Cytomegalovirus Immune Globulin Intravenous(Human)
(CMV-IGIV) is an immunoglobulin G (IgG) containing a standardized amount of antibody to Cytomegalovirus (CMV). It may be used for the prophylaxis of cytomegalovirus disease associated with transplantation of kidney, lung, liver, pancreas, and heart.
Alone or in combination with an antiviral agent, it has been shown to:
• Reduce the risk of CMV-related disease and death in some of the highest-risk transplant patients
• Provide a measurable long-term survival benefit
• Produce minimal treatment-related side effects and adverse events.
Symptoms of Cytomegalovirus Infection
Most adults exhibit mild, nonspecific clinical signs and symptoms, or none at all. Some adults develop mononucleosis with 2 weeks of irregular high fever.
Immunodeficient patients and those receiving immunosuppressive therapy may develop symptoms of pneumonia (such as fever, cough, or dyspnea), or symptoms of other secondary infections, as mentioned above.
Nyctalopia is a condition making it difficult or impossible to see in relatively low light. It is a symptom of several eye diseases. Night blindness may exist from birth, or be caused by injury or malnutrition (for example, a lack of vitamin A).
The most common cause of nyctalopia is retinitis pigmentosa, a disorder in which the rod cells in the retina gradually lose their ability to respond to the light. Patients suffering from this genetic condition have progressive nyctalopia and eventually their daytime vision may also be affected. In X-linked congenital stationary night blindness, from birth the rods either do not work at all, or work very little, but the condition doesn't get worse. Another cause of night blindness is a deficiency of retinol, or vitamin A, found in fish oils, liver and dairy products. In the Second World War disinformation was used by the British to cover up the reason for their pilots' successful nighttime missions. Their success was, in the disinformation, attributed to improved night vision and pilots flying night missions were encouraged to eat plenty of carrots, which contain carotenoids and can be converted into retinol.[citation needed] The real reason for their success was their use of advanced radar technologies.
The opposite problem, known as hemeralopia, is much rarer.
The outer area of the retina is made up of more rods than cones. The rod cells are the cells that enable us to see in poor illumination. This is the reason why loss of side vision often results in night blindness. Individuals suffering from night blindness not only see poorly at night, but also require some time for their eyes to adjust from brightly lit areas to dim ones. Contrast vision may also be greatly reduced.
Refractive "vision correction" surgery is a widespread cause of nyctalopia due to the impairment of contrast sensitivity function (CSF) which is induced by intraocular light-scatter resulting from surgical intervention in the natural structural integrity of the cornea.
Night blindness is much more common among men than women
Causes
• Vitamin A deficiency
• retinitis pigmentosa
• congenital night blindness
• Sorsby's fundus dystrophy
• pathological myopia
• peripheral cortical cataract
• oguchi disease
• refractive surgery (RK, PRK, LASIK)
Transverse myelitis: A disease of the spinal cord in which there is demyelination (erosion of the myelin sheath that normally protects nerve fibers). The onset of the disorder is typically sudden. Symptoms include back pain followed by ascending weakness in the legs. There is no cure. Many patients are left with permanent disabilities or paralysis. Transverse myelitis occurs alone and in combination with demyelination of other parts of the nervous system. It may be associated with multiple sclerosis.
Transverse myelitis can cause low back pain, spinal cord dysfunction, muscle spasms, a general feeling of discomfort, headache, loss of appetite, and numbness or tingling in the legs. Almost all patients develop leg weakness. The arms are involved in a minority of cases. (This depends upon the level of spinal cord involvement.) Sensation, pain and temperature sensation are typically diminished below the level of spinal cord involvement. Appreciation of vibration and joint position sense may also be decreased. Bladder and bowel sphincter control is disturbed in the majority of cases. Many patients with transverse myelitis report a tight banding or girdle-like sensation around the trunk and that area may be very sensitive to touch.
Transverse myelitis may be caused by viral infections, spinal cord injuries, immune disorders (including systemic lupus erythematosus, Sjogren's syndrome, sarcoidosis and multiple sclerosis) or insufficient blood flow through the blood vessels in the spinal cord. It may occur as a complication of such disorders as optic neuromyelitis, multiple sclerosis, smallpox, and measles, or as a complication of chickenpox or rabies vaccinations.
