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61.
G. Schaison O. B. Eden G. Henze W. A. Kamps F. Locatelli J. Ninane J. Ortega P. Riikonen H. P. Wagner 《European journal of pediatrics》1998,157(12):955-966
During 1996 and 1997 a panel of European haematologists, oncologists, and neonatologists developed specific paediatric guidelines
for the use of colony stimulating factors based on published literature and the clinical experience of these specialists within
each of 13 countries. Well established indications for use comprise intervention in patients with life-threatening infection,
adjunctive therapy post autologous bone marrow transplantation (BMT), mobilization of peripheral blood progenitor cells for
autologous BMT, patients with acquired aplastic anaemia on anti-lymphocyte globulin and cyclosporin regimen, and severe congenital
neutropenia. Less clear indications include primary prophylaxis to support dose intensification in children with high risk/advanced
malignancies, secondary prophylaxis to prevent neutropenia in patients with a history of severe neutropenia, support therapy
in cases of poor marrow function following BMT and for deteriorating marrow function following successful BMT, in neonatal
sepsis and non infectious neonatal neutropenia, in drug induced neutropenia and in HIV-positive patients. Treatment is generally
well tolerated and granulocyte colony stimulating factor appears better tolerated than granulocyte and macrophage colony stimulating
factor. Economically colony stimulating factors have not been shown to induce excessive costs for a given patient.
Conclusion In general the adult guidelines are applicable to children but additional considerations (aggressive or very progressive
childhood neoplasms, specific indications, neonatal use, congenital disorders) must be taken into account.
Received: 21 October 1997 and in revised form: 30 April 1998 /Accepted: 5 May 1998 相似文献
62.
P de Lonlay-Debeney JC Fournet D Martin F Poggi C Dionisi Vicci M Spada G Touati J Rahier F Brunelle C Junien JJ Robert C Nihoul-Fékété JM Saudubray 《Archives de pédiatrie》1998,5(12):1347-1352
Persistent hyperinsulinemic hypoglycaemia of infancy (PHHI) is the most frequent cause of hypoglycaemia in infancy. Clinical presentation is heterogeneous, with variable onset of hypoglycaemia and response to diazoxide, and presence of sporadic or familial forms. Underlying histopathological lesions can be focal or diffuse. Focal lesions are characterised by focal hyperplasia of pancreatic islet-like cells, whereas diffuse lesions implicate the whole pancreas. The distinction between the two forms is important because surgical treatment and genetic counselling are radically different. Focal lesions correspond to somatic defects which are totally cured by limited pancreatic resection, whereas diffuse lesions require a subtotal pancreatectomy exposing to high risk of diabetes mellitus. Diffuse lesions are due to functional abnormalities involving several genes and different transmission forms. Recessively inherited PHHI have been attributed to homozygote mutations for the beta-cell sulfonylurea receptor (SUR1) or the inward-rectifying potassium-channel (Kir6.2) genes. Dominantly inherited PHHI can implicate the glucokinase gene, particularly when PHHI is associated with diabetes, the glutamate dehydrogenase gene when hyperammonaemia is associated, or another locus. 相似文献
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64.
J.C. Alonso Farto I. Almoguera Arias F.J. Lopez Longo C.M. Gonzalez Fernandez I. Monteagudo Saez A. Ortega Valle M. Bascones J.M. Peréz Vázquez L. Carreño Perez 《European journal of nuclear medicine and molecular imaging》2000,27(12):1768-1773
Abdominal scintigraphy shows silent gut inflammation in patients with spondyloarthropathies (Sp) without clinical evidence of gut inflammation. Abdominal scintigraphy images are different than those obtained in patients with ulcerative colitis or Crohn's disease and are not related to the anti-inflammatory drugs administered. The aim of this study was to examine the clinical associations of findings on abdominal scintigraphy in patients with Sp. A total of 204 Sp patients (European Spondylarthropathy Study Group 1991 criteria) and 54 non-Sp controls receiving non-steroidal anti-inflammatory drugs were studied. Abdominal scintigraphy images were obtained at 30 and 120 min after injection of technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO)-labelled leucocytes. 99mTc-HMPAO-labelled leucocyte scans were positive in 104 Sp patients (50.9%) and in six non-Sp controls (2.9%) (P<0.001; OR=8.32; 95% CI=3.23-22.67). Silent gut inflammation was not associated with any of the following: age of onset, duration of evolution, sex, family history of Sp or psoriasis, articular manifestations, extra-articular manifestations, radiological findings or HLA-B27 positivity. Positive abdominal scintigraphy was associated with active disease (P<0.0001; OR=52.7; 95% CI=19-145.6) and an increase in the C-reactive protein (P<0.005; OR=3.4; 95% CI=1.5-7.4). It is concluded that (a) abdominal scintigraphy using 99mTc-HMPAO-labelled leucocytes is of value in detecting the silent gut inflammation in Sp patients, and (b) silent gut inflammation is related to the clinical activity, but is not associated with any particular type of illness or with HLA-B27. 相似文献
65.
