Long Term Outcomes of Pediatric Liver Transplantation According to Age

Liver transplantation (LT) has been the key therapy for end stage liver diseases. However, LT in infancy is still understudied. From 1992 to 2010, 152 children had undergone LT in Seoul National University Hospital. Operations were performed on 43 patients aged less than 12 months (Group A) and 109 patients aged over 12 months (Group B). The mean age of the recipients was 7 months in Group A and 74 months in Group B. The patients' survival rates and post-LT complications were analyzed. The mean Pediatric End-stage Liver Disease score was higher in Group A (21.8) than in Group B (13.4) (P = 0.049). Fulminant hepatitis was less common in Group A (4.8%) than in Group B (13.8%) (P = 0.021). The post-transplant lymphoproliferative disorder and portal vein complication were more common in Group A (14.0%, 18.6%) than in Group B (1.8%, 3.7%) (P = 0.005). However, the 1, 5, and 10 yr patient survival rates were 93%, 93%, and 93%, in Group A and 92%, 90%, and 88% in Group B (P = 0.212). The survival outcome of pediatric LT is excellent and similar regardless of age. LTs in infancy are not riskier than those of children.

PCR-based diagnosis of a case of herpetic whitlow in an AIDS patient

As infeccoes herpeticas sao complicacoes comuns em pacientes com AIDS. As manifestacoes clinicas podem ser incomuns e o tratamento antiviral e imperativo. Um metodo diagnostico rapido pode prevenir abordagens e tratamentos incorretos. A reacao em cadeia da polimerase (PCR) e um metodo rapido, sensivel e especifico para a amplificacao de DNA e para o diagnostico de doencas infecciosas, especialmente as de etiologia viral. Esta abordagem tem vantagens quando comparada com os metodos convencionais de diagnostico virologico. Recentemente nos relatamos um novo protocolo de PCR para o dignostico rapido de infeccoes herpeticas com supressao da etapa de extracao de DNA. Neste trabalho nos apresentamos um caso de paroniquea herpetica com diagnostico atraves de PCR especifico para Herpes Simplex tipo 1 usando o referido protocolo

Infecções causadas por vírus em 100 pacientes submetidos a transplante cardíaco / Infections caused by virus in 100 patients submitted to heart transplantation

PURPOSE: To analyse prevalence, clinical features and organ involvement in viral infections occuring after heart transplantation. METHODS: One hundred consecutive heart transplantation patients were studied. The follow-up was three to 90 (mean 23.32 +/- 25.97) months. Viral infections were diagnosed using the Center for Disease Control criteria. RESULTS: Viral infections were responsible for 51 infections, 19.6 of all infections in this patient population. Herpesvirus infection was the most common etiology: 32 (59.25) of all viral infections were caused by reactivation of or reinfection by cytomegalovirus. Of those infections 27 (84.37) occurred in the first three weeks following surgery. Only 4 (12.50) of those showed clinical signs of cytomegalovirus disease. Other herpesvirus causing infections were herpes simplex and varicella-zoster virus. CONCLUSION: Infections are common after heart transplantation and viral infections of herpesviridae family are important causes of those infections; usually as reactivation in an immune suppressed patient. The most important viral infections were caused by reactivation of or reinfection by cytomegalovirus.

Purpose - To analyse prevalence, clinical features and organ involvement in viral infections occuring after heart transplantation. Methods - One hundred consecutive heart transplatation patients were studied. The follow-up was three to 90 (mean 23.32 ± 25.97) months. Viral infections were diagnosed using the Center for Disease Control criteria. Results - Viral infections were responsible for 51 infections, 19.6% of all infections in this patient population. Herpesvirus infections was the most common etiology: 32 (59.25%) of all viral infections were caused by reactivation of or reinfection by cytomegalovirus. Of those infections 27 (84.37%) occurred in the first three weeks following surgery. Only 4 (12.50%) of those showed clinical signs of cytomegalovirus disease. Other herpesvirus causing infections were herpes simplex and varicella-zoster virus. Conclusion - Infections are common after heart transplantation and viral infections of herpesviridae family are important causes of those infections; usually as reactivation in an immune suppressed patient. The most important viral infections were caused by reactivation of or reinfection by cytomegalovirus

Infecçöes pelo vírus herpes simplex: correlaçöes com outras patologias / Herpes simplex virus infection: correlations with others pathologies

A presente revisäo de literatura teve o propósito de estabelecer as correlaçöes existentes entre vários estágios da infecçäo pelo virus herpes simplex com outras patologias discutindo os diversos tratamentos preventivos, profiláticos e terapêuticos existentes, a partir do conhecimento das diversas formas de contágio relacionadas a este tipo de infecçäo

Lupus eritematoso sistémico e infección herpética / Herpetic infection in sistemic lupus erithematosus

Comunicamos la experiencia en el manejo de pacientes con Lupus Eritematoso Sistémico (LES) e infección herpética (IH), de la Unidad de Inmunología y Reumatología del Hospital Nacional Cayetano Heredia, en el período 1985-1991. En esos años se atendieron 135 pacientes lúpicos, de los cuales 15 (11.1 por ciento) presentaron cuadro clínico compatible con IH, trece fueron mujeres. Tres pacientes tenían LES activo; de los doce inactivos ninguno se activó al presentarse la IH. Catorce pacientes se encontraban en tratamiento con prednisona y/o inmunosupresores. Se encontró compromiso dermatomal a nivel cervical, dorsal y lumbar; siendo más frecuente a nivel dorsal bajo y lumbar alto (10/14). En un caso se realizó serología para investigar IH, la cual fue positiva por Elisa para VHS-1, negativa para VHS-2 y VHZ. Concluimos que las IH se presentan mayormente en pacientes con LES inactivo y no modifican el curso de la enfermedad lúpica, tienen un curso clínico favorable, no se observa diseminación de la IH

Características y rol del herpes gluteo en población femenina / Characteristics and role of the gluteal herpes in a female population

Basado en el hecho que el herpes glúteo puede constituir la expresión clínica de la reactividad de un virus Herpes simplex latente a nivel de ganglio sacro, fue nuestro interés investigar en un grupo de mujeres portadoras de infección herpética glútea, las características de la infección, el tipo viral prodominantemente asociado a ella y su posible relación con el herpes genital. Se estudiaron 41 mujeres con herpes glúteo confirmado por laboratorio virológico. El 75,7% de esta población tenía además antecedentes de infección herpética en otra localización fundamentalmente genital. Se detectó un promedio de 7,2 episodios recurrentes al año, con un rango de 1 a 18 episodios anuales. De las cepas aisladas, el 78% fue tipificada como HSV-2 mediante el uso de anticuerpos monoclonales. Se resalta la importancia de considerar el antecedente de herpes glúteo como causal de clasificación de alto riesgo herpético

Carcinoma del cervix durante el embarazo / Carcinoma of the cervix during pregnancy

La presencia de citología cervical anormal durante el embarazo, varía entre 1.26 y 3%, y de los pacientes con carcinoma del cérvix aproximadamente del 1 al 2.8% se encuentran embarazadas. Se ha relacionado al carcinoma de cérvix con la existencia de títulos altos de anticuerpos contra virus herpes tipo 2, demostrándose que existe un 25% de riesgo de desarrollar carcinoma en mujeres que tuvieron infección viral herpética. Se revisan y discuten los medios diagnósticos y el tratamiento de carcinoma de cérvix en mujeres embarazadas