Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the 1987 through 1988 seasonal peak of respiratory syncytial virus (RSV), 177 courses of ribavirin were administered at St Christopher's Hospital for Children, a tertiary care medical center in Philadelphia, Pa. Charts were reviewed on 100 treated patients with proved or suspected RSV disease to determine adherence to American Academy of Pediatrics treatment guidelines. Ninety-four percent fulfilled criteria for the risk of significant morbidity: cardiac, pulmonary, or immunodeficiency conditions (38%); an age of 6 weeks or younger (35%); or severe illness (21%). Severe illness was defined as hypoxemia, hypercapnia, or marked tachypnea. Of those treated because of underlying conditions, 71% had RSV documented, as did 71% of patients aged 6 weeks or younger and 81% of patients with severe disease. A study of 80 consecutive patients who were hospitalized with illness compatible with RSV infection revealed that 56% of patients were treated with ribavirin. Adherence to guidelines led to ribavirin use in half of the hospitalized patients with suspected RSV infection. The majority of these patients received therapy because of underlying conditions or very young age.
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PMID:Impact of treatment guidelines on use of ribavirin. 239 11

Surveillance studies generally have underestimated the importance of viruses in the pathogenesis of nosocomial respiratory tract infections. The development of rapid, sensitive and reliable diagnostic techniques has permitted documentation of viral respiratory pathogens and has led to increased understanding of the epidemiology of these organisms in the hospital. These advances are exemplified by studies of respiratory syncytial virus infections in hospitalized children. The pulmonary sequelae of RSV infection are particularly serious in neonates and in children with underlying cardiopulmonary disease or immunodeficiency. Virus is spread by direct hand contact with the secretions of infected patients or with contaminated objects in the patients' environment. Personnel may infect themselves by rubbing their eyes or nose with contaminated hands, thus becoming vectors in the transmission of RSV to patients under their care. Compliance with contact precautions, which requires the use of gloves and gown, dramatically reduces the incidence of nosocomial RSV infection. When children do become ill, ribavirin may ameliorate the disease. Immunological approaches to treatment and prevention are being examined.
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PMID:Nosocomial viral infections: recent developments and new strategies. 249 55

For 10 winters, 608 children five years old or younger who were hospitalized with respiratory syncytial virus (RSV) infection were prospectively studied to evaluate the relation between their immune status and the severity of their infection. Forty-seven had been immunocompromised by chemotherapy, steroid therapy, or a primary immunodeficiency disorder. Among the immunocompromised children, those receiving chemotherapy for cancer and those with immunodeficiency disease had more severe RSV disease, with pneumonia occurring at all ages, and a higher mortality rate. Children receiving long-term steroid therapy did not appear to have more severe clinical manifestations than normal children. Viral shedding, however, was significantly greater and more prolonged in the children receiving steroid therapy, and particularly in those receiving chemotherapy or with an immunodeficiency disease. Giant-cell pneumonia was documented in one child with leukemia. Over half the immunocompromised children acquired the RSV infection nosocomially. These findings indicate that children receiving chemotherapy for cancer and those with immunodeficiency disease are at risk for complicated or fatal infections from RSV and should be considered for antiviral and other therapies as they become available. Efforts should also be made to protect compromised children if hospitalization cannot be avoided.
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PMID:Respiratory syncytial viral infection in children with compromised immune function. 372 2

The single most important respiratory pathogen in infancy and early childhood is respiratory syncytial virus (RSV). Approximately 40% of primary RSV infections in children result in lower respiratory tract disease. Approximately 1% of RSV-infected children require hospitalization. Especially in high-risk children, primary RSV infection results in significant morbidity and, sometimes, death. This high-risk group includes children with bronchopulmonary dysplasia, children with congenital heart disease, premature infants less than 6 months of age, and children with immunodeficiency diseases. It has been estimated that, in the United States, 14,000 infants with chronic lung disease and 16,400 infants with heart disease will be identified by 12 months of age. More than 91,000 children are hospitalized annually with lower respiratory tract disease caused by RSV, and 4500 deaths occur. In 1985 a report from the Institute of Medicine calculated that the annual hospitalization costs attributable to RSV infection were $300 million. Data collected at the New England Medical Center in 1991 show that the average cost of hospitalization of a child with RSV was $808 each day. Because of difficulty in developing a safe and effective RSV vaccine, attention is now focused on passive immunization using an RSV immune globulin. On the basis of a recently completed multiinstitutional trial, RSV immune globulin appears to be a safe and cost-effective option for prevention of severe RSV disease in high-risk children.
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PMID:Economic impact of viral respiratory disease in children. 816 53

RNA and ribonuclease-resistant RNA analogs that bound and neutralized Rous sarcoma virus (RSV) were isolated from a large pool of random sequences by multiple cycles of in vitro selection using infectious viral particles. The selected RNA pool of RSV-binding sequences at a concentration of 0.16 microM completely neutralized the virus. Of 19 sequences cloned from the selected pool, 5 inhibited RSV infection. The selected RNA and RNA analogs were shown to neutralize RSV by interacting with the virus, rather than by adversely affecting the host cells. The selection of the anti-RSV RNA and RNA analogs by intact virions immediately suggests the potential application of this approach to develop RNA and RNA analogs as inhibitors of other viruses such as human immunodeficiency virus.
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PMID:Isolation of virus-neutralizing RNAs from a large pool of random sequences. 852 93

