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Mirkovic R, Werch J, South MA, Benyesh-Melnick M. Incidence of cytomegaloviremia in blood-bank donors and in infants with congenital cytomegalic inclusion disease. Infect Immun 2010; 3:45-50. [PMID: 16557945 PMCID: PMC416105 DOI: 10.1128/iai.3.1.45-50.1971] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
During a 15-month period, cytomegalovirus (CMV) isolations were attempted from leukocytes derived from 290 healthy blood-bank donors. The major proportion of the specimens were tested 2 to 5 hr after donation. However, CMV was not recovered from any of the specimens examined. At the time of donation, 75% of donors had CMV complement-fixing antibodies demonstrable in titers of 10 to >/=320. The age of the study group ranged from 17 to 57 years. During the same time period and with the use of identical isolation techniques, postnatal cytomegaloviremia was demonstrated in four infants with cytomegalic inclusion disease. Failure to detect cytomegaloviremia in 290 normal blood donors questions its occurrence outside pathological conditions. These results do not support the concept that CMV infection, concurrent with post-transfusion mononucleosis syndrome, is transmitted through the blood donor's leukocytes.
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Affiliation(s)
- R Mirkovic
- Department of Virology and Epidemiology, Department of Pathology, and Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77025
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Kapsenberg JG, Langenhuysen MMAC, Nieweg HO, Deiss H. POSTTRANSFUSION MONONUCLEOSIS WITH HETEROPHIL ANTIBODIES. ACTA ACUST UNITED AC 2009. [DOI: 10.1111/j.0954-6820.1970.tb02910.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Spread of Human Cytomegalovirus (HCMV) After Infection of Human Hematopoietic Progenitor Cells: Model of HCMV Latency. Blood 1997. [DOI: 10.1182/blood.v90.6.2482] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractClinical experience and laboratory data suggest that human cytomegalovirus (HCMV) is present in peripheral blood of seropositive individuals in a latent or persistent state and can be transmitted via blood products and be reactivated in seropositive imunocompromised patients. The pathophysiology of HCMV latency and the nature of HCMV interaction with hematopoietic cells remains unknown. In this study, we investigated the infection of bone marrow (BM) progenitor cells and their progeny as a model of HCMV latency. A clinical isolate and the recombinant laboratory strain Towne/lox containing the Escherichia coli β galactosidase (β-gal) gene regulated by immediately early (IE) HCMV promoter were used to infect highly purified CD34+ cells. Although the infection of these cells with a clinical isolate was associated with an inhibition of proliferation by 59%, an expansion of progeny derived from these cells was possible. Polymerase chain reaction analysis and staining for β-gal have shown that HCMV persisted in infected BM CD34+ cells and their progeny for up to 4 weeks. However, IE and late gene products (mRNA and protein) were detected only late in the course of infection and their expression correlated with terminal macrophage differentiation of the CD34+-derived progeny. Although early infection of CD34+ progenitor cells was not productive (as shown by the plaque assay), infectious virus could be recovered from the terminally differentiated cultures. BM progenitor cells may serve as a reservoir of the latent virus with limited transcription. Proliferation and monocytic maturation of infected progenitors may lead to the numerical expansion of HCMV-infected cells, which serve as a source of HCMV dissemination and reactivation.
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Spread of Human Cytomegalovirus (HCMV) After Infection of Human Hematopoietic Progenitor Cells: Model of HCMV Latency. Blood 1997. [DOI: 10.1182/blood.v90.6.2482.2482_2482_2491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Clinical experience and laboratory data suggest that human cytomegalovirus (HCMV) is present in peripheral blood of seropositive individuals in a latent or persistent state and can be transmitted via blood products and be reactivated in seropositive imunocompromised patients. The pathophysiology of HCMV latency and the nature of HCMV interaction with hematopoietic cells remains unknown. In this study, we investigated the infection of bone marrow (BM) progenitor cells and their progeny as a model of HCMV latency. A clinical isolate and the recombinant laboratory strain Towne/lox containing the Escherichia coli β galactosidase (β-gal) gene regulated by immediately early (IE) HCMV promoter were used to infect highly purified CD34+ cells. Although the infection of these cells with a clinical isolate was associated with an inhibition of proliferation by 59%, an expansion of progeny derived from these cells was possible. Polymerase chain reaction analysis and staining for β-gal have shown that HCMV persisted in infected BM CD34+ cells and their progeny for up to 4 weeks. However, IE and late gene products (mRNA and protein) were detected only late in the course of infection and their expression correlated with terminal macrophage differentiation of the CD34+-derived progeny. Although early infection of CD34+ progenitor cells was not productive (as shown by the plaque assay), infectious virus could be recovered from the terminally differentiated cultures. BM progenitor cells may serve as a reservoir of the latent virus with limited transcription. Proliferation and monocytic maturation of infected progenitors may lead to the numerical expansion of HCMV-infected cells, which serve as a source of HCMV dissemination and reactivation.
