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61.
Lucie MT Byrne-Davis Peter Salmon Katja Gravenhorst Tim OB Eden Bridget Young 《BMC medical research methodology》2010,10(1):101
Background
High accrual to clinical trials enables new treatment strategies to be tested rapidly, accurately and with generalisability. Ethical standards also must be high so that participation is voluntary and informed. However, this can be difficult to achieve in trials with complex designs and in those which are closely embedded in clinical practice. Optimal recruitment requires a balance of both ethical and accrual considerations. In the context of a trial of stratified treatments for children with acute lymphoblastic leukaemia (UKALL2003) we examined how recruitment looked to an observer and how it felt to the parents, to identify how doctors' communication could promote or inhibit optimal recruitment. 相似文献62.
Takashi Tanimoto MD Toshio Imanishi MD PhD Atsushi Tanaka MD PhD Takashi Yamano MD Hironori Kitabata MD Shigeho Takarada MD PhD Takashi Kubo MD PhD Kazushi Takemoto MT Nobuo Nakamura MD Kumiko Hirata MD PhD Masato Mizukoshi MD PhD Takashi Akasaka MD PhD 《Journal of the American Society of Echocardiography》2009,22(9):1015-1021
63.
A. Wolfensberger R. Benz E.W. Russi M. Tinguely C. Keller Dr. B. Gerber 《Der Internist》2013,54(8):1011-1015
Multicentric Castleman’s disease (MCD) is a rare polyclonal lymphoproliferative disorder that is typically accompanied by an overproduction of circulating cytokines (mainly interleukin-6). We here report the case of a 40-year-old HIV-negative woman with pulmonary manifestation of MCD. There is no standard treatment for MCD. In our patient, various treatment courses with immunomodulatory drugs were unsuccessful. Finally, treatment with the interleukin-6 receptor antibody tocilizumab has resulted in continual clinical improvement over the last 5 years. 相似文献
64.
BAL findings in a patient with pulmonary alveolar proteinosis successfully treated with GM-CSF 总被引:10,自引:1,他引:9 下载免费PDF全文
BACKGROUND: Idiopathic pulmonary alveolar proteinosis (PAP) has recently been recognised as a disease of impaired alveolar macrophage function caused by neutralising anti-granulocyte-macrophage colony-stimulating (anti-GM-CSF) autoantibodies. Subcutaneous recombinant human GM-CSF is a novel treatment for PAP, but its mechanism of action is unclear. METHODS: Clinical, functional, and bronchoalveolar lavage (BAL) findings were prospectively evaluated in a patient with PAP treated with daily subcutaneous GM-CSF 8 microg/kg for 12 weeks. RESULTS: Treatment resulted in improvements in dyspnoea, lung function, and peak cycle ergometry performance. In serum and BAL fluid the titre of anti-GM-CSF autoantibodies was raised at baseline and markedly reduced on treatment. At baseline the BAL fluid cellular profile showed a decrease in the absolute number and the percentage of macrophages (50%) and an increase in lymphocytes (45%), predominantly CD4+. This cellular distribution remained unchanged after 6 and 12 weeks of treatment while macrophages became morphologically normal and functionally improved. Extracellular proteinaceous material completely disappeared. CONCLUSIONS: Clinically successful treatment of PAP with GM-CSF was associated with a profound reduction in GM-CSF neutralising autoantibodies, improvement in alveolar macrophage morphology and function, but persistent BAL lymphocytosis. 相似文献
65.
66.
Induction of chromosome-specific aneuploidy and micronuclei in human lymphocytes by metabolites of 1,3-butadiene 总被引:5,自引:1,他引:5
1,3-Butadiene is a carcinogen in rodents, but its potential carcinogenicity
to humans remains controversial. Numerous studies have shown that butadiene
and its metabolites cause sister chromatid exchanges in vitro and in vivo.
