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591.
The potential value of measurements of peripheral bone mass in rheumatoid
arthritis (RA) as an assessment of long-term disease activity has recently
received renewed attention. This study examines the effects of RA and
corticosteroid therapy on newer methods of measuring peripheral bone mass,
comparing the results with dual-energy X-ray absorptiometry (DXA) at axial
sites. Peripheral quantitative computed tomography of the radius,
ultrasound of the calcaneus, and DXA of the hip and spine were compared
between 29 controls and 46 women with RA of whom 25 were receiving low-dose
corticosteroid therapy. Bone mass was significantly reduced in the RA
groups for: (i) radial trabecular (36.1%) and total (15.6%) measurement
sites; (ii) calcaneal ultrasound attenuation (31.7%) and velocity (6.6%);
and (iii) femoral neck (15.4%) bone mineral density. Lumbar spine and
radial cortical measurements were not significantly affected. There were no
significant differences between the RA groups. Disease activity and
physical activity did appear to be responsible for much of the reduction in
bone mass. These results demonstrate that RA is associated with significant
bone loss at the hip, radius and calcaneus, but not at the lumbar spine. In
this small study, low-dose corticosteroids had little additional
deleterious effect.
相似文献
592.
Effects of recombinant interleukin-2 administration on cytotoxic function following high-dose chemo-radiotherapy for hematological malignancy 总被引:1,自引:0,他引:1
Gottlieb DJ; Prentice HG; Heslop HE; Bello-Fernandez C; Bianchi AC; Galazka AR; Brenner MK 《Blood》1989,74(7):2335-2342
Activated killer cells, unrestricted by major histocompatibility (MHC) antigens circulate in the peripheral blood of patients who have undergone autologous and allogeneic bone marrow transplant (BMT) and may contribute to the reduced risk of leukemic relapse observed after these procedures. Interleukin-2 (IL-2) in vitro augments this cytotoxicity and used therapeutically might thereby promote the eradication of minimal residual disease. In order to assess whether these effects on cytotoxicity can be reproduced in vivo, we studied changes in number, phenotype, and MHC unrestricted cytotoxicity of peripheral blood mononuclear cells obtained from patients with hematologic malignancy receiving IL-2 infusions. Patients with acute myeloid leukemia and multiple myeloma were treated after cytotoxic chemotherapy or autologous BMT. IL-2 infusions produced an initial lymphopenia, followed by a progressive recovery in mononuclear cell numbers and a rebound lymphocytosis after the termination of treatment. This affected all lymphocyte subsets; in particular CD25 (IL-2 receptor) positive cell numbers rose sevenfold. Cells with the ability to kill a natural killer (NK)-resistant, lymphokine activated killer cell (LAK)-sensitive target appeared in the circulation during 16 of 19 infusions and mean LAK activity rose from 5.9% to 15.5% during infusion (E:T ratio, 50:1; P less than .001). During IL-2 infusion, cells present in the peripheral blood inhibited the growth of myeloid leukemia blasts in agar after overnight co-culture. Depletion experiments showed that LAK activity was mediated by cells of both CD3- CD16+ (NK derived) and CD3+ CD16- (T derived) subsets. LAK precursor activity in peripheral blood also significantly increased during IL-2 infusion. Increases in major histocompatibility complex (MHC) unrestricted cytotoxicity can be produced by IL-2 infusions in vivo and may result in improved relapse-free survival following chemotherapy or BMT. 相似文献
593.
Neelima Mishra Jai Prakash Narayan Singh Bina Srivastava Usha Arora Naman K Shah SK Ghosh RM Bhatt SK Sharma MK Das Ashwani Kumar Anupkumar R Anvikar Kamlesh Kaitholia Ruchi Gupta GS Sonal AC Dhariwal Neena Valecha 《Bulletin of the World Health Organization》2012,90(12):895-904
Objective
To describe India’s National Antimalarial Drug Resistance Monitoring System, measure the efficacy of first-line malaria treatments, and determine risk factors for treatment failure.Methods
In 2009–2010, prospective studies with 28 days of follow-up were conducted at 25 sentinel sites. Patients infected with Plasmodium falciparum were given artesunate plus sulfadoxine-pyrimethamine (AS+SP); those infected with P. vivax were given chloroquine. Polymerase chain reaction was used to distinguish post-treatment reinfection from treatment failure. Isolates of P. falciparum were checked for dhfr and dhps mutations.Findings
Overall, 1664 patients were enrolled. Kaplan–Meier survival analysis showed an efficacy of 98.8% for AS+SP. Most patients with P. falciparum parasitaemia cleared their parasitaemias within 24 hours of treatment initiation, but six, including four with treatment failure, remained parasitaemic after 72 hours. Double mutants in dhfr were found in 68.4% of the genotyped isolates. Triple or quadruple mutants in dhfr and mutations in dhps were rare. A daily dose of artesunate of < 3 mg per kg of body weight, age of less than 5 years, and fever at enrolment were associated with an increased risk of treatment failure. Chloroquine remained 100% efficacious and generally cleared P. vivax parasitaemias within 48 hours. Vomiting (seen in 47 patients) was the most common adverse event.Conclusion
India’s National Antimalarial Drug Resistance Monitoring System provides wide coverage. The first-line antimalarials used in the country remain safe and efficacious. The treatment of malaria in young children and the relative benefits of age- and weight-based dosing need further exploration. 相似文献594.