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Willerson JT. James Thornton Willerson, MD: a conversation with the editor. Interview by William Clifford Roberts. Am J Cardiol 1997; 79:457-67. [PMID: 9052350 DOI: 10.1016/s0002-9149(96)00811-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Affiliation(s)
- R A Bowden
- Program in Infectious Diseases, University of Washington, Seattle, USA
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Nageswaran A, Kinghorn GR. Sexually transmitted diseases in children: herpes simplex virus infection, cytomegalovirus infection, hepatitis B virus infection and molluscum contagiosum. Genitourin Med 1993; 69:303-11. [PMID: 7721295 PMCID: PMC1195094 DOI: 10.1136/sti.69.4.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- A Nageswaran
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK
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Söderberg C, Larsson S, Bergstedt-Lindqvist S, Möller E. Definition of a subset of human peripheral blood mononuclear cells that are permissive to human cytomegalovirus infection. J Virol 1993; 67:3166-75. [PMID: 7684461 PMCID: PMC237655 DOI: 10.1128/jvi.67.6.3166-3175.1993] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The identity of cells responsible for transmission of human cytomegalovirus (HCMV) in blood products or bone marrow transplants is unknown. We have tested the capacity of HCMV to in vitro infect human peripheral blood mononuclear cells (PBMC) from healthy donors and found that certain PBMC are permissive to HCMV infection. In vitro-infected viable cells were double stained for surface expression of different HMCV proteins and for cell-type-specific antigens to allow the identification of sensitive cells. All analysis were performed on viable cells, using HCMV-specific monoclonal antibodies and automated flow cytofluorimetry. PBMC were infected either with the laboratory-adapted HCMV strain AD169 or with a virus isolate obtained from a viremic patient. Up to 25% of all PBMC could express the major immediate-early antigen as well as the pp65 antigen, known at the lower matrix protein. Infected cells were mainly CD14+ monocytes, but also a small population of large CD8+ cells were susceptible to HCMV infection. CD19+ B lymphocytes were resistant to HCMV infection. Different populations of infected cells were enriched by using Dynabeads coated with cell-type-specific antibodies, and the presence of infectious virus was demonstrated by incubating the selected and sonicated cell material on human fibroblasts. Only material from infected monocytes and from CD3+ CD8+ cells gave rise to HCMV-specific plaques. The presence of HCMV mRNA as a sign of active viral transcription of the major immediate-early and late pp150 genes in infected cells was demonstrated by using nested reversed polymerase chain reaction. A common denominator was found for all cells that could be infected with HCMV. The CD13 antigen, a 130- to 150-kDa integral membrane protein identical to the enzyme aminopeptidase N, was expressed on all HCMV-permissive cells.
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MESH Headings
- Antigens, CD/immunology
- Antigens, CD19
- Antigens, Differentiation, B-Lymphocyte/immunology
- Antigens, Differentiation, Myelomonocytic/immunology
- B-Lymphocyte Subsets/immunology
- B-Lymphocyte Subsets/microbiology
- Base Sequence
- CD13 Antigens
- CD8 Antigens/immunology
- Cell Separation
- Cytomegalovirus/growth & development
- Cytomegalovirus Infections/microbiology
- Genetic Variation
- Humans
- Immunity, Innate
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/microbiology
- Lipopolysaccharide Receptors
- Molecular Sequence Data
- Monocytes/immunology
- Monocytes/microbiology
- Receptors, Virus
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/microbiology
- Transcription, Genetic
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Affiliation(s)
- C Söderberg
- Department of Clinical Immunology, NOVUM, Karolinska Institute, Huddinge Hospital, Stockholm, Sweden
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Louie SG, Jaresko GS. Biological Agents in Infectious Diseases. J Pharm Pract 1991. [DOI: 10.1177/089719009100400505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article examines the use of classical as well as novel immunological agents to augment the immune system. Strategies to prevent infectious disease using vaccines to prime the immune system are discussed. A prospective overview of acquired immunodeficiency syndrome (AIDS) vaccine development provides insights into the possible agents that may be developed in the near future. The rationale for the use of intravenous immunoglobulin and colony stimulating factors in selected clinical situations is also discussed.
