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51.
Lovell DJ Giannini EH Reiff A Jones OY Schneider R Olson JC Stein LD Gedalia A Ilowite NT Wallace CA Lange M Finck BK Burge DJ;Pediatric Rheumatology Collaborative Study Group 《Arthritis and rheumatism》2003,48(1):218-226
OBJECTIVE: To evaluate the long-term efficacy and safety of etanercept in children with juvenile rheumatoid arthritis (JRA) participating in an ongoing multicenter, open-label, extended-treatment trial. All patients had been participants in an initial randomized efficacy and safety trial of etanercept. METHODS: Etanercept was administered at a dosage of 0.4 mg/kg (maximum 25 mg) subcutaneously twice each week. Safety and efficacy evaluations were performed every 3-4 months. The JRA 30% definition of improvement (DOI) was defined as improvement of > or =30% in at least 3 of 6 response variables used to assess disease activity, with no more than 1 variable worsening by more than 30%. RESULTS: At the time of analysis, 48 of the 58 patients (83%) were still enrolled in the study; 43 of them (74%) had completed 2 years of treatment. Of these 43 patients, 81% met the JRA 30% DOI, 79% met the JRA 50% DOI, and 67% met the JRA 70% DOI. Ten children started low-dose methotrexate after year 1. Of the 32 children taking prednisone, the dosage was decreased to <5 mg/day in 26 (81%). Two children had serious infections (varicella with aseptic meningitis in one and complicated sepsis in the other). In general, adverse events were of the types seen in a general pediatric patient population. CONCLUSION: Children with severe, longstanding, methotrexate-resistant polyarticular JRA demonstrated sustained clinical improvement with >2 years of continuous etanercept treatment. Etanercept was generally well-tolerated. There were no increases in the rates of adverse events over time. However, children taking etanercept should be monitored closely for infections. 相似文献
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Sachin S. Goel Olcay Aksoy E. Murat Tuzcu Richard A. Krasuski Samir R. Kapadia 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2013,40(4):439-444
Transcatheter patent foramen ovale (PFO) closure is an alternative to antiplatelet or anticoagulative therapy in patients with cryptogenic stroke, and it is associated with a small incidence of periprocedural sequelae. Because embolization of PFO closure devices is a very rare procedural complication, data on its frequency, causes, and management are sparse. We sought to review the medical literature and the cases of PFO closure-device embolization at our institution with the aim of identifying likely problems and reporting potential solutions. Out of 310 adult patients who underwent transcatheter PFO closure from June 2002 through April 2011, there were 2 cases (0.6%) of PFO closure-device embolization. In both patients, hypermobile septum primum and thick septum secundum were present. In one patient, failure to use a sizing balloon might have resulted in an underestimation of the PFO''s size. In both patients, device embolization was identified in a timely fashion, the embolized device was safely retrieved, and the PFO was percutaneously closed with success.The incidence of PFO closure-device embolization is very low. The cases described here underscore the importance of imaging in the identification of morphologic predispositions to closure-device malpositioning, in the recognition of impending embolization, and in the timely management of embolization.Key words: Contrast media/diagnostic use, device removal/methods, echocardiography, transesophageal, fluoroscopy, foramen ovale, patent/radiography/therapy/ultrasonography, foreign body migration, ischemic attack, transient/prevention & control, prosthesis implantation/adverse effects, septal occluder device/adverse effects, stroke/prevention & controlSeveral studies1–3 have shown the feasibility of transcatheter patent foramen ovale (PFO) closure as an adjunct or alternative to antiplatelet or anticoagulative therapy in patients with cryptogenic stroke. Procedural sequelae are rare. In a meta-analysis of 10 studies consisting of more than 1,350 patients with transcatheter PFO closure,4 major sequelae (death, tamponade, hemorrhage requiring blood transfusion, fatal pulmonary embolism, and need for surgical intervention) occurred in 1.5% of patients, and minor sequelae (device embolization with percutaneous retrieval, arrhythmias, device fracture, asymptomatic device thrombosis, symptomatic air embolism, and groin sequelae) occurred in 7.9% of patients. Data exist on the predisposing factors for embolization of atrial-septal-defect closure devices (inadequate rim and undersized device)5–8; but PFO closure-device embolization is such a rare complication that data on its frequency, causes, and management are sparse.1,9,10
We sought to review the literature on PFO closure-device embolization and to describe such cases at our institution with the aim of identifying likely problems and reporting potential solutions. Open in a separate window 相似文献
55.
