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1.
《Vaccine》2022,40(19):2679-2695
Vaccinations are essential for preventing infectious diseases in children with chronic diseases as they have increased risk of infection from frequent use of biologics. Response to immunizations in this group is not well known.ObjectiveA systematic review was performed to evaluate three primary outcomes: efficacy; immunogenicity; and safety of vaccines in children with chronic conditions treated with biologics.MethodsThe protocol for our systematic review and meta-analysis was registered and published with PROSPERO. We searched electronic bibliographic databases for studies published from 2009 to 2019, focusing on vaccinations in children with chronic conditions treated with biologics.ResultsWe retrieved 532 records. Thirty-one full-text articles were selected, and 14 were included in the meta-analysis. No significant publication bias was found. Efficacy: limited data are available regarding the efficacy of vaccination, as most studies have focused on immunogenicity as surrogate outcome for efficacy. Immunogenicity: patients receiving anti-TNF-alpha therapy had a statistically significant risk of poor seroconversion (p = 0.028) and seroprotection by the serotype B influenza vaccine [inflammatory bowel disease (IBD) p = 0.013; juvenile idiopathic arthritis (JIA) p = 0.004]. We found adequate responses with H1N1 and H3N2 serotypes. Few studies existed for pneumococcal, hepatitis A virus, hepatitis B virus, varicella-zoster virus, Measles Mumps Rubella virus, and multiple vaccine administration. Safety: vaccine administration was not associated with serious side effects, but JIA patients on anti-TNF alpha therapy had a statistically significant risk of presenting with myalgia or arthralgia postinfluenza vaccine (p = 0.014).ConclusionsMore evidence concerning efficacy, immunogenicity, and safety of vaccinations is needed to guide physicians in the vaccine decision process for this pediatric population. 相似文献
2.
本文通过对特发性肺纤维化急性发作病因病机的分析,认为其病因为外邪或内伤引动肺络虚火,从阳化热,病机为“肺热”、“络瘀”;并结合其病因病机,探究归纳《温病条辨》中清络法和中药复方清络饮在论治特发性肺纤维化急性发作时的理论基础,为临床中论治特发性肺纤维化急性发作,改善患者症状提供新方法,为肺络病证治体系构建及应用提供新思路。 相似文献
3.
ObjectivesDespite its use in determining nigrostriatal degeneration, the lack of a consistent interpretation of nigrosome 1 susceptibility map-weighted imaging (SMwI) limits its generalized applicability. To implement and evaluate a diagnostic algorithm based on convolutional neural networks for interpreting nigrosome 1 SMwI for determining nigrostriatal degeneration in idiopathic Parkinson's disease (IPD).MethodsIn this retrospective study, we enrolled 267 IPD patients and 160 control subjects (125 patients with drug-induced parkinsonism and 35 healthy subjects) at our institute, and 24 IPD patients and 27 control subjects at three other institutes on approval of the local institutional review boards. Dopamine transporter imaging served as the reference standard for the presence or absence of abnormalities of nigrosome 1 on SMwI. Diagnostic performance was compared between visual assessment by an experienced neuroradiologist and the developed deep learning-based diagnostic algorithm in both internal and external datasets using a bootstrapping method with 10000 re-samples by the “pROC” package of R (version 1.16.2).ResultsThe area under the receiver operating characteristics curve (AUC) (95% confidence interval [CI]) per participant by the bootstrap method was not significantly different between visual assessment and the deep learning-based algorithm (internal validation, .9622 [0.8912–1.0000] versus 0.9534 [0.8779-0.9956], P = .1511; external validation, 0.9367 [0.8843-0.9802] versus 0.9208 [0.8634-0.9693], P = .6267), indicative of a comparable performance to visual assessment.ConclusionsOur deep learning-based algorithm for assessing abnormalities of nigrosome 1 on SMwI was found to have a comparable performance to that of an experienced neuroradiologist. 相似文献
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Katarzyna Zaborowska-Sapeta Tomasz Giżewski Anna Binkiewicz-Glińska Anna M. Kamelska-Sadowska Ireneusz M. Kowalski 《Acta orthopaedica et traumatologica turcica》2019,53(1)
Objective
The aim of the study was to evaluate the loss of truncal rotation over 54 hours after removing Chêneau brace.Methods
The studied groups consisted of 39 girls aged 10–18 years old, diagnosed with adolescent idiopathic scoliosis (AIS) and treated with Chêneau brace (CAST) and 20 AIS girls aged 10–18 years old, not treated with bracing. Posterior-anterior radiographs were obtained from the clinical assessment of all subjects and were subsequently used to determine Cobb angles. The measurements of the angle of trunk rotation (ATR) were taken with the Scoliometer® and back-contour device during Adams forward bending test by the two evaluators. The changes in ATRs during 54 hours of observation were performed after the brace had been taken off (0, 2, 24, 30, 48 and 54 hours after debracing). This was described using VATR variable, defined as the change in the absolute Scoliometer® readings in the time intervals against the time interval Δt between the measurements. During back-contour assessment the differential factor (kra) has been used for the digital analysis. The changes in kra over 54 hours of observation were expressed as Vkra factor, defined as the difference in the absolute value of the amplitude differential factor (kra) in the time intervals against the time interval Δt between the measurements.Results
The highest changes were observed in the thoracic as well as in lumbar spine in patients with Cobb angle ≥30°, axial rotation of the apical vertebrae within 5–15°, Risser sign 0–2. The biggest change in the trunk rotation after Chêneau brace had been taken off was noted within the first two hours of observation.Conclusion
The patients should be advised to take the brace off for a minimum of two hours before the scheduled x-ray, to allow full relaxation of the trunk in order to obtain reliable radiological images of the deformation.Level of Evidence
Level III Therapeutic study. 相似文献7.
