renal injury. He was treated with diuretics and suspension of immunosuppressive therapy; however, the patient died. The second patient presented with respiratory tract symptoms, hypoxemia, and progressive deterioration of renal function followed by improvement. Her mycophenolate mofetil was stopped after admission, and tacrolimus was discontinued 10 days later. Moxifloxacin and methylprednisolone were continued in combination with albumin and gamma globulin infusion. A diuretic was administered, and prednisone was gradually reduced along with tacrolimus. The patient exhibited a satisfactory clinical recovery. CONCLUSION: Patients who develop COVID-19 after kidney transplantation are at risk of acute kidney injury, and their prednisone, immunosuppressant, and gamma globulin treatment must be adjusted according to their condition.


Assuntos
Injúria Renal Aguda/patologia , Infecções por Coronavirus/patologia , Transplante de Rim/efeitos adversos , Rim/patologia , Pneumonia Viral/patologia , Injúria Renal Aguda/virologia , Adulto , Betacoronavirus , COVID-19 , Esquema de Medicação , Feminino , Humanos , Imunossupressores/administração & dosagem , Imunossupressores/uso terapêutico , Rim/virologia , Masculino , Pessoa de Meia-Idade , Pandemias , Prednisona/administração & dosagem , Prednisona/uso terapêutico , SARS-CoV-2 , Transplantados , gama-Globulinas/administração & dosagem , gama-Globulinas/uso terapêutico
18.
Complement Ther Med ; 52: 102481, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32951731

RESUMO

Sickle Cell Disease (SCD) is a chronic hemolytic disorder associated with frequent pain episodes, end organ damage and a shortened lifespan. Currently there exist no disease specific targeted therapies for the treatment of acute vaso-occlusive crisis (VOC) and management with analgesics and hydration is purely supportive. Improvement in understanding of disease pathophysiology has resulted in a great interest in disease modifying novel therapies and many are being evaluated in clinical trials. Here we report the results from the pre-specified mid-point analysis of the Phase 2 study of Intravenous Gamma Globulin (IVIG) for the treatment of acute VOC in patients with SCD and lessons learned.


Assuntos
Anemia Falciforme/tratamento farmacológico , Imunoglobulinas Intravenosas/uso terapêutico , Manejo da Dor/métodos , gama-Globulinas/uso terapêutico , Adolescente , Adulto , Anemia Falciforme/complicações , Criança , Método Duplo-Cego , Feminino , Humanos , Fatores Imunológicos/uso terapêutico , Masculino , Adulto Jovem
19.
Brasília; s.n; 6 jul. 2020. 31 p.
Não convencional em Português | BRISA/RedTESA, LILACS, PIE | ID: biblio-1117629

RESUMO

O Informe Diário de Evidências é uma produção do Ministério da Saúde que tem como objetivo acompanhar diariamente as publicações científicas sobre tratamento farmacológico e vacinas para a COVID-19. Dessa forma, são realizadas buscas estruturadas em bases de dados biomédicas, referente ao dia anterior desse informe. Não são incluídos estudos pré-clínicos (in vitro, in vivo, in silico). A frequência dos estudos é demonstrada de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, coortes, entre outros). Para cada estudo é apresentado um resumo com avaliação da qualidade metodológica. Essa avaliação tem por finalidade identificar o grau de certeza/confiança ou o risco de viés de cada estudo. Para tal, são utilizadas ferramentas já validadas e consagradas na literatura científica, na área de saúde baseada em evidências. Cabe ressaltar que o documento tem caráter informativo e não representa uma recomendação oficial do Ministério da Saúde sobre a temática. Foram encontrados 17 artigos.


Assuntos
Humanos , Pneumonia Viral/tratamento farmacológico , Infecções por Coronavirus/tratamento farmacológico , Betacoronavirus/efeitos dos fármacos , Avaliação da Tecnologia Biomédica , gama-Globulinas/uso terapêutico , Imunoglobulinas/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Vacinas/uso terapêutico , Cloroquina/uso terapêutico , Interferon beta/uso terapêutico , Aldeído Redutase/antagonistas & inibidores , Corticosteroides/uso terapêutico , Azitromicina/uso terapêutico , Sulfato de Zinco/uso terapêutico , Ritonavir/uso terapêutico , Oseltamivir/uso terapêutico , Lopinavir/uso terapêutico , Hidroxicloroquina/uso terapêutico
20.
Aging (Albany NY) ; 12(12): 11224-11237, 2020 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-32554861

RESUMO

With the outbreak of coronavirus disease-19 (COVID-19), Changsha faced an increasing burden of treating the Wuhan migrants and their infected patients. This study is a retrospective, single-center case series of the 238 consecutive hospitalized patients with confirmed COVID-19 at the First Hospital of Changsha city, China, from 01/21 to 02/14, 2020; the final date of follow-up was 02/27, 2020. Of 238 patients 43.7% visited Wuhan, 58.4% got in touch with Wuhan people, and 47.5% had contacted with diagnosed patients. 37.8% patients had family members infected. 190 cases had mild / general disease, and 48 cases had severe / critical disease. Compared to mild or general patients, more severe or critical patients visited Wuhan (59.6% vs 40.2%; P=0.02) and contacted with Wuhan people (74.5% vs 55.0%; P=0.02). All patients received antiviral treatment, including Lopinavir / Ritonavir (29.3%), Interferon (14.6%) and their combination (40.6%), Arbidol (6.7%), Xuebijing (7.1%) and Chloroquine phosphate (1.3%). Severe and critical patients received glucocorticoid, Gamma-globulin and oxygen inhalation. Some received mechanic ventilation support. As of 02/27, 161 patients discharged. The median length of hospital stay was 13 days. The 10-, 14-, 20- and 28-day discharge rate was 19.1%, 42.8%, 65.0% and 76.4%, respectively. No hospital-related transmission was observed.


Assuntos
Antivirais/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Respiração Artificial , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , COVID-19 , China/epidemiologia , Cloroquina/análogos & derivados , Cloroquina/uso terapêutico , Combinação de Medicamentos , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Hospitalização , Humanos , Fatores Imunológicos/uso terapêutico , Indóis/uso terapêutico , Interferons/uso terapêutico , Lopinavir/uso terapêutico , Masculino , Pessoa de Meia-Idade , Oxigênio/uso terapêutico , Pandemias , Estudos Retrospectivos , Ritonavir/uso terapêutico , SARS-CoV-2 , gama-Globulinas/uso terapêutico
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