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Affiliation(s)
- Stan G. Louie
- School of Pharmacy, University of Southern California, Los Angeles
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Abstract
Human cytomegalovirus (CMV) is a ubiquitous deoxyribonucleic acid virus that commonly infects a majority of individuals at some time during their life. Although most of these CMV infections are asymptomatic, certain patient groups are at risk to develop serious illness. Understanding the epidemiology of this virus is a key element in the development of strategies for preventing CMV disease. However, a number of features of this virus complicate such understanding. Following infection, CMV can remain latent, with subsequent reactivation; the factors controlling latency and reactivation and those factors which determine whether a CMV infection will be symptomatic are unknown. CMV disease can be acquired by natural routes, including horizontal and vertical transmission. Due to the ubiquity of CMV, the delineation of CMV transmission by these natural routes is complicated by the myriad of possible sources. Moreover, concerns over the risk of CMV transmission to the seronegative pregnant female have been raised in relation to preventing CMV transmission. By using molecular biologic techniques, much knowledge has been gained regarding the transmission of CMV disease by natural routes; however, a number of questions remain unanswered. The transmission of CMV infection by natural routes is therefore reviewed and the issues are highlighted. Primary infection, reactivation, and reinfection are the types of active CMV infections that can occur in an immunocompromised patient. In addition to natural routes of infection, introduction of presumably latently infected organs and requirements for multiple blood transfusions increase potential exposure to CMV in the immunocompromised patient. Understanding the epidemiology of CMV infections in the immunocompromised patient is difficult and in some instances controversial due to the complexity and interdependency of a number of factors which lead to CMV infection. In an immunocompromised individual, a major risk factor in developing overt CMV-related disease is associated with the serological status of an organ donor, the recipient, and the blood product given to these patients. In addition, a large body of inferential data supports the transmission of CMV by blood products or organs from seropositive donors; however, the mechanisms by which transmission occurs remain unclear. The possible sources and mechanisms of transmission of CMV infections in the immunocompromised host are reviewed. Lastly, strategies for the ultimate prevention of CMV disease are discussed in light of the epidemiology of CMV infections. To date, these strategies have included use of CMV-seronegative blood products or organs, antiviral agents, and vaccines.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- B A Forbes
- Department of Clinical Pathology, State University of New York Health Science Center, Syracuse 13210
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 8-1987. A 44-month-old girl with fever of unknown origin after repair of the tetralogy of Fallot. N Engl J Med 1987; 316:466-75. [PMID: 3492674 DOI: 10.1056/nejm198702193160808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
Infants with very low birthweights (less than 1250g) are immunocompromised and have immature hematopoietic systems. They require frequent blood transfusions and have an increased susceptibility to infection. These very low birthweight infants who lack passively acquired antibody against CMV, acquire transfusion-associated CMV infections with a frequency of approximately 30%. These infections are associated with significant morbidity and mortality. The source of these postnatally acquired CMV infections are seropositive blood donors. These infections can be prevented by appropriate donor selection and/or blood processing. Recent but limited data suggests that all infants (regardless of birthweight or the presence of antibody against CMV) should receive CMV seronegative blood products if they are likely to receive multiple transfusions from multiple donors.
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Schrier RD, Nelson JA, Oldstone MB. Detection of human cytomegalovirus in peripheral blood lymphocytes in a natural infection. Science 1985; 230:1048-51. [PMID: 2997930 DOI: 10.1126/science.2997930] [Citation(s) in RCA: 256] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In situ hybridization was used to detect human cytomegalovirus (HCMV) in the peripheral blood mononuclear cells of some naturally infected (seropositive) individuals. A subpopulation of cells hybridized specifically to a portion of the HCMV genome that is heavily transcribed during the immediate-early period of infection. The hybridization signal was markedly reduced by base hydrolysis and ribonuclease, and therefore the probe appears to be detecting viral RNA. A fluorescence-activated cell sorter was used to select lymphocytes bearing the OKT4 and OKT8 markers. Hybridization with the HCMV probe revealed a higher proportion of positive cells in the OKT4 than in the OKT8 subset. This observation specifically identifies lymphocytes as a cell population involved in natural HCMV infection and suggests that lymphocytes may be a reservoir for maintaining infection and may also serve as a vehicle for its spread by blood transfusion.
