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Asheebo Rojas Jianxiong Jiang Thota Ganesh Myung‐Soon Yang Nadia Lelutiu Paoula Gueorguieva Raymond Dingledine 《Epilepsia》2014,55(1):17-25
Epilepsy is one of the more prevalent neurologic disorders in the world, affecting approximately 50 million people of different ages and backgrounds. Epileptic seizures propagating through both lobes of the forebrain can have permanent debilitating effects on a patient's cognitive and somatosensory brain functions. Epilepsy, defined by the sporadic occurrence of spontaneous recurrent seizures (SRS), is often accompanied by inflammation of the brain. Pronounced increases in the expression of key inflammatory mediators (e.g., interleukin ‐1β [IL‐1β], tumor necrosis factor alpha [TNFα], cyclooxygenase‐2 [COX‐2], and C‐X‐C motif chemokine 10 [CXCL10]) after seizures may cause secondary damage in the brain and increase the likelihood of repetitive seizures. The COX‐2 enzyme is induced rapidly during seizures. The increased level of COX‐2 in specific areas of the epileptic brain can help to identify regions of seizure‐induced brain inflammation. A good deal of effort has been expended to determine whether COX‐2 inhibition might be neuroprotective and represent an adjunct therapeutic strategy along with antiepileptic drugs used to treat epilepsy. However, the effectiveness of COX‐2 inhibitors on epilepsy animal models appears to depend on the timing of administration. With all of the effort placed on making use of COX‐2 inhibitors as therapeutic agents for the treatment of epilepsy, inflammation, and neurodegenerative diseases there has yet to be a selective and potent COX‐2 inhibitor that has shown a clear therapeutic outcome with acceptable side effects. 相似文献
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Parent and peer relationships are important social resources for adolescents. South African research on adolescents' relationships, however, underemphasises these relationships as potential positive resources. Studies also tend to use samples from urban populations, while rural and semi-rural adolescent populations are neglected. This study focused on White and Coloured adolescents living in one South African semi-rural community and their ratings of positive and negative relationship qualities in relationships with parents and peers. Using the Network of Relationships Inventory (NRI), we found that mothers, best friends and romantic partners were relatively equal sources of social support. Mothers' high ratings for support, conflict and punishment may point to mothers bearing the primary responsibility for child care. Fathers' low support ratings raise concern as father involvement is important for adolescents' well-being. White participants overall rated their relationship higher for support and lower for negative qualities than the Coloured participants. 相似文献
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Nicola Fossati R. Jeffrey Karnes Michele Colicchia Stephen A. Boorjian Alberto Bossi Thomas Seisen Nadia Di Muzio Cesare Cozzarini Barbara Noris Chiorda Claudio Fiorino Giorgio Gandaglia Paolo Dell’Oglio Shahrokh F. Shariat Gregor Goldner Steven Joniau Antonino Battaglia Karin Haustermans Gert De Meerleer Alberto Briganti 《European urology》2018,73(3):436-444
Background
Salvage radiation therapy (SRT) is a recommended treatment option for biochemical recurrence after radical prostatectomy (RP). However, its effectiveness may be limited to specific categories of patients.Objective
We aimed to identify the optimal candidates for early SRT after RP.Design, setting, and participants
The study included 925 node-negative patients treated with SRT after RP at seven institutions. Patients received SRT for either prostate-specific antigen (PSA) rising, or PSA persistence after RP that was defined as PSA level ≥0.1 ng/ml at 1 mo after surgery. All patients received local radiation to the prostate and seminal vesicle bed.Outcome measurements and statistical analysis
The primary outcome measured was distant metastasis after SRT. Regression tree analysis was used to develop a risk-stratification tool. Multivariable Cox regression analysis and nonparametric curve fitting methods were used to explore the relationship between PSA level at SRT and the probability of metastasis-free survival at 8 yr.Results and limitations
At a median follow-up of 8.0 yr, 130 patients developed distant metastasis. At multivariable analysis, pre-SRT PSA level was significantly associated with distant metastasis (hazard ratio: 1.06, p < 0.0001). However, when patients were stratified into five risk groups using regression tree analysis (area under the curve: 85%), early SRT administration provided better metastasis-free survival in three groups only: (1) low risk: undetectable PSA after RP, Gleason score ≤7, and tumour stage ≥pT3b, (2) intermediate risk: undetectable PSA after RP with Gleason score ≥8, (3) high risk: PSA persistence after RP with Gleason score ≤7.Conclusions
We developed an accurate risk stratification tool to facilitate the individualised recommendation for early SRT based on prostate cancer characteristics. Early SRT proved to be beneficial only in selected groups of patients who are more likely to be affected by clinically significant but not yet systemic recurrence at the time of salvage treatment administration.Patient summary
In patients affected by prostate cancer recurrence after radical prostatectomy, the early administration of salvage radiation therapy is beneficial only for selected subgroups of patients. In this study, these groups of patients were identified. 相似文献20.