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Risk Factors for Adverse Outcomes in Cancer Patients With Sepsis.

BACKGROUND: Cancer and its various treatment modalities increase susceptibility to the development of sepsis. Because of the complex relationship between sepsis and cancer, we aimed to study the differences in risk factors and outcomes of sepsis in patients with cancer (SCa) compared to patients without cancer (SnoCa). METHODS: A retrospective cohort analysis of all adult patients who received care for sepsis in an urban tertiary healthcare center was conducted. Risk factors and outcomes were compared between the SCa and SnoCa groups. RESULTS: SCa group (n = 310) was older than SnoCa group (

The Risk of Sarcoidosis Misdiagnosis and the Harmful Effect of Corticosteroids When the Disease Picture Is Incomplete.

Sarcoidosis is a complex granulomatous disease of unknown etiology. Due to the heterogeneity of the disease, the diagnosis remains challenging in many cases, often at the physician's discretion, requiring a thorough and complex investigation. Many other granulomatous diseases have the potential to mimic sarcoidosis, whether infectious, occupational, or autoimmune diseases and starting an unnecessary corticosteroid treatment can worsen the patient's prognosis, leading to side effects that can be harder to treat than the actual disease.

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… variable immunodeficiency syndrome (CVID). 4.1. … Common Variable Immunodeficiency Syndrome (CVID) Common variable immunodeficiency syndrome is a heterogeneous disease that represents the most frequent form of primary immunodeficiency. …

End-stage kidney disease and rationing of kidney replacement therapy in the free state province, South Africa: a retrospective study.

BackgroundEnd-stage kidney disease (ESKD) and the required kidney replacement therapy (KRT) are significant public health challenges for low-and-middle-income countries. The South African government adopted a KRT rationing policy to balance the growing need for KRT and scarce resources. We aimed to describe the epidemiology and KRT access in patients with ESKD referred to the main public sector hospital in the Free State Province, South Africa.MethodsA retrospective study of adult patients with ESKD admitted to Universitas Academic Hospital for KRT, was conducted between 1 January 2016 and 31

Evans syndrome: clinical perspectives, biological insights and treatment modalities.

Evans syndrome (ES) is a rare and chronic autoimmune disease characterized by autoimmune hemolytic anemia and immune thrombocytopenic purpura with a positive direct anti-human globulin test. It is classified as primary and secondary, with the frequency in patients with autoimmune hemolytic anemia being 37%-73%. It predominates in children, mainly due to primary immunodeficiencies or autoimmune lymphoproliferative syndrome. ES during pregnancy is associated with high fetal morbidity, including severe hemolysis and intracranial bleeding with neurological sequelae and death. The clinical presenta

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… variable immunodeficiency and Evans syndrome complicated by autoimmune hemolysis due to anti-Jka auto-antibodies Leuk Lymphoma 2008 49 6 1220 1222 18452064 10.1080/10428190801993488 39 Azizi G Abolhassani H Asgardoon MH Autoimmunity in common variable immunodeficiency: epidemiology, pathophysiology … Y Increased lymphocyte Fas expression and high incidence of common variable immunodeficiency disorder in childhood Evans’ syndrome Clin Immunol 2007 125 3 224 229 17936685 10.1016/j.clim.2007.08.010 42 Paaske H Srensen CW Astrup L Evans’ syndrome in IgA deficiency. …

The Expanding Field of Secondary Antibody Deficiency: Causes, Diagnosis, and Management.

Antibody deficiency or hypogammaglobulinemia can have primary or secondary etiologies. Primary antibody deficiency (PAD) is the result of intrinsic genetic defects, whereas secondary antibody deficiency may arise as a consequence of underlying conditions or medication use. On a global level, malnutrition, HIV, and malaria are major causes of secondary immunodeficiency. In this review we consider secondary antibody deficiency, for which common causes include hematological malignancies, such as chronic lymphocytic leukemia or multiple myeloma, and their treatment, protein-losing states, and side

Multiple Myeloma: A Review of the Literature and a Case Report Highlighting the Immunocompromised State of Myeloma Patients.

Multiple myeloma (MM), a malignancy involving plasma cells, disproportionately affects older adults with an average age of diagnosis of about 70 years. Oftentimes, the therapies used in the treatment of MM are associated with a risk for immunotoxicity, lowering the ability of the immune system to fight off opportunistic infections. This is an important relationship for clinicians to realize as the incidence of opportunistic infections in myeloma patients is increasing. As an example, we present a case of a patient with MM who subsequently developed a cryptococcal infection. Our paper will high

Subcutaneous Administration of Biotherapeutics: An Overview of Current Challenges and Opportunities.