To test for other types of genotoxicity, the micronucleus assay and
fluorescence in situ hybridization (FISH) have been used to detect
chromosome damage in human lymphocytes caused by two reactive metabolites
of butadiene, diepoxybutane (DEB) and monoepoxybutene (MEB). DEB (0.5-5.0
microM) significantly increased micronucleus formation 4- to 6-fold (P
<0.01) and MEB (1-500 microM) by 2- to 4-fold (P <0.01) over control
levels. The ability of DEB and MEB to induce aneuploidy of chromosomes 7,
8, 12, and X was examined using dual-color FISH in both interphase and
metaphase cells. These chromosomes were chosen because of their involvement
in leukemogenesis. Both DEB and MEB caused dose-dependent increases in
hyperdiploidy of chromosomes 12 and X, but had no discernible effect on
chromosomes 7 and 8. These results suggest that DEB and MEB cause
chromosome-specific aneuploidy in human cells. If formed in sufficient
amounts, DEB and MEB may produce chromosome damage of the type found in
leukemia following exposure to butadiene.
相似文献
67.
MT Tauber C Pienkowski P Pigeon M Cataldi P Rochiccioli 《Acta paediatrica (Oslo, Norway : 1992)》1993,82(S389):28-30
Six children presenting with partial growth hormone (GH) deficiency (mean GH peak in two different tests, 8.0 k1.3 μ g/l ) aged 8–10.3 years (mean, 2.7 ± 0.9 years) were treated for 6 months by continuous subcutaneous infusion of GH-releasing hormone(1–29)-NH, (GHRH(1–29)-NH2 ); 24-hour GH profiles and height velocity were measured. A biphasic effect of GHRH(1–29)-NH2 infusion was observed. After an early substantial increase in the 24-hour integrated concentration of GH, from 1.6 ± 0.1 to 3.5 ± 0.7 μg/l/minute, a subsequent consistent decrease occurred by 3 months, which was more pronounced after 6 months (mean 24-hour integrated concentration of GH, 1.9± 0.9 μg/l/minute). This effect reflects modification of both pulse amplitude and frequency of GH secretion. At the end of the study, one child had complete suppression of GH secretion and two others showed only one peak above 5 μg/1 during a 24-hour period. No correlation was found between these changes and height velocity. Three children did not grow significantly; the other three children who had a growth response to GHRH(1–29)-NH2 were those with the lowest 24-hour integrated GH concentration at the end of the study. The possible mechanisms involved in this biphasic effect, including GHRH antibodies, changes in somatostatin levels and/or desensitization of pituitary GHRH receptors, have been investigated. 相似文献
68.
Moderate and severe malnutrition are endemic in much of the developing world and in association with pockets of deprivation in the developed world. The cost in terms of individual and social development is high. The principles of effective management are clearly documented. A low cost, community based treatment programme for moderately and severely malnourished children under 3 years of age was established at a health centre in rural Jamaica. Children were followed up monthly and defaulters were rigorously recalled. Management consisted of carefully delivered dietary advice, antibiotics, anthelminthics, and vitamin supplements. All children improved and the response of 36 children, who were treated in the first year, showed an accelerated weight gain, with catch-up growth and the maintenance of length gain. There was a significant increase in the weight for age, at 1.9% per month over six months, which exceeds the rate reported with food supplementation programmes and nutrition rehabilitation centres. 相似文献
69.
MT Bardella N Molteni L Prampolini AM Giunta AR Baldassarri D Morganti PA Bianchi 《Archives of disease in childhood》1994,70(3):211-213
The use of follow up studies was evaluated in 128 patients with coeliac disease during their first visit to a department for adults. The original diagnosis had been made in childhood in all patients. Fifty eight (45%) of the subjects were following a gluten free diet, 23 (18%) were following a gluten free diet but with occasional gluten consumption, and 47 (37%) had adopted an unrestricted, gluten containing diet for a mean of 11.2 years. There was no correlation in individual subjects between the presence of symptoms, biochemical and immunological abnormalities, severity of histological findings, and the amount of dietary gluten, despite the greater frequency of symptoms in the group following an unrestricted diet than in the other two groups. Short stature and epilepsy with cerebral calcifications only occurred in patients following an unrestricted diet. As only diagnosis based on two or three biopsy samples and regular follow up correlated positively with dietary compliance, it is suggested that a histologically confirmed diagnosis of coeliac disease and regular lifelong follow up are essential in the management of these patients. 相似文献
70.
Wooden foreign bodies in soft tissue: detection at US 总被引:4,自引:0,他引:4