J A Ortega García D Carrizo Gallardo J Ferris i Tortajada M M P García J O Grimalt 《Archives of disease in childhood》2006,91(8):642-646
BACKGROUND: Exposure to organochlorine compounds (OCs) has been a subject of interest in recent years, given their potential neurotoxicity. Meconium is easily available and accumulates neurotoxicants and/or metabolites from the 12th week of gestation. AIMS: To determine whether neurotoxicants, specifically OCs, could be detected in serially collected meconium, and to compare the results with those obtained in cord blood samples. METHODS: A sample of cord blood and three serial stool samples were analysed in 10 newborns. Pentachlorobenzene (PeCB), hexachlorobenzene (HCB), polychlorinated biphenyls (PCBs), dichlorodiphenyl trichloroethane (p,p'-DDT) and its metabolite dichlorodiphenyl dichloroethylene (p,p'-DDE), and hexachlorocyclohexane isomers (alpha-, beta-, gamma-, and delta-HCH) were analysed by gas chromatography. RESULTS: From serial stool collection and analysis in newborns, there was an increase in the concentrations of HCB, p,p'-DDE, PCBs, and beta-HCH between the first and last stools of the newborn. Levels of DDT diminished as pregnancy progressed. Concentrations in cord blood were positively associated with concentrations in meconium for p,p'-DDE and beta-HCH. CONCLUSIONS: Meconium is a very useful instrument for the investigation of fetal exposure to neurotoxicants; serial collection and analysis of meconium should estimate the timing and degree of in utero exposure of the fetus to neurotoxicants. Analysis and interpretation of neurotoxicants in meconium results is a complex process. Measurement in meconium of a wide range of neurotoxic substances should facilitate early identification of harmful exposures, and enable rehabilitation and instigation of preventive measures. 相似文献
66.
67.
68.
Fernando Moreno Antón Javier Sastre Valera Belén Loboff de León Sara López-Tarruella Luis Ortega Medina Eduardo Díaz-Rubio 《Clinical & translational oncology》2005,7(7):321-323
Metastastic tumours involving the epididymis are rare and most often found in patients with disseminated disease. It is even more unusual when the metastasis of the epididymis is the first sign of tumour recurrence. We report a case of an asymptomatic recurrent colon carcinoma presenting as metastasis in the epididymis. Although metastatic cancer presenting as an intra-scrotal mass is extremely rare, it should be considered as a possibility in patients who present with a mass involving the testicle or epididymis. 相似文献
69.
JI Tang M Back T Shakespeare JJ Lu R Mukherjee C Wynne S Liang 《Journal of Medical Imaging and Radiation Oncology》2005,49(5):390-395
The aims were to determine the median survival and prognostic factors of patients with central nervous system (CNS) metastases managed with whole‐brain radiation therapy (WBRT), and to explore selection criteria in recently published clinical trials using aggressive interventions in CNS metastases. A retrospective audit was performed on patients managed with WBRT for CNS metastases. Potential prognostic factors were recorded and analysed for their association with survival duration. The proportion of patients with these factors was also compared with those of patients managed under three recently reported studies investigating aggressive interventions, such as radiosurgery and chemotherapy for CNS metastases. Seventy‐three patients were treated with WBRT for cerebral metastases over a 12‐month period. The median survival of the population was 3.4 months (95% confidence interval: 2.7–4.1), with 6‐ and 12‐month survival rates of 30 and 18%, respectively. Significant prognostic factors for prolonged median survival were Eastern Cooperative Oncology Group status 0–2 (P = 0.015), Medical Research Council neurological functional status 0–1 (P = 0.006), and Recursive Partitioning Analysis Class 2 versus Class 3 (P = 0.020). On multivariate analysis, younger patient age (P = 0.02) and better performance status (P < 0.01) were associated with improved outcome. When comparing these characteristics with selected published studies, our study cohort demonstrated a higher proportion of patients with poor performance status, a greater number of metastases per patient and a higher incidence of extracranial disease. This reflects the selected nature of patients in these published studies. Central nervous system metastases confer a poor prognosis and, for the majority of patients, aggressive interventions are unlikely to improve survival. The use of potentially toxic and expensive treatments should be reserved for those few in whom these studies have shown a potential benefit. 相似文献
70.
Heart arrest in cemented hip arthroplasty 总被引:12,自引:0,他引:12
Ortega S Ortega JP Pascual A Fraca C García-Enguita MA Arauzo P Urieta-Solanas A 《Revista espa?ola de anestesiología y reanimación》2000,47(1):31-35
Hip arthroplasty is a common surgical intervention in our hospital practice, involving high perioperative risk related to patients age and multiple concomitant diseases. Hemodynamic complications described vary from slight hypotension during surgery to heart failure and sudden death, particularly if the operation involves a cemented femoral component. Because of the type of patients undergoing such operations (elderly patients, with osteoporosis and scarce cardiopulmonary reserve), the unclear origin of complications and the lack of consensus on what constitutes adequate monitoring during surgery, hip arthroplasty is problematic for the specialists involved. We report on five deaths during cemented hip arthroplasty; after reviewing the case history and autopsy report of one, we believe the events leading to death were triggered by massive pulmonary embolism. 相似文献