12 research outputs found
Two cases of aspergillus endocarditis in non neutropenic children on chemotherapy for acute lymphoblastic leukaemia.
Fungal endocarditis (FE) is a rare complication in immunocompromised patients which is difficult to diagnose and has been characterized by excessive mortality (> 50%) and morbidity, regardless of treatment. The lack of clinical trials due to the small number of cases contributes further to a poor outcome. In our two cases of aspergilllus endocarditis we reviewed the clinical features, echocardiographic findings, microbiologic data, treatment, and outcome of these 2 cases and provide a current characterization of the syndrome. In this paper we have demonstrated the diversity of presentation of a critical fungal infection in immunocompromised but non neutropenic paediatric patients. The prompt diagnosis and initiation of treatment is crucial for a favourable outcome along with the use of double antifungal treatment with liposomal amphotericin and voriconazole initially which could be later switched to oral voriconazole with a good tissue penetration. Histological samples as well as radiological evidence and echocardiograms should be reviewed by experienced clinicians in order to aid diagnosis and promptly initiate treatment for these patients in order to achieve a favourable outcom
Routine management, healthcare resource use and patient and carerâreported outcomes of patients with transfusionâdependent ÎČâthalassaemia in the United Kingdom: A mixed methods observational study
Abstract Objectives We evaluated routine healthcare management, clinical status and patientâ and carerâreported outcomes in UK paediatric and adult patients with transfusionâdependent ÎČâthalassaemia (TDT). Methods A multiâcentre, observational mixedâmethodology study evaluated 165 patients (50% male; median age 24.1 [interquartile range (IQR)] 11.8â37.2] years) from nine UK centres. Results Patients had a mean of 13.7 (standard deviation [SD] ±3.2) transfusion episodes/year (mean retrospective observation period 4.7 [±0.7] years). The median (IQR) for iron overload parameters at the last assessment during the observation period were: serum ferritin (n = 165) 1961.0 (1090.0â3003.0) ÎŒg/L (38% > 2500 Όg/L); R2 liver iron (n = 119) 5.4 (2.9â11.6) mg/g (16% â„15 mg/g); T2* cardiac iron (n = 132) 30.3 (22.0â37.1) ms (10% < 10 ms). All patients received â„1 iron chelator during the observation period; 21% received combination therapy. Patients had a mean of 7.8 (±8.1) nonâtransfusionârelated hospital attendances or admissions/year. Adult patientsâ mean EQâ5D utility score was 0.69 (±0.33; n = 94 [â„16 years]) and mean Transfusionâdependent quality of life score was 58.6 (±18.4; n = 94 [â„18 years]). For Work Productivity and Activity impairment, mean activity impairment for patients â„18 years (n = 88) was 48% (±32%) and for carers (n = 29) was 28% (±23%). Conclusions TDT presents significant burden on patients, carers and healthcare resources
UK experience of unrelated cord blood transplantation in paediatric patients
No abstract available