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Despite increasing intensity and profound immunosuppression associated with newer therapies for hematologic malignancies, little information exists regarding cytomegalovirus (CMV) reactivation in settings other than allogeneic stem cell transplantation (SCT).
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Intravenous, oral, or intravitreal antiviral medications, including acyclovir, valacyclovir, famciclovir, valganciclovir, ganciclovir, and foscarnet; prophylactic laser retinopexy; aspirin; oral steroids.
Neuropsychiatric symptoms related to aciclovir or valaciclovir treatment have been a problem since aciclovir was introduced in the early 1980s. We have previously found that subjects with aciclovir-related neuropsychiatric symptoms have increased serum concentrations of aciclovir's main metabolite, 9-carboxymethoxymethylguanine (CMMG). The aim of this study was to investigate whether CMMG was present in the CSF of aciclovir- or valaciclovir-treated subjects with or without neuropsychiatric side effects that appeared during therapy.
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ISRCTN Registry identifier: ISRCTN79871784 . Registered on 2 May 2013.
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The authors report on the first known case of valacyclovir-induced psychosis with symptoms of mania in a young woman with no previous psychiatric history.
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Bell's palsy (BP) is the most frequent form of peripheral palsy of the facial nerve. Prognosis for recovery is good for most patients; in the remaining cases, different grades of residual impairment persist. Physical therapy, in association with drug administration, aims to improve outcomes.
To determine the intestinal absorption capacity, pharmacokinetic studies and an in situ loop assay were used. The intestinal permeability was measured by a Caco-2 Transwell model. Real time PCR and Western blots were applied to detecting the expression changes of cell junction genes.
Participants took the first drug for 28 days followed by 28 days of washout before taking the second drug for 28 days. Throughout treatment, the participants collected genital swabs 4 times daily for testing by HSV polymerase chain reaction assays.
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The Albion Street Centre was established in 1985 as an HIV testing and early management center. More than 22,000 people have been screened for HIV and other blood-borne infections at the Centre, and approximately 3,600 people with HIV/AIDS have been managed there. Approximately 1,600 patients with various stages of HIV disease are currently managed at the Centre by a staff of 60 health care professionals and about 1,000 volunteers. The Albion Street Centre's computer database began recording selected demographic, epidemiologic, clinical, and laboratory characteristics when the first patient presented in 1985. Since then, the complexity and utilization of the database has increased in parallel with improvement in the understanding of the natural history and pathogenesis of HIV infection. Over 100 peer-reviewed publications and presentations have been produced from the database and 45 clinical trials have used the database to identify potential subjects. All data are de-identified and are protected by multiple password codes. Approximately 700 variables are collected from each HIV-positive patient at the initial visit to the Centre and up to 200 variables are added at each subsequent routine clinic visit. The variables collected include the following: standard epidemiologic characteristics; transmission and behavioral parameters, clinical signs and symptoms; laboratory test results; treatments; nutritional history; body composition parameters; psychological assessment results; and management history, including neuropsychological testing. The overall number and characteristics of patients recorded in the database are reported monthly, and are used to plan services, for prevention and educational programs, and as an indicator of the effectiveness of campaigns to encourage HIV-positive people to attend clinics for early management. When these patients have been identified they are invited to participate in the study. Individual patient records are identified and accessed if they meet certain criteria for flagging. For example, patients who have lost more than 5% of their maximal weight are flagged and referred to the dietician for assessment. Further uses for the database are to identify cohorts of patients who are seroconverters and to follow their natural history-the Centre has over 250 patients for whom a documented HIV-positive test has been obtained within 12 months of a documented HIV-negative test; to investigate clinical observations that have been associated with particular drug therapy, e.g., investigation of the reported association between the use of valacyclovir and the thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS)-like complex showed patients with terminal-stage AIDS demonstrated this syndrome independently of their therapy and probably as a consequence of multiorgan failure; and to document the relationship between nutritional intervention and survival, for which use of the database enabled an historical cohort that matched the cases under investigation to be selected. In conclusion, the database is a dynamic and integral part of the assessment, management, and research program of the Albion Street Centre, where it is used by all professional staff.
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Both herpes simplex virus (HSV) type I and HSV type 2 can cause genital herpes. Because the infection is chronic, genital herpes has become the most common sexually transmitted disease among women. The prevalence of the HSV-2 antibody among women in the United States is 26%, although genital herpes has been diagnosed in only a small proportion (10-25%) of individuals with HSV-2 antibodies. Herpes simplex virus type I is becoming a more frequent cause of genital herpes, especially among young women. Overall,HSV-I seroprevalence in the United States is estimated at 67%, although sero-logic data do not provide information about site of infection. Recent advances in diagnostic methods and therapeutic options are likely to change the management of genital herpes.
