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991.
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) with pulmonary hemorrhage is rare in childhood. Standard treatment includes corticosteroids and cyclophosphamide (CYC), which is associated with a high level of toxicity. We report a white female with ANCA positive pulmonary hemorrhage who was treated with cyclophosphamide (CYC) and rituximab (RTX) combination therapy. 相似文献
992.
Serge Boveda Rodrigue Garcia Pascal Defaye Olivier Piot Kumar Narayanan Sergio Barra Daniel Gras Rui Providencia Vincent Algalarrondo Frankie Beganton Marie-Cécile Perier Sophie Jacob Pierre Bordachar Dominique Babuty Didier Klug Christophe Leclercq Laurent Fauchier Nicolas Sadoul Eloi Marijon 《Archives of Cardiovascular Diseases》2019,112(8-9):523-531
993.
Mimica Milena Barra Ignacio Ormeño Rocío Flores Patricia Calderón Jorge Padilla Oslando Bravo-Zehnder Marcela González Alfonso Massardo Loreto 《Clinical rheumatology》2019,38(11):3129-3137
Clinical Rheumatology - Central nervous system disease occurs in over 20% of patients with systemic lupus erythematosus (SLE) resulting in major morbidity and damage. Cognitive dysfunction is... 相似文献
994.
Renzo Corvò Michele ZeverinoStefano Vagge Stefano AgostinelliSalvina Barra Gianni TacciniMaria Teresa Van Lint Francesco FrassoniAndrea Bacigalupo 《Radiotherapy and oncology》2011,98(3):382-386
Background and purpose
To report our clinical experience in planning and delivering total marrow irradiation (TMI) after total body irradiation (TBI) in patients with relapsed acute leukemia undergoing an allogeneic stem-cell transplant (SCT).Materials and Methods
Patients received conventional TBI as 2 Gy BID/day for 3 days boosted the next day by TMI (2 Gy in a single fraction) and followed by cyclophosphamide (Cy) 60 mg/kg for 2 days. While TBI was delivered with linear accelerator, TMI was performed with helical tomotherapy (HT).Results
Fifteen patients were treated from July 2009 till May 2010, ten with acute myeloid leukemia, and five with acute lymphoid leukemia. At the time of radiotherapy eight patients were in relapse and seven in second or third complete remission (CR) after relapse. The donor was a matched sibling in 7 cases and an unrelated donor in 8 cases. Median organ-at-risk dose reduction with TMI ranged from 30% to 65% with the largest reduction (-50%-65%) achieved for brain, larynx, liver, lungs and kidneys. Target areas (bone marrow sites and spleen in selected cases) were irradiated with an optimal conformity and an excellent homogeneity. Follow-up is short ranging from 180 to 510 days (median 310 days). However, tolerance was not different from a conventional TBI-Cy. All patients treated with TBI/TMI reached CR after SCT. Three patients have died (2 for severe GvHD, 1 for infection) and 2 patients showed relapsed leukemia. Twelve patients are alive with ten survivors in clinical remission of disease.Conclusions
This study confirms the clinical feasibility of using HT to deliver TMI as selective dose boost modality after TBI. For patients with advanced leukemia targeted TMI after TBI may be a novel approach to increase radiation dose with low risk of severe toxicity. 相似文献995.
JA Pineda J Macías JA Mira N Merchante J del Valle KI Neukam 《European journal of medical research》2010,15(3):93-96
The overall effect of HAART on the liver is the result of the balance between hepatotoxicity and the consequences of immunoreconstitution on the evolution of HIV-associated liver diseases, particularly viral hepatitis. HAART may lead to the emergence of acute toxic hepatitis, steatosis, steatohepatitis, liver fibrosis, and noncirrhotic portal hypertension. On the other hand, HAART use has been associated with slower fibrosis progression in HIV/HCV-coinfected patients in most studies dealing with this issue. As well, an improvement of the clinical outcome of liver disease has been reported in patients taking HAART. For these reasons, the short- and mid-term effects of HAART on the liver are mostly beneficial. 相似文献
996.
997.