介绍时毓民分期辨治儿童慢性特发性中性粒细胞减少症的临床经验。认为本病病机以肺脾肾不足、虚实夹杂为主,治疗重视标本兼顾、分期施治。感染期以祛邪治标为主,用药轻清发散、佐以扶正;稳定期以治本补虚为主,以健脾补肾、补益肺卫及益气补血、活血生血为主要治法,常用异功散、十全大补汤合左归丸加减治疗。并附验案1则。 相似文献
9.
《Archives de pédiatrie》2020,27(6):333-337
Background dataLittle is known about daily walking distance levels, which accounts for approximately 80% of overall physical activity per day, in adolescents with idiopathic scoliosis (AIS).ObjectiveThe aim of this study was to assess the level of walking distance in AIS treated by bracing or not, comparing this activity with that of a control group. We used an original method based on smartphone pedometers for studying walking distance in everyday life.MethodsNineteen AIS patients, aged 14.1 (13–17) years, and 25 asymptomatic patients, aged 12.9 (12–14) years were included prospectively. The 19 AIS cases comprised 9 untreated individuals and 10 with ongoing night brace treatment. The mean walking distance per day as estimated by the pedometer application on smartphones for 2 months was assessed. Weekly sports activities (hours per week) were also reported.ResultsDuring the first month, the mean walking distance was 2.58 ± 0.65 km/day for control patients, 2.31 ± 1.38 km/day for untreated AIS, and 3.65 ± 0.72 km/day for AIS patients treated with a night brace. During the second month, the mean walking distance was 2.60 ± 0.73 km/day for control patients, 2.40 ± 1.41 km/day for untreated AIS, and 3.70 ± 0.72 km/day for AIS patients treated with a night brace. Statistical analysis between groups showed a statistically significant difference with a higher level of daily walking distance in adolescents treated with a night brace compared with other groups.ConclusionThe pedometer on smartphones is a cost-effective and friendly tool to assess adolescents’ level of walking distance. Our results indicate no restriction in terms of daily walking distance between adolescents without scoliosis and those with idiopathic scoliosis.Level of evidenceLevel II. 相似文献
10.
目的:探讨维生素D受体基因多态性与特发性癫痫的相关性。方法:通过病例对照研究方法,选取91例特发性癫痫患者作为病例组,另选取同期105例健康者作为对照组,抽取所有研究对象外周静脉血提取DNA,采用PCR直接测序法进行维生素D受体基因BsmI(rs1544410)、FokI(rs2228570)、Cdx2(rs11568820)位点多态性检测。结果:病例组与对照组的BsmI与FokI位点基因型频率和等位基因频率无显著差异(P>0.05);Cdx2位点基因型频率存在显著差异(χ2=6.67,P=0.036),等位基因频率无显著差异,该位点发生A/G变异,分布不处于Hardy-Weinberg遗传平衡。在Cdx2位点基因型与特发性癫痫关联性分析中,病例组中Cdx2位点AG基因型是特发性癫痫发病的危险因素(OR=2.222,95% CI:1.190~4.150,P=0.027)。结论:维生素D受体基因Cdx2位点多态性与特发性癫痫具有关联性。 相似文献