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A 63-year-old patient with Good syndrome presented with bilateral necrotizing retinitis starting from the posterior pole. He had a history of thymoma status post thymectomy 4 years previously, left-sided sinusitis, and recent pulmonary aspergillosis. Qualitative PCR was performed on aqueous fluid.
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Fifty-nine patients (29 in Arm A, 26 in Arm B, and 4 in Arm C) completed the trial. The median age was 68 years (range, 39-85 years). The median follow-up for the entire group was 13.5 months (range, 1.4-27.8 months). Only Arm A patients were observed to have an increase in PSA on Day 14. The PSA then declined appropriately. All patients in Arm A (median follow-up, 13.4 months) and Arm B (median follow-up, 13.9 months) had biochemical control at last follow-up. Three patients in Arm C (with pretreatment PSA of 335, 19.6, and 2.5 ng/mL and a combined Gleason score of 8, 9, and 9 involving all biopsy cores) had biochemical failure at 3, 3, and 7.7 months. Two patients had distant failure in bone and 1 patient in the para-aortic lymph nodes outside the RT portal. Six to twelve prostate biopsies performed in these 3 patients revealed no evidence of residual carcinoma. In Arm A, biopsy showed no evidence of carcinoma in 66.7% (18 of 27), 92.3% (24 of 26), 91.7% (11 of 12), 100% (8 of 8), and 100% (6 of 6) at 6 weeks, 4 months, 12 months, 18 months, and 24 months after treatment, respectively. In Arm B, no evidence of carcinoma on biopsy was noted in 96% (24 of 25), 90.5% (19 of 21), 100% (14 of 14), 100% (7 of 7), and 100% (2 of 2), respectively, in the same interval after treatment.
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BAY 57-1293 may be more effective than valacyclovir, without the cytotoxicity or potential healing retardation seen with trifluridine. Oral BAY 57-1293 may be a substitute for eye drops as an effective treatment for herpetic keratitis and might be useful in treating stromal keratitis and iritis, as well as preventing recurrences of ocular herpes.
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It has been postulated from virologic studies that herpesvirus infection could play a role in the progression of MS.
On 7 October 2014 we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, DARE, NHS EED, and HTA. We also reviewed the bibliographies of the identified trials and contacted trial authors and known experts in the field and relevant drug companies to identify additional published or unpublished data. We searched clinical trials registries for ongoing studies.
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Suicide gene therapy with TK is under investigation in a variety of solid tumors. Replacing ACV by VCV will offer a cost-effective alternative and will significantly reduce duration of hospital stay improving quality of life and facilitating an outpatient gene therapy concept.
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Valacyclovir significantly decreased early breast milk and plasma HIV-1 RNA among women receiving PMTCT.
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Valacyclovir was 100% effective in the prevention of HSV reactivation in both regimens with no adverse effects reported.
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Fetal viral load and drug concentration were monitored in amniotic fluid and in fetal blood. Data on the course and outcome of a group of untreated symptomatic fetuses infected with CMV are also reported.
In both cases, there were no hypersensitivity reactions or breakthrough viral infections after famciclovir initiation but this observation is limited by a small patient population.
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To report a case of herpetic optic neuritis associated with herpetic keratitis.
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A 58-year old lady under active follow-up with the respiratory services at our institution for bronchiectasis secondary to hypogammaglobulinaemia presented with hoarseness and haemoptysis. She was also receiving rituximab maintenance therapy for follicular lymphoma. Bronchoscopy demonstrated vesicular lesions on her vocal cords and trachea, confirmed as herpes simplex virus (HSV) on cytological analysis of brushings. She responded well to intravenous valacyclovir. Rituximab is increasingly utilised in the treatment of haematological and auto-immune disorders. This case highlights the potential of this drug to potentiate susceptibility to infection in an already immunocompromised individual.
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A 7-day regimen of valacyclovir 500 mg BID will reduce the length of time until clinical clearance of an outbreak of recurrent HG. Its usage reduced duration of viral presence by 21%.
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Data were extracted from the Scandinavian Bell's palsy study, which included 829 patients. The study design was factorial; 416 patients given prednisolone, 413 not given prednisolone, 413 patients given valacyclovir, 416 not given valacyclovir. Data were analyzed with intention-to-treat principle and complete-case analysis methods and recovery was defined as Sunnybrook score 100, House-Brackmann grade I or < or =grade II at 12 months.
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We searched Medline and EMBASE until September 2010 using PubMed and Elsviere search engines. A network meta-analysis was performed to assess disease recovery using a mixed effects hierarchical model. Goodness of fit of the model was assessed, and the pooled odds ratio (OR) and 95% confidence interval (CI) were estimated.
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No dosage adjustment is required when valaciclovir and digoxin are coadministered.