Respiratory syncytial virus (RSV) infection can be severe in pediatric patients. Risk factors for severe disease include age less than 6 months, prematurity, preexisting heart or lung disease or malformations, gastroesophageal reflux, and immunodeficiency. The aim of the present study was to investigate the influence of family history of allergy on the clinical course of RSV infection in ambulatory and hospitalized infants. In a retrospective study, 172 patients younger than 12 months of age (99 inpatients and 73 outpatients) were enrolled. Information was obtained from hospital charts and from questionnaires sent to pediatricians. Inpatients had a significantly higher rate of atopy in their family history than outpatients, 62% and 29%, respectively (P < 0.001). Bronchiolitis was diagnosed more frequently in patients with an atopic burden than those without, 89% versus 74%, respectively (P < 0.02). Inpatients with an atopic family history had a significantly longer hospital stay than those without such a history, 7.4 +/- 3.7 days and 6.1 +/- 2.3 days, respectively (P < 0.04). Factors other than age that are considered a risk for severe infection with RSV (prematurity, preexisting heart or lung disease or malformation, and gastroesophageal reflux) were not confirmed in the present study. We conclude that infants with a family history of atopy are at increased risk for severe RSV infection as indicated by higher rates of hospitalization, longer hospital stay, and more frequent occurrence of bronchiolitis.
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PMID:Family history of atopy and clinical course of RSV infection in ambulatory and hospitalized infants. 1101 30

(1) RSV infection, the main cause of bronchiolitis, can necessitate hospitalisation, especially of infants at risk, i.e. those with a history of prematurity or bronchodysplasia. No drug prevention has been available. (2) Palivizumab, a monoclonal antibody directed against respiratory syncytial virus (RSV), is now marketed for preventing respiratory tract infection by RSV in certain infants. (3) The evaluation dossier barely answers the questions raised by the use of this drug. (4) The results of six trials suggest that the optimal dose is 15 mg/kg palivizumab by monthly injection throughout the seasonal epidemic period. (5) A double-blind trial in 1 502 infants either aged less than 6 months and born prematurely (35 weeks of gestation or earlier), or aged under 2 years with a history of bronchopulmonary dysplasia, has shown that, relative to a placebo, palivizumab reduces the hospitalisation rates by 5% in absolute values. It does not influence mortality or the need for mechanical ventilation. (6) Given the lack of relevant trials, we do not know if palivizumab is effective in infants with immunodeficiency or congenital heart diseases. We do not know, either, whether the definition of groups at risk used in the only relevant trial is appropriate. (7) No serious adverse effects attributable to palivizumab were reported in clinical trials. (8) Treatment with palivizumab is costly.
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PMID:Palivizumab in prevention of bronchiolitis: new preparation. Moderate efficacy in some infants. 1147 94

The authors assessed RSV infection issues within the Department of Neonatology during the year 2000/2001. The epidemiology, pathology, pathogenesis and the clinical course were discussed. The treatment and prevention patterns have been also presented. There were 5 cases of RSV infection of premature neonates within the Department of Neonatology. One of the mothers was probably the source of infection. The course of infection was described as severe in two infants (diagnosed respiratory insufficiency) and moderate in two other cases (respiratory disorders improved with n-CPAP). The symptoms of disease have been mild only in one case. Prematurity, age between 2-6 months, lung, and heart pathology and immunodeficiency must be considered as negative prognostic factors. Development of vaccination against RSV infection seems to be crucial solution for preterm neonates.
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PMID:[RSV infections in children including managed cases in premature babies]. 1200 57

Respiratory syncytial virus (RSV) is the most common pathogen of the lower respiratory tract in infants. Groups at risk for severe disease include preterm infants, infants with pulmonary disease such as bronchopulmonary dysplasia, infants with congenital heart disease, and infants suffering from immunodeficiency. However, most infants getting severely ill from RSV are otherwise healthy and born at term. The incidence of hospitalisation caused by RSV is increasing, and there is an association between diagnosed RSV infection and subsequent development of wheeze and asthma. No vaccine or causal therapy is available. However, prophylaxis with a humanized monoclonal antibody of murine origin, palivizumab, reduces the risk of hospitalisation in high-risk infants, but the treatment is expensive. The most important prophylaxis methods at the present time are therefore hygienic measures with the purpose of preventing nosocomial infection in hospitals.
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PMID:[Respiratory syncytial virus]. 1252 6

Respiratory syncytial virus (RSV) is the most important cause of lower respiratory tract infection in infants and young children. Around 20 000 RSV-infected infants require hospitalization in the UK during each yearly epidemic, which is about 3% of the birth cohort. Most children are infected by 2 years of age. Risk factors for severe disease include young infants, prematurity, chronic lung and cardiac conditions or immunodeficiency. Humoral immunity is incomplete and short-lived, yet reinfections cause less severe disease. RSV infects infants despite the presence of specific neutralizing antibodies. RSV infection can be linked to the development of individual wheezing episodes. A competent cellular immune system is necessary to reduce disease severity. RSV infection provokes an RSV-specific T-lymphocyte response with the release of cytokines. There is a delicate balance between the protective and disease-enhancing effects of the host's immune response to RSV infection.
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PMID:Basic epidemiology and immunopathology of RSV in children. 1253 Oct 81


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