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Reikvam A, Orstavik I, Endresen K, Bae E. Identification of patients at risk of symptomatic cytomegalovirus infection after open-heart surgery. SCANDINAVIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 1985; 19:173-6. [PMID: 2996127 DOI: 10.3109/14017438509102714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In a prospective study, 58 consecutive patients submitted to open-heart surgery were followed from the preoperative period up to 3 months postoperatively with regard to clinical status, cytomegalovirus (CMV) antibodies and signs of enzymatic liver damage. Forty-eight patients (83%) were seropositive prior to operation. Of the ten (17%) preoperatively seronegative patients, five became CMV-seropositive during follow-up. Of the 48 initially seropositive patients, nine showed heightened CMV-antibody titers after the operation. Significant symptomatic CMV illness with protracted fever developed in four patients, all from the group of five with seroconversion. All five of these patients had enzymatic liver damage. The incidence of symptomatic CMV infection after open-heart surgery in CMV-negative patients probably is higher than previously assumed, while CMV-positive patients seem to have complete protection against CMV morbidity.
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Abstract
A healthy young adult is described in whom acute erosive esophagitis developed four weeks after undergoing splenectomy and receiving six units of blood because of trauma. Cytomegalovirus inclusion bodies were identified in esophageal mucosa, and cytomegalovirus was cultured from blood and throat. Within three weeks, the patient's anticytomegalovirus antibody had increased four-fold. The patient was initially anergic and had a titer of antinuclear antibody of 1:10,240. His symptoms and histopathologic findings disappeared over five weeks, and his immunologic abnormalities were partially corrected. It is suggested that cytomegalovirus was the primary cause of gastrointestinal disease in this nonimmunocompromised patient.
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Shannon K, Ball E, Wasserman RL, Murphy FK, Luby J, Buchanan GR. Transfusion-associated cytomegalovirus infection and acquired immune deficiency syndrome in an infant. J Pediatr 1983; 103:859-63. [PMID: 6315905 DOI: 10.1016/s0022-3476(83)80701-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
An infant who received multiple blood transfusions in the neonatal intensive care unit developed a transfusion-associated CMV infection at age 11 weeks and thereafter was noted to have hepatosplenomegaly, mitogen hyporesponsiveness, persistent viruria, an abnormal distribution of T-lymphocyte subpopulations, and poor growth. He has had recurrent opportunistic infections, including Pneumocystis carinii pneumonia. Six donors of blood products received by this infant were investigated; one was found to have chronic lymphadenopathy, weight loss, intermittent diarrhea, lymphopenia, and a profound depression of lymphocytes with a helper/inducer surface phenotype (T4 positive). Family members have an abnormal distribution of T cell subpopulations similar to those reported in asymptomatic homosexuals. The course of disease in our patient suggests that acquired immune deficiency syndrome may be transmitted to young infants via blood products.
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Nishimura RA, Fuster V, Burgert SL, Puga FJ. Clinical features and long-term natural history of the postpericardiotomy syndrome. Int J Cardiol 1983; 4:443-54. [PMID: 6642779 DOI: 10.1016/0167-5273(83)90194-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We followed 34 consecutive patients with the postpericardiotomy syndrome for a median of 7 years. In each patient, the syndrome was documented by the occurrence of: (1) a pericardial type of pain or pericardial rub (or both); and (2) fever or an elevated erythrocyte sedimentation rate. The postpericardiotomy syndrome occurred at a median postoperative time of 4 weeks (range, 2 to 52 weeks). The duration of the syndrome was highly variable (range, 2 to 100 days; median, 22 days) and depended primarily on treatment; the median duration of symptoms in 21 patients treated with salicylates alone was only 4 days. Of the 9 patients receiving anticoagulants alone and in whom this treatment was continued, none had clinical evidence of hemopericardium. On follow-up, 7 patients (21%) had an initial recurrence at an interval of 1 to 3 months; 5 of these patients had further recurrences at an interval of 3 to 30 months. This long-term study indicates that the postperiocardiotomy syndrome is a benign but often recurrent clinical entity, presumably related to viral and/or immunologic factors.
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Abstract
Three patients with granulomatous hepatitis due to cytomegalovirus are described. They are compared to the three previously described patients with this disease, and their clinical and serologic characteristics are discussed. Similarities and differences between infectious mononucleosis (Epstein-Barr virus) and cytomegalovirus infections are adduced. That cytomegalovirus may be a cause of granulomatous hepatitis in the adult is stressed.