Subcutaneous delivery of biotherapeutics has become a valuable alternative to intravenous administration across many disease areas. Although the pharmacokinetic profiles of subcutaneous and intravenous formulations differ, subcutaneous administration has proven effective, safe, well-tolerated, generally preferred by patients and healthcare providers and to result in reduced drug delivery-related healthcare costs and resource use. The aim of this article is to discuss the differences between subcutaneous and intravenous dosing from both health-economic and scientific perspectives. The article c

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… A systematic review of studies comparing the efficacy and safety of IVIG and SCIG was conducted based on data from 1028 eligible patients receiving immunoglobulin replacement (67.7% were adults, 56.3% had a diagnosis of common variable immunodeficiency). …

Liver Disease Associated with Non-Hepatitis Viruses

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Effect of Intravenous Immunoglobulin (IVIG) Supplementation on infection-free survival in recipients of BCMA-directed bispecific antibody therapy for multiple myeloma.

The main objective of this multi-institutional study is to understand the effect of primary intravenous immunoglobulin (IVIG) replacement on clinical outcomes in recipients of BCMA-directed bispecific antibody (bsAb), where infection remains an important cause of morbidity and mortality. This is a retrospective study of patients treated with either standard of care teclistamab or BCMA-directed investigational bsAb between Nov 2017 and Dec 2023. Primary IVIG prophylaxis was defined as starting IVIG prior to first documented infection. All analyses were adjusted for immortal-time bias inherent i

Causes of Moderate and Severe Anaemia in a High-HIV and TB-Prevalent Adult Population in the Eastern Cape Province, South Africa.

BACKGROUND: Anaemia affects one in four adults in South Africa, with a higher prevalence in persons with HIV and tuberculosis. The aim of this study is to characterise the causes of anaemia in primary care and a district hospital setting. METHODS: A cross-sectional study design investigated a purposive sample of adult males and non-pregnant females at two community health centres and a hospital casualty and outpatients. Fingerpick blood haemoglobin was measured with HemoCueHb201+. Those with moderate and severe anaemia underwent clinical examination and laboratory tests. RESULTS: Of 1327 pat

Should treatment of hypogammaglobulinemia with immunoglobulin replacement therapy (IgRT) become standard of care in patients with chronic lymphocytic leukemia?

Hypogammaglobulinemia (HGG) is a frequent finding in patients with hematological malignancies, and is commonly described in chronic lymphocytic leukemia (CLL) before or after treatment. We reviewed published literature available online in the last thirty years through Medline search of indexed articles focusing on the main differences and advantages of the products now available on the market, namely intravenous Ig (IVIg) and subcutaneous Ig (SCIg) preparations. IgRT is effective and safe in the prophylaxis of infections in a selected group of patients with CLL and hypogammaglobulinemia and is

Monoclonal antibody and protein therapeutic formulations for subcutaneous delivery: high-concentration, low-volume vs. low-concentration, high-volume.

Biologic drugs are used to treat a variety of cancers and chronic diseases. While most of these treatments are administered intravenously by trained healthcare professionals, a noticeable trend has emerged favoring subcutaneous (SC) administration. SC administration of biologics poses several challenges. Biologic drugs often require higher doses for optimal efficacy, surpassing the low volume capacity of traditional SC delivery methods like autoinjectors. Consequently, high concentrations of active ingredients are needed, creating time-consuming formulation obstacles. Alternatives to tradition

Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview.

Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors pre

Реальное воздействие NVX-CoV2373 COVID-19 вакцина для иммунокомпромиссных людей в Южной Корее.

BackgroundNVX-CoV2373 - наночастица, белковая COVID-19 вакцина. Лица, страдающие от иммунокомпрометированных заболеваний, подвергаются высокому риску инфицирования и серьезных заболеваний; однако в реальном мире NVX-CoV2373 Цель настоящего исследования состояла в том, чтобы оценить, являются ли данные о воздействии в МКС ограниченными. NVX-CoV2373 снижение риска SARS-CoV-2 :: инфекция и серьезные заболевания в ИМС по сравнению с лицами, не имеющими иммунокомпромиссных свойств (не связанными с ИС). Южнокорейский МКС в возрасте ≥12 лет, которые получили первичную серию, третью дозу или четвертую

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… status (Z94.7) Other transplanted organ and tissue status (Z94.8) Transplanted organ and tissue status, unspecified (Z94.9) | 1682 (0.5) Other intrinsic immune condition/immunodeficiency | Immunodeficiency with predominantly antibody defects (includes conditions such as X-linked agammaglobulinemia and common … variable immunodeficiency; D80) Combined immunodeficiencies (e.g., severe combined immunodeficiency; D81) Immunodeficiency associated with other major defects (e.g., DiGeorge syndrome; D82) Common variable immunodeficiency (D83) Other immunodeficiencies (e.g., selective IgA deficiency; D84) Functional …

Real-world effectiveness of immunoglobulin replacement for hypogammaglobulinemia and infections in multiple myeloma.