Hakan Coksuer Mustafa Koplay Fatih Oghan Cengiz Coksuer Nadi Keskin Olcay Ozveren 《Archives of gynecology and obstetrics》2011,283(5):1045-1051
Aim
To investigate the effects of Angeliq on hormonal, metabolic, biochemical and cardiovascular profile, carotid intima-media thickness (CIMT) and vertigo/dizziness symptoms in postmenopausal women. 相似文献56.
Ural M Yildirim N Danabas D Kaplan O Yildirim NC Ozcelik M Kurekci EF 《Bulletin of environmental contamination and toxicology》2012,88(2):172-176
Concentrations of metals were determined in the gills, liver, kidney, heart and muscle in Capoeta umbla caught from six stations from the Munzur River system. Metal concentrations in the tissues tended to vary significantly among
stations (p < 0.05). Liver (Cu, 10.10 ± 0.23–23.03 ± 9.37 ppm; Zn, 14.67 ± 3.01–21.82 ± 2.39 ppm; Cd, 18.04 ± 4.56–52.69 ± 10.65 ppb
and Fe, 28.87 ± 6.78–115.11 ± 34.87 ppm) and kidney (Cu, 1.80 ± 0.25–3.70 ± 0.62 ppm; Zn, 20.81 ± 0.37–29.36 ± 0.70 ppm; Cd,
132.06 ± 5.29–639.51 ± 20.14 ppb and Fe, 24.40 ± 1.98–59.39 ± 1.97 ppm) tissues showed higher metal concentrations than other
tissues. It seems that metal contamination in the river is too high for the health of fish and the people who eat them. The
geographical locations of catch, season, nature of diet, and the size of fish used for analyses might lead to different metal
concentration in the same fish species. 相似文献
57.
Aycan Z Berberoglu M Adiyaman P Ergür AT Ensari A Evliyaoglu O Siklar Z Ocal G 《Journal of pediatric endocrinology & metabolism : JPEM》2004,17(11):1565-1569
Latent autoimmune diabetes mellitus in adults (LADA) is characterized by clinical presentation as type 2 diabetes mellitus after 25 years of age, initial control achieved with oral hypoglycemic agents for at least 6 months, presence of autoantibodies and some immunogenetic features of type 1 diabetes mellitus. An 8.3 year-old girl was referred to our pediatric endocrinology department because of incidental glucosuria. She did not complain of polyuria, polydipsia, or weight loss. Her body mass index (BMI) was at the 80th percentile. Fasting glucose was 126 mg/dl, and OGTT glucose level at 120 min was 307 mg/dl. Although C-peptide levels were normal, her first phase insulin response (FIR) was lower than the 1st percentile. Anti-insulin antibody (AIA), islet cell antibody (ICA), and anti-glutamic acid decarboxylase (antiGAD) were negative. According to the clinical and laboratory findings, she was diagnosed as having type 2 diabetes mellitus. She was started with oral anti-diabetic treatment for a period of 1 year. Insulin had to be initiated for worsening of HbA1c levels. In the fourth year of follow-up, she was admitted to our hospital with diabetic ketoacidosis although she was on an intensive insulin regimen. At this time, C-peptide levels were low, antiGAD and AIA were positive with HLA DR3/DQ2 haplotype. In addition, her thyroid peroxidase antibody and endomysium antibody were found to be high at follow-up. Small intestinal biopsy revealed celiac disease. This patient may represent the first case of latent autoimmune diabetes mellitus in children (LADC) with autoimmune thyroiditis and celiac disease. 相似文献
58.
Ulker Gül Seray Külcü Cakmak Isil Olcay Arzu Kili? Müzeyyen G?nül 《The Journal of asthma》2007,44(5):383-384
Nickel sulphate frequently causes allergic contact dermatitis; less known effects are nasal inflammation (rhinitis) and bronchial asthma. In this study, we aimed to find if there is a relationship between asthma and nickel sensitivity. Asthmatic patient, non-asthmatic atopic, and healthy control groups were patch tested with nickel sulphate. Nickel sensitivity was more prevalent in the asthmatic patient group compared to the non-asthmatic atopic and healthy control groups. 相似文献
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Kadriye Yurdak k Olcay Oran Gü lsevin Tekinalp Semra Dü ndar Murat Yurdak k 《Pediatric hematology and oncology》1989,6(1):59-61
Thromboembolic complications have been reported in association with neonatal polycythemia, the primary cause of hyperviscosity in the newborn. Although there are some studies on coagulation in polycythemic neonates, the situations that predispose these newborns to thrombosis are still not clear.1 One of the causes may be the reduction in blood flow within the microcirculation, which favors coagulation. As protein C (PC) and antithrombin III (AT III) are important coagulation inhibitors, we decided to study them in polycythemic newborns. 相似文献