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Should renal-transplant patients be screened for C.M.V.? Lancet 1978; 2:770-1. [PMID: 80691 DOI: 10.1016/s0140-6736(78)92654-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bäck E, Höglund C, Malmlund HO. Cytomegalovirus infection associated with severe encephalitis. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1977; 9:141-3. [PMID: 197592 DOI: 10.3109/inf.1977.9.issue-2.17] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A previously healthy 37-year-old woman had a 5-week febrile disease starting 10 days after delivery, which was complicated by disseminated intravascular coagulation and treated with fresh blood transfusions. She developed severe encephalitis with coma. She also had signs of perimyocarditis and enlargement of liver and lymph nodes. The encephalitis was completely reversible. There was a 16-fold rise in complement-fixing antibodies against cytomegalovirus.
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Cesario TC. Viral infections that affect the fetus. Postgrad Med 1976; 59:66-72. [PMID: 177962 DOI: 10.1080/00325481.1976.11714294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Several viral infections besides rubella are known to cause fetal anomalies and disease. Cytomegalovirus, for example, may adversely affect the fetus in a number of ways. Either herpesvirus or hepatitis B virus is transmissible from mother to offspring. Viruses whose potential for fetal harm is less clear are those of varicella, mumps, and influenza.
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Abstract
Leukocyte and urine cultures were done at monthly intervals in 36 children with acute lymphocytic leukemia known to be excreting cytomegalovirus in their or saliva in order to determine the relationship of viremia to clinical cytomegalic inclusion disease. Eleven of 36 (30.5%) patients had viremia. Viremia was related to clinical disease in only three patients; two with chorioretinitis and one with a CMV monomucleosis syndrom. However, the presence of viremia did not serve as a useful means to determine active CID. Viremic patients with CID all had elevated serum levels of IgM and multiple episodes of viremia. Viremia was not related to the duration, type or number of drugs used in immunosuppression, nor to the hematologic status of leukemia. Viremic patients received more blood transfusions than noviremic patients, but the administration of blood products could not be related to the acquisition of infection. Leukopenia, neutropenia, total lymphocyte count, fourfold rise or fall in complement-fixing titer, and viruria had no consistent relationship to viremia or clinical CID.
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Abstract
Complications after heart valve replacement remain a substantial source of morbidity and mortality despite continuing advances in surgical care and prosthetic design. Infectious endocarditis occurs in about 4 percent of patients and may appear early (within 60 days) or late after operation. Endocarditis of early onset is commonly due to staphylococcal, fungal or gram-negative organisms and is fatal in 70 percent or more of cases. Infection of late onset is more often of streptococcal origin and the mortality rate is lower, about 35 percent. With either type, prompt recognition, vigorous and appropriate antimicrobial therapy and early consideration of surgical intervention are crucial. The postperfusion and postpericardiotomy syndromes are relatively common and relatively benign syndromes associated with postoperative fever. Their recognition is important to prevent confusion with endocarditis or sepsis and thus to reassure the patient and physician. Treatment is primarily symptomatic. Intravascular hemolysis occurs with most prosthetic heart valves but is more common with certain prostheses and with paraprosthetic valve regurgitation, with significant hemolytic anemia in 5 to 15 percent. Oral iron replacement therapy is effective in the majority of patients, but occasionally blood transfusion or reoperation for leak around the prosthesis is necessary. Prosthesis dysfunction due to thrombus may be recognized clinically by recurrence of heart failure, syncope, cardiomegaly and altered prosthetic valve sounds or new murmurs. Hemodynamic studies verify the diagnosis, and prompt reoperation is indicated for this potentially lethal problem. Systemic embolization has decreased markedly with the introduction of cloth-covered prostheses and is frequently related to erratic or ineffective anticoagulant therapy. We continue to recommend anticoagulant therapy for all patients with prosthetic heart valves unless there is a major contraindication.
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McCracken AW, Newman JT. The current status of the laboratory diagnosis of viral diseases of man. CRC CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 1975; 5:331-63. [PMID: 805015 DOI: 10.3109/10408367509107047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Candeias JA, Stewien KE, Barbosa V. [Serological study of infections caused by Cytomegalovirus]. Rev Saude Publica 1974; 8:257-63. [PMID: 4376258 DOI: 10.1590/s0034-89101974000300002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Estudou-se a distribuição etária e por sexo de anticorpos fixadores do complemento para citomegalovírus em 1294 soros de indivíduos do município de São Paulo. A uma porcentagem de positividade de 33%, nos primeiros quinze anos de vida, seguiu-se, após uma queda inicial no nível de anticorpos, um aumento progressivo até níveis de ordem de 70%. Não se observaram diferenças de positividade significativas em relação ao sexo. A comparação dos resultados obtidos com a reação de fixação do complemento e a reação de neutralização, numa amostra de 236 soros de indivíduos adultos, usando-se a cepa de citomegalovírus AD 169, evidenciou uma boa correlação.
