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Ann Marie Szymanski Blachy Dvila Saldaa Carlos R. Ferreira Brett Loechelt Lawrence Jung 《Pediatric transplantation》2020,24(1)
MA is a rare, autosomal recessive disorder characterized by episodes of inflammation and periodic fevers. In its most severe form, it can result in facial dysmorphism, growth inhibition, ataxia, liver dysfunction, intellectual disability, and at times can be fatal. A number of case reports exist stating that SCT is curative in these patients. We present the case of a patient diagnosed with MA at birth, who underwent SCT at the age of 14 months with intent to cure. She achieved complete engraftment and urine mevalonate became undetectable. However, 18 months following transplant, she developed frequent episodes of fevers, rashes, arthritis, and a rising urinary mevalonate. She was subsequently diagnosed with relapse. She now requires treatment with steroids and canakinumab to manage her disease. This case is the first report of disease relapse following transplant for MA. It runs contrary to prior reports that SCT is fully curative of MA and suggests that transplant may instead provide a means of decreasing disease severity without entirely eradicating the condition. 相似文献
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[目的]通过考证相关文献,更全面认识小儿推拿特定穴“六腑”,正确指导临床应用。[方法]通过整理研究小儿推拿经典古籍和现代文献,对六腑的定位、操作、功效、配伍及现代临床应用、机制研究进行详细解析,从多个方面深入了解该穴。[结果]归纳古籍发现六腑的定位和操作存在争议,普遍认为穴性为寒凉,有退热、通腑之效,常与三关配伍合用于寒热、虚实夹杂之证。现代医家认为该穴有通腑、泻热、解毒的作用,临床可用于小儿多系统病变的治疗,尤以肺、脾胃系疾病多见,效果显著,但目前对于作用机制的研究较少,退热机制可能与神经反馈调节、免疫调节等相关,通腑、解毒机制尚未有前人研究。[结论]小儿推拿六腑穴退热、通腑功效卓著,古今广泛用于临床多种小儿疾病的治疗,备受医家推崇。全面了解该穴,正确指导辨证施术,才能发挥其最佳临床疗效。 相似文献
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目的探讨清金降火汤加减联合阿奇霉素对痰湿闭阻型小儿支原体肺炎患者的临床疗效。方法 210例患者随机分为清金降火汤加减组、阿奇霉素组、联合组,每组70例,疗程14 d。检测临床疗效、肺功能指标(PEF、VPTEF、TPTEF、PFV)、血清抗炎因子(IL-2、IL-4、IL-10、IL-13)、血清促炎因子(TNF-α、IFN-γ、IL-6、IL-8)、血清免疫功能指标(CD^3+、CD^4+、CD^8+、RBC-ICR)、不良反应发生率变化。结果联合组总有效率、VPTEF、TPTEF、PFV、IL-2、IL-13、CD3+、CD4+高于清金降火汤加减组、阿奇霉素组(P<0.05),PEF、IL-4、IL-10、TNF-α、IFN-γ、IL-6、IL-8、CD^8+、RBC-ICR降低(P<0.05),不良反应发生率低于阿奇霉素组(P<0.05)。结论清金降火汤加减联合阿奇霉素可有效改善痰湿闭阻型小儿支原体肺炎患者肺功能、血清炎性因子、免疫功能,安全性较高。 相似文献
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Carrie R. Howell Carmen L. Wilson Yutaka Yasui Deo K. Srivastava Wei Lu Kari L. Bjornard Matthew J. Ehrhardt Tara M. Brinkman Wassim Chemaitilly Jason R. Hodges Jennifer Q. Lanctot Leslie L. Robison Melissa M. Hudson Kirsten K. Ness 《International journal of cancer. Journal international du cancer》2020,147(2):338-349
Survivors of childhood cancer are at risk for obesity, a condition potentially modifiable if dietary intake and physical activity are optimized. These health behaviors are likely influenced by neighborhood of residence, a determinant of access to healthy, affordable food and safe and easy exercise opportunities. We examined associations between neighborhood level factors and obesity among survivors in the St. Jude Lifetime cohort and community comparison group members. Persons with residential addresses available for geocoding were eligible for analysis (n = 2,265, mean age 32.5 [SD 9.1] years, 46% female, 85% white). Survivors completed questionnaires regarding individual behaviors; percent body fat was assessed via dual X-ray absorptiometry (obesity: ≥25% males; ≥35% females); neighborhood effect was characterized using census tract of residence (e.g., neighborhood socioeconomic status [SES], rurality). Structural equation modeling was used to determine associations between neighborhood effect, physical activity, diet, smoking, treatment exposures and obesity. Obese survivors (n = 1,420, 62.7%) were more likely to live in neighborhoods with lower SES (RR: 1.23, 95% CI: 1.10–1.38) and rural areas (RR: 1.22, 95% CI: 1.07–1.39) compared to survivors with normal percent body fat. Resource-poor neighborhoods (standardized effect: 0.06, p < 0.001) and cranial radiation (0.16, p < 0.001) had direct effects on percent body fat. Associations between neighborhood of residence and percent body fat were increased (0.01, p = 0.04) among individuals with a poor diet. Neighborhoods where survivors reside as an adult is associated with obesity. Interventions targeting survivors should incorporate strategies that address environmental influences on obesity. 相似文献
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Raya Saab MD Anas Obeid MD Fatiha Gachi MD Houda Boudiaf MD Lilit Sargsyan MD Khulood Al-Saad MD Tamar Javakhadze MD Azim Mehrvar MD Sawsan Sati Abbas MD Yasir Saadoon Abed Al-Agele MD Salma Al-Haddad MD Mouroge Hashim Al Ani MD Suleiman Al-Sweedan MD Amani Al Kofide MD Wasil Jastaniah MD Nisreen Khalifa MD Elie Bechara MD Malek Baassiri MD Peter Noun MD Jamila El-Houdzi MD Mohammed Khattab MD Krishna Sagar Sharma MD Yasser Wali MD Naureen Mushtaq MD Aliya Batool MD Mahwish Faizan MD Muhammad Rafie Raza MD Mohammad Najajreh MD Mohammed Awad Mohammed Abdallah MD Ghada Sousan MD Khaled M. Ghanem MD Ulker Kocak MD Tezer Kutluk MD Hacı Ahmet Demir MD Hamoud Hodeish MD Samar Muwakkit MD Asim Belgaumi MD Abdul-Hakim Al-Rawas MD Sima Jeha MD 《Cancer》2020,126(18):4235-4245