AbstractThis study assessed the real-world effectiveness of immunoglobulin replacement therapy (IgRT) for treatment of hypogammaglobulinemia and infections in patients with multiple myeloma (MM). A retrospective study was conducted on adult patients diagnosed with MM on or after 1 January 2010 using the Mass General Brigham Research Patient Data Registry. Infections were compared before and after IgRT initiation. Generalized estimating equation logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). In patients with accessible serum protein elect

Secondary Neutropenias.

Neutrophils are a critical component of immunity, particularly against bacteria and other pathogens, but also in inflammation and tissue repair. As a consequence, individuals with neutropenia, defined by a reduction in absolute neutrophil counts, exhibit a strong propensity to severe infections that typically present with muted symptoms. Neutropenias encompass a heterogeneous set of disorders, comprising primary neutropenias, in which specific genes are mutated, and the more common secondary neutropenias, which have diverse non-genetic causes. These include hematological and other cancers, inv

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… Primary immunodeficiencies have also been implicated in secondary neutropenia that has been attributed to impacts on neutrophil survival and/or development [ 52 ], such as in the context of common variable immunodeficiency (CVID) [ 55 ]. … Common variable immunodeficiency: Autoimmune cytopenias and advances in molecular diagnosis. Hematol. Am. Soc. Hematol. Educ. Program. 2019;2024:137–142. doi: 10.1182/hematology.2024000538. 56. Walkovich K., Boxer L.A. How to approach neutropenia in childhood. Pediatr. …

Secondary Immunodeficiency in Hematological Malignancies: Focus on Multiple Myeloma and Chronic Lymphocytic Leukemia.

Secondary immunodeficiency is reported in most patients with hematological malignancies such as chronic lymphocytic leukemia and multiple myeloma. The aim of our review was to evaluate the existing literature data on patients with hematological malignancies, with regard to the effect of immunodeficiency on the outcome, the clinical and therapeutic approach, and on the onset of noninfectious complications, including thrombosis, pleural effusion, and orofacial complications. Immunodeficiency in these patients has an intense impact on their risk of infection, in turn increasing morbidity and mort

Impact of germline predisposition genes to hematologic malignancies on transplant outcomes and donor selection.

INTRODUCTION: Germline predisposition gene mutations may influence outcomes in patients undergoing hematopoietic stem cell transplantation (HSCT). METHODS: This retrospective study of 558 patients undergoing HSCT (allo-HSCT in 557 cases, auto-HSCT in 1 case) evaluated the impact of germline predisposition gene mutations on outcomes. RESULTS: Enrichment of HAVCR2 mutations in B-NHL and UNC13D mutations in MDS was associated with poorer prognosis. While homozygous mutation carriers (7.5%) overall did not have reduced survival, their outcomes were significantly better with unrelated versus rela

Impact of Thrombopoietin Receptor Agonists on Pathophysiology of Pediatric Immune Thrombocytopenia.

Immune thrombocytopenia (ITP) in pediatric patients is a common cause of isolated thrombocytopenia. Various pathophysiological mechanisms are implicated in ITP pathogenesis, including the production of autoantibodies against components of platelets (PLTs) by B-cells, the activation of the complement system, phagocytosis by macrophages mediated by Fcγ receptors, the dysregulation of T cells, and reduced bone marrow megakaryopoiesis. ITP is commonly manifested with skin and mucosal bleeding, and it is a diagnosis of exclusion. In some ITP cases, the disease is self-limiting, and treatment is not

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… Testing for common variable immunodeficiency with measurement of quantitative immunoglobulins (Ig IgG, IgA, IgM) is recommended for children with ITP [ 28 , 29 ]. … Pathogenesis of Immune Thrombocytopenia in Common Variable Immunodeficiency. Autoimmun. Rev. 2020;19:102616. doi: 10.1016/j.autrev.2020.102616. 30. Demir S., Keskin A., Sağ E., Kaya Akca Ü., Atalay E., Cüceoğlu M.K., Batu Akal E.D., Özen S., Bilginer Y. …

Profile of elderly patients receiving antiretroviral therapy at Newlands Clinic in 2020: A cross-sectional study.

BACKGROUND: People living with HIV (PLWH) face new challenges such as accelerated ageing and higher rates of comorbidities including cardiovascular, renal and metabolic diseases as they age. OBJECTIVES: To profile the demographic and clinical characteristics of elderly patients receiving HIV care at Newlands Clinic (NC), Harare, Zimbabwe, as of 01 October 2019. METHODS: A cross-sectional analysis was conducted using clinic data. All patients who were 50 years and older on 01 October 2019 were enrolled. Descriptive statistics (medians, interquartile ranges [IQRs] and proportions) were used to