SÉBASTIEN KNECHT M.D. MATTHEW WRIGHT M.B.B.S. Ph.D. SEIICHIRO MATSUO M.D. ISABELLE NAULT M.D. F.R.C.P.C. NICOLAS LELLOUCHE M.D. FRÉDÉRIC SACHER M.D. STEVEN J. KIM M.S.E.E. DENNIS MORGAN M.S. VALTINO AFONSO Ph.D. MIYAZAKI SHINZUKE M.D. MÉLÈZE HOCINI M.D. JACQUES CLÉMENTY M.D. SANJIV M. NARAYAN M.B. M.D. PHILLIPE RITTER M.D. PIERRE JAÏS M.D. MICHEL HAÏSSAGUERRE M.D. 《Journal of cardiovascular electrophysiology》2010,21(7):766-772
Autonomic Blockade During Atrial Fibrillation . Introduction: The influence of the autonomic nervous system on the pathogenesis of complex fractionated atrial electrograms (CFAE) during atrial fibrillation (AF) is incompletely understood. This study evaluated the impact of pharmacological autonomic blockade on CFAE characteristics. Methods and Results: Autonomic blockade was achieved with propanolol and atropine in 29 patients during AF. Three‐dimensional maps of the fractionation degree were made before and after autonomic blockade using the Ensite Navx® system. In 2 patients, AF terminated following autonomic blockade. In the remaining 27 patients, 20,113 electrogram samples of 5 seconds duration were collected randomly throughout the left atrium (10,054 at baseline and 10,059 after autonomic blockade). The impact of autonomic blockade on fractionation was assessed by blinded investigators and related to the type of AF and AF cycle length. Globally, CFAE as a proportion of all atrial electrogram samples were reduced after autonomic blockade: 61.6 ± 20.3% versus 57.9 ± 23.7%, P = 0.027. This was true/significant for paroxysmal AF (47 ± 23% vs 40 ± 22%, P = 0.003), but not for persistent AF (65 ± 22% vs 62 ± 25%, respectively, P = 0.166). Left atrial AF cycle length prolonged with autonomic blockade from 170 ± 33 ms to 180 ± 40 ms (P = 0.001). Fractionation decreases only in the 14 of 27 patients with a significant (>6 ms) prolongation of the AF cycle length (64 ± 20% vs 59 ± 24%, P = 0.027), whereas fractionation did not reduce when autonomic blockade did not affect the AF cycle length (58 ± 21% vs 56 ± 25%, P = 0.419). Conclusions: Pharmacological autonomic blockade reduces CFAE in paroxysmal AF, but not persistent AF. This effect appears to be mediated by prolongation of the AF cycle length. (J Cardiovasc Electrophysiol, Vol. pp. 766‐772, July 2010) 相似文献
998.
LA Szczech P Menezes E Byrd Quinlivan C Van Der Horst JA Bartlett LP Svetkey 《HIV medicine》2010,11(7):419-426
Background
This study examines the association between microalbuminuria and the development of proteinuria among HIV‐infected persons.Methods
A total of 948 subjects provided urine samples for albumin, protein and creatinine measurements semiannually. Microalbuminuria was defined as an albumin‐to‐creatinine ratio of >30 mg/g. Proteinuria was defined as a protein‐to‐creatinine ratio of ≥0.350 mg/mg. The progression from microalbuminuria to proteinuria was described.Results
At baseline, 69.4% of the subjects had no detectable proteinuria, 20.2% had microalbuminuria, and 10.4% had proteinuria. Subjects with microalbuminuria and proteinuria were more likely to be black (P=0.02), have lower CD4 cell counts (P=0.02 comparing subjects without abnormal urine protein excretion to subjects with microalbuminuria; P=0.0001 comparing subjects with microalbuminuria to subjects with proteinuria), and have a higher HIV RNA level (P=0.08 and 0.04, respectively). Among 658 subjects with normal urine protein, 82.7% continued to have no abnormality, 14.3% developed microalbuminuria, and 3.0% developed proteinuria. Subjects without baseline proteinuria (i.e. either normal protein excretion or microalbuminuria) who developed proteinuria were more likely to have microalbuminuria (P=0.001), a lower CD4 cell count (P=0.06), and a higher plasma HIV RNA (P=0.03) than those who did not progress to proteinuria. In multivariate analysis, only microalbuminuria remained associated with the development of proteinuria (odds ratio 2.9; 95% confidence interval 1.5, 5.5; P=0.001).Conclusion
Microalbuminuria predicts the development of proteinuria among HIV‐infected persons. Because proteinuria has been linked to poorer outcomes, strategies to affect microalbuminuria should be tested.999.
P Pérez-Vallecillos R Conde-Muíño I Segura-Jiménez N Maldonado-Fernández JA Ferrón V García-Róspide P Palma 《BMC gastroenterology》2010,10(1):59
Background
Visceral artery aneurysms (VAA), although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA) and celiac trunk, successfully treated with surgery. 相似文献1000.