Cytomegalovirus Immunoglobulin After Thoracic Transplantation: An Overview

Cytomegalovirus (CMV) is a highly complex pathogen which, despite modern prophylactic regimens, continues to affect a high proportion of thoracic organ transplant recipients. The symptomatic manifestations of CMV infection are compounded by adverse indirect effects induced by the multiple immunomodulatory actions of CMV. These include a higher risk of acute rejection, cardiac allograft vasculopathy after heart transplantation, and potentially bronchiolitis obliterans syndrome in lung transplant recipients, with a greater propensity for opportunistic secondary infections. Prophylaxis for CMV using antiviral agents (typically oral valganciclovir or intravenous ganciclovir) is now almost universal, at least in high-risk transplants (D+/R-). Even with extended prophylactic regimens, however, challenges remain. The CMV events can still occur despite antiviral prophylaxis, including late-onset infection or recurrent disease, and patients with ganciclovir-resistant CMV infection or who are intolerant to antiviral therapy require alternative strategies. The CMV immunoglobulin (CMVIG) and antiviral agents have complementary modes of action. High-titer CMVIG preparations provide passive CMV-specific immunity but also exert complex immunomodulatory properties which augment the antiviral effect of antiviral agents and offer the potential to suppress the indirect effects of CMV infection. This supplement discusses the available data concerning the immunological and clinical effects of CMVIG after heart or lung transplantation

Poems, letters and prose fragments of Kirke White /

Mode of access: Internet.

The Gests of King Alexander of Macedon; two middle-English alliterative fragments, Alexander A and Alexander B,

"Previous editions": p. 14-15.

An examination of the Shelley manuscripts in the Bodleian Library : being a collation therof with the printed texts, resulting in the publication of several long fragments hitherto unknown, and the introduction of many improved readings into Prometheus unbound, and other poems /

Mode of access: Internet.

Biographical sketches of Bath celebrities, ancient and modern : with some fragments of local history /

Includes index.

Les bronzes d'Osuna; fragments nouvellement découverts de la loi coloniale de Genetiva Juliae.

Mode of access: Internet.

King Horn : with fragments of Floriz and Blancheflur, and of the Assumption of Our Lady : from a MS (GG. 4.27.2) in the Cambridge University Library : also from MSS. in the British Museum The Assumption of Our Lady (A.D. MSS. 10036), and Fragments of the Floyres and Blanchefleur (Cotton Vitelluis D.111) /

Includes glossarial index.

Archaelogic and historic fragments. Containing, inter alia, a facsimile of a rare ms. page dated 1638, having reference to two of Shakespeare's most famous plays, with notes thereon.

On a ms. list of plays of the year 1638. -- Sir Anthony Browne, standard bearer to king Henry VIII, and his descendants. -- On the source and nomenclature of the river Thames. -- On Sir Philip Sidney and his father, Sir Henry Sidney, in relation to Ludlow castle. -- Episodes in the career of Humphrey duke of Gloucester, and his first duchess, and their connection with the abbey of St. Albans. -- On the involuntary visit of Philip of Austria and Juana of Spain to Weymouth in 1506, and its consequences. -- Recuiver, the Regulbium of the Romans. -- Appendix.

Mémoire sur des fragments de papyrus écrits en latin, et déposés au Cabinet des antiques de la Bibliothèque royale, au Musée du Louvre et au Musée des antiquités de la ville de Leyde.

"Extrait des Mémoires de l'Académie des inscriptions et belles-lettres, tome XV, l.ptie."

Technical report No. 6 : containment of fragments from a runaway reactor /

"SRI Project No. GU-2164."

Containment of fragments from a runaway reactor : final report /

"Contract No. AT(04-3)-115 ; Project Agreement No. 2."

Tragedies and fragments /

Disbound Original Held in Oak Street Library Facility.

An examination of the Shelley manuscripts in the Bodleian library. Being a collation thereof with the printed texts, resulting in the publication of several long fragments hitherto unknown, and the introduction of many improved readings into Prometheus unbound, and other poems,

Mode of access: Internet.

Fragments of a Plate with Engraved Designs

Glass, Islamic, Abbasid; 19/32 in.x 11 1/32 in.; glass, blown with applied trail, scratch-engraved