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Elefsiniotis IS Pantazis KD Ilias A Pallis L Mariolis A Glynou I Kada H Moulakakis A 《European journal of gastroenterology & hepatology》2004,16(6):593-598
OBJECTIVE: Tamoxifen induced hepatotoxicity has not been investigated in breast cancer patients with pre-existing liver steatosis. The aim of our study was to investigate the most common predisposing factors for non-alcoholic fatty liver disease in breast cancer patients with liver steatosis, treated with adjuvant tamoxifen therapy, in order to evaluate their role in the appearance of tamoxifen induced hepatotoxicity. METHODS: Clinical and laboratory evaluation, including an oral glucose tolerance test, was done in 60 women with breast cancer and liver steatosis before the beginning of adjuvant tamoxifen treatment and every 6 months during treatment. Tamoxifen induced hepatotoxicity was defined as abnormal liver function tests during tamoxifen treatment whereas these test results were below the normal range at baseline control. Statistical evaluation of data was performed using parametric methodology (the chi-squared test, and Student's t-test, P < 0.05). RESULTS: Twenty-six patients (43.3%) exhibited tamoxifen induced hepatotoxicity (group A) whereas 34 (56.7%) did not (group B). The mean overall follow-up period for the whole group was 37.5 months (SD 27.8, range 6-120 months) and did not differ between the two groups (P = 0.055). There was significant statistical difference in body mass index (BMI) and baseline fasting glucose, cholesterol and triglyceride levels between the two groups. Eighteen of 26 patients (69.2%) from group A had impaired glucose tolerance compared with only 8/34 patients (23.5%) from group B (P < 0.001), a finding observed even in BMI matched patients from the two groups (62.5% vs 12.5%, P = 0.002). CONCLUSIONS: Tamoxifen induced hepatotoxicity is observed in a great proportion of breast cancer patients with pre-existing liver steatosis, especially those with higher BMI and higher glucose and lipid levels at baseline control. Glucose intolerance before the beginning of tamoxifen treatment seems to be a predictor of the hepatotoxicity, unrelated to baseline BMI. 相似文献
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Irini Flouri Theodora E. Markatseli Paraskevi V. Voulgari Kyriaki A. Boki Ioannis Papadopoulos Loukas Settas Dimitrios Zisopoulos Fotini N. Skopouli Alexios Iliopoulos George K. Bertsias Pierre Geborek Alexandros A. Drosos Dimitrios T. Boumpas Prodromos Sidiropoulos 《Seminars in arthritis and rheumatism》2014
Objective
To compare effectiveness, drug survival, and safety between infliximab, adalimumab, and etanercept, in a nationwide cohort of rheumatoid arthritis (RA) patients.Methods
This study is a prospective cohort study of 1208 active RA patients. Effectiveness, drug survival, and serious adverse events during entire follow-up (median 2.9 years) were monitored.Results
EULAR and CDAI responses were comparable between the three agents (EULAR good/moderate responses at 12 months ranged 76–79%). At 12 months, 15–23% achieved remission. For adalimumab and etanercept, adjusted hazard rate (HR) for EULAR/ACR remission (reference: infliximab) was 2.7 and 2.1 (95% confidence interval was 1.7–4.1 and 1.3–3.4, respectively); males (HR 1.6; 1.1–2.4), use of glucocorticoids (HR 2.0; 1.3–3.0), and swollen joint count >7 (HR 0.36; 0.24–0.55) were independent predictors. Five-year drug survival was 31%, 43%, and 49% for infliximab, adalimumab, and etanercept, respectively (p = 0.010). Infliximab was associated with significantly more withdrawals due to adverse events. Disease activity, CRP, and use of glucocorticoids predicted efficacy-related drug survival; age, use of methotrexate, and prior DMARDs failures predicted safety-related survival. Risk for serious infections was lower with adalimumab (odds ratio [OR] 0.62; 0.38–1.00) or etanercept (OR 0.39; 0.21–0.72) than infliximab, independent of the effects of age (OR 1.65; 1.37–2.00 per 10 years), tender joint count >10 (OR 1.86; 1.21–2.86), and glucocorticoids >35 mg/week (OR 1.83; 1.12–2.99).Conclusions
Response rates were comparable among anti-TNF agents. Overall, 5-year drug survival was below 50%, with infliximab demonstrating increased safety-related discontinuations. Remission rates are low in clinical practice. Strategies to increase effectiveness and long-term survival of anti-TNF agents in RA are needed. 相似文献25.
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Martin M. Mortazavi Meghan Denning Bulent Yalcin Mohammadali M. Shoja Marios Loukas R. Shane Tubbs 《Child's nervous system》2013,29(7):1073-1078
Introduction
The intracranial bridging veins are pathways crucial for venous drainage of the brain. They are not only involved in pathological conditions but also serve as important landmarks within neurological surgery.Methods
The medical literature on bridging veins was reviewed in regard to their historical aspects, embryology, histology, anatomy, and surgery.Conclusion
Knowledge on the intracranial bridging veins and their dynamics has evolved over time and is of great significance to the neurosurgeon. 相似文献28.
Asma Mian Mohammadali M. Shoja Koichi Watanabe Curtis J. Rozzelle Marios Loukas R. Shane Tubbs 《Child's nervous system》2013,29(1):1-4
Introduction
The Scottish surgeon Robert Liston was an accomplished anatomist of the nineteenth century. The study of anatomy during this day was often overshadowed by the so-called resurrectionists. Conclusions: The present historic paper reviews the life and contributions of Robert Liston and discusses his fascination with childhood hydrocephalus. 相似文献29.
Christoph J. Griessenauer Philip Veith Martin M. Mortazavi Carrie Stewart Angela Grochowsky Marios Loukas R. Shane Tubbs 《Child's nervous system》2013,29(4):543-547
Introduction
Enlarged parietal foramina are variable ossification defects in the parietal bones that present as symmetric radiolucencies on skull radiographs. In contrast to the normal small parietal foramina, enlarged parietal foramina are a hereditary condition and genes associated with it have been identified.Methods
A literature review was performed to discuss the many known findings related to enlarged parietal foramina.Conclusions
Even though they remain asymptomatic in the majority of cases, they may be associated with other pathologies and occasionally become symptomatic. This article provides a comprehensive review of the current knowledge of enlarged parietal foramina. 相似文献30.