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Lopez C, Simmons RL, Mauer SM, Najarian JS, Good RA, Gentry S. Association of renal allograft rejection with virus infections. Am J Med 1974; 56:280-9. [PMID: 4360465 DOI: 10.1016/0002-9343(74)90609-3] [Citation(s) in RCA: 162] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Numazaki Y, Sekiguchi H, Tateda A, Kikuchi K. A serologic study on cytomegalovirus infection associated with blood transfusion in Japanese. JAPANESE JOURNAL OF MICROBIOLOGY 1974; 18:91-3. [PMID: 4368354 DOI: 10.1111/j.1348-0421.1974.tb00748.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Le Thymus humain, réservoir de virus? Med Mal Infect 1973. [DOI: 10.1016/s0399-077x(73)80008-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Lang DJ. Cytomegalovirus infections in organ transplantation and post transfusion. An hypothesis. ARCHIV FUR DIE GESAMTE VIRUSFORSCHUNG 1972; 37:365-77. [PMID: 4339109 DOI: 10.1007/bf01241460] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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37
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39
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Caul EO, Dickinson VA, Roome AP, Mott MG, Stevenson PA. Cytomegalovirus infections in leukaemic children. Int J Cancer 1972; 10:213-20. [PMID: 4350511 DOI: 10.1002/ijc.2910100127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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40
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Porter R, Crombie AL, Gardner PS, Uldall RP. Incidence of ocular complications in patients undergoing renal transplantation. BRITISH MEDICAL JOURNAL 1972; 3:133-6. [PMID: 4339112 PMCID: PMC1788625 DOI: 10.1136/bmj.3.5819.133] [Citation(s) in RCA: 69] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The eyes of 39 patients who had received allogenic renal transplants were examined for signs of disease. Nine (23%) had early posterior subcapsular cataracts, two (5%) developed acute cytomegalovirus retinitis, and one developed steroid-induced glaucoma. The lesions which were found were all attributable to the immunosuppressive drug therapy. Thirty-five (87%) had detectable complement-fixing antibodies to cytomegalovirus.
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Ferchal F, Salles M, Perol Y, Toulier M. La virémie à virus de la maladie des inclusions cytomégaliques au cours des syndromes mononucléosiques post-transfusionnels. Med Mal Infect 1971. [DOI: 10.1016/s0399-077x(71)80036-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Benzing G, Kaplan S. Late complications of cardiac surgery. Pediatr Clin North Am 1971; 18:1225-42. [PMID: 4257827 DOI: 10.1016/s0031-3955(16)32637-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Blacklow NR, Watson BK, Miller G, Jacobson BM. Mononucleosis with heterophil antibodies and EB virus infection. Acquisition by an elderly patient in hospital. Am J Med 1971; 51:549-52. [PMID: 4345944 DOI: 10.1016/0002-9343(71)90260-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Prince AM, Szmuness W, Millian SJ, David DS. A serologic study of cytomegalovirus infections associated with blood transfusions. N Engl J Med 1971; 284:1125-31. [PMID: 4324227 DOI: 10.1056/nejm197105202842004] [Citation(s) in RCA: 142] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Stevens DA, Levine PH, Lee SK, Sonley MJ, Waggoner DE. Concurrent infectious mononucleosisand acute leukemia. Case reports. Review of theliterature and serologic studies with the herpes-type virus (EB virus). Am J Med 1971; 50:208-17. [PMID: 4322791 DOI: 10.1016/0002-9343(71)90150-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Luthardt T, Siebert H, Lösel I, Quevedo M, Todt R. [Cytomegalo-virus infections in infants with blood exchange transfusions after birth]. KLINISCHE WOCHENSCHRIFT 1971; 49:81-6. [PMID: 4322559 DOI: 10.1007/bf01497304] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Foster KM, Jack I. Binucleate DNA-synthesizing cells in cytomegalovirus infection after extracorporeal circulation. Pathology 1971; 3:9-12. [PMID: 4329052 DOI: 10.3109/00313027109071316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Breen KJ, Schenker S. Liver function tests. CRC CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 1971; 2:573-99. [PMID: 4944522 DOI: 10.3109/10408367109151317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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