The infectious agents associated with transverse myelitis include viruses and bacteria: herpes simplex, herpes zoster, cytomegalovirus, Epstein-Barr virus, enteroviruses (poliomyelitis, Coxsackie virus, echovirus), human T-cell leukemia virus, human immunodeficiency virus (HIV), influenza, measles, and rabies, Mycoplasma pneumoniae, Lyme borreliosis, syphilis, and tuberculosis.
There is no specific treatment for transverse myelitis. The prognosis for complete recovery from transverse myelitis is generally not good. Although recovery usually begins between 2 and 12 weeks after onset and may continue for up to 2 years, most individuals are left with considerable disability. Some individuals may have minor or no deficits, while others may have significant motor, sensory, and sphincter (bowel) deficits or no recovery at all.
Gaucher's disease is a genetic disease in which a fatty substance (lipid) accumulates in cells and certain organs. Gaucher's disease is the most common of the lysosomal storage diseases.[1]:536 It is caused by a hereditary deficiency of the enzyme glucocerebrosidase (also known as acid ß-glucosidase). The enzyme acts on a fatty substance glucocerebroside (also known as glucosylceramide). When the enzyme is defective, the substance accumulates, particularly in cells of the mononuclear cell lineage. Fatty material can collect in the spleen, liver, kidneys, lungs, brain and bone marrow.
Signs and symptoms
• Painless hepatomegaly and splenomegaly; the size of the spleen can be 1500-3000 ml, as opposed to the normal size of 50-200 ml.
• Hypersplenism: the rapid and premature destruction of blood cells, leading to anemia, neutropenia and thrombocytopenia (with an increased risk of infection and bleeding)
• Cirrhosis of the liver is rare
• Neurological symptoms occur only in some types of Gaucher's (see below):
o Type II: serious convulsions, hypertonia, mental retardation, apnea.
o Type III: muscle twitches known as myoclonus, convulsions, dementia, ocular muscle apraxia.
• Osteoporosis: 75% develop visible bony abnormalities due to the accumulated glucosylceramide. A deformity of the distal femur in the shape of an Erlenmeyer flask is commonly described (aseptic necrosis of the femur joint).
• Yellowish-brown skin pigmentation
Treatment
Previously, severe cases of Type I Gaucher's disease were treated by spleen removal and bone marrow transplants, both of which carry substantial risks. Purification of adequate quantities of alglucerase (glucocerebrosidase-beta-glucosidase) has allowed intravenous administration on a regular basis. The drug reduces the body's total supply of glycolipid and improves symptoms. Unfortunately, it is an exceptionally expensive drug.
B-cell chronic lymphocytic leukemia (B-CLL), also known as chronic lymphoid leukemia (CLL), is the most common type of leukemia. Leukemias are abnormal and malignant neoplastic proliferations ("cancers") of the white blood cells (leukocytes). CLL involves a particular subtype of white blood cells, which is a lymphocyte called a B cell. B cells originate in the bone marrow, develop in the lymph nodes, and normally fight infection. In CLL, the DNA of a B cell is damaged, so that it can't fight infection by producing antibodies. Additionally, they grow out of control and accumulate in the bone marrow and blood, where they crowd out healthy blood cells.
CLL is a disease of adults, but in rare cases it can occur in teenagers and occasionally in children (inherited). Most (>75%) people newly diagnosed with CLL are over the age of 50, and the majority are men.
Symptoms and signs
Most people are diagnosed without symptoms as the result of a routine blood test that returns a high white blood cell count. Uncommonly, CLL presents as enlargement of the lymph nodes without a high white blood cell count or no evidence of the disease in the blood. This is referred to as small lymphocytic lymphoma. In some individuals the disease comes to light only after the neoplastic cells overwhelm the bone marrow resulting in anemia producing tiredness or weakness.
CLL TREATMENT
CLL treatment focuses on controlling the disease and its symptoms rather than on an outright cure. CLL is treated by chemotherapy, radiation therapy, biological therapy, or bone marrow transplantation. Symptoms are sometimes treated surgically (splenectomy removal of enlarged spleen) or by radiation therapy ("de-bulking" swollen lymph nodes).
Initial CLL treatments vary depending on the exact diagnosis and the progression of the disease, and even with the preference and experience of the health care practitioner. There are dozens of agents used for CLL therapy, and there is considerable research activity studying them individually or in combination with each other.
