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Objective: To investigate the effect of long-term low dose prednisone administration on bone mineral density (BMD) in patients with inactive systemic lupus erythematosus (SLE). Methods: A total of 118 inactive female SLE patients with long-term administration of low dose prednisone were recruited from the Department of Rheumatology and Immunology at An hui Provincial Hospital.All patients were given low dose prednisone for long-term (≤10 mg/d, more than half a year). According to prednisone doses, subjects were divided into two groups, namely group A (≤7.5 mg/d) and group B (7.5-10 mg/d). In addition, patients were also divided into four groups based on the duration of administration, including groupⅠ≤3 years, Ⅱfrom 4-5 years, Ⅲ 6-10 years and Ⅳ>10 years.Twenty-nine healthy people were recruitedas normal controls.The BMD was measured by dual energy X-ray absorptiometry.The association of BMD with prednisone dose and duration was compared between different groups. Results: The incidence of osteopenia in all patients with SLE was 42.4%(50/118), and the incidence of osteoporosis was 14.4%(17/118). BMD of all bone sites in both group A and B were significantly lower than that in normal control group (P<0.05). Similarly, the BMD of all bone sites in groupⅠ, Ⅱ, Ⅲ and Ⅳ were significantly decreased (P<0.05). What needed to be stressed was the BMD in group Ⅳ was lower than those in other three groups (P<0.05). Multiple logistic regression analysis showed that the cumulative prednisone dose was the risk factor for osteopenia, while taking calcium and alfacalcidol were protective factors. Conclusion: Long-term use of low dose prednisone result in the decrease of BMD in patients with inactive SLE.The lumbar spine and femoral neck had more severe osteopenia. Long-term administration of prednisone, even less than 7.5 mg/d, can also cause osteopenia.Calcium and alfacalcidol were protective factors of BMD.
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The anterior chamber reaction improved gradually, with tapering down of topical and oral treatment, until a complete resolution of the anterior chamber reaction was observed.
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Chronic urticaria (CU) patients often present activation of the coagulation cascade and fibrinolysis whose markers correlate with disease severity.
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This retrospective data analysis examined the outcome of 99 acute lymphoblastic leukemia (ALL) patients treated at Tawam Hospital between January 2000 and December 2009. Sixteen patients were treated before June 2002, and 83 patients were treated from June 2002. A modified form of UKALL XII/ECOG E2993 with pulsed dexamethasone in induction phase one (modified UKALL) was the main therapy from June 2002 (71/83). The median age was 28 years. Fifty-eight percent had pre-B ALL where 36 % of them were Philadelphia chromosome-positive (Ph+). Overall, complete remission (CR) rate was 86.7 % which was significantly inferior for patients with white blood cell count 30-100 × 10⁹/l (p = 0.009), therapy before June 2002 (p = 0.02), pregnancy (p = 0.005), CNS leukemia (p = 0.028), and unknown karyotype (p = 0.004). With a median follow-up of 11.8 months (0.49-126 months), the estimated overall survival (OS) and event-free survival (EFS) at 3 years were 50.6 and 28.7 %, respectively. OS and EFS were significantly inferior for patients not in CR after induction, age >20 years, Ph+, unknown karyotype and therapy before June 2002. In addition, CR, OS and EFS were significantly superior (p = 0.004, p < 0.001 and p = 0.001, respectively) for therapy with our modified UKALL protocol compared to Tawam protocol (main therapy before June 2002). In conclusion, the outcome of treatment for ALL at our institute is encouraging with significant improvement in the outcome of older adolescents and young adults when using high-intensity chemotherapy. This suggests that such an approach is feasible in developing countries in spite of some limitations including lack of stem cell transplantation service.
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Ten patients were enrolled in the phase I component; nine were evaluable. No DLTs were identified. The MTD was established as the approved doses for both drugs (cabazitaxel 25 mg/m(2) every 3 weeks and abiraterone 1000 mg once daily). Daily abiraterone treatment did not impact on cabazitaxel clearance. Twenty-seven patients received cabazitaxel plus abiraterone plus prednisone (5 mg twice daily) in phase II. The median number of cycles administered (cabazitaxel) was seven (range: 1-28). Grade 3-4 treatment-emergent adverse events included asthenia (in 5 patients; 14%), neutropenia (in 5 patients; 14%) and diarrhea (in 3 patients; 8%). Nine patients (24%) required dose reductions of cabazitaxel. Of 26 evaluable patients, 12 achieved a PSA response [46%; 95% confidence interval (CI): 26.6-66.6%]. Median PSA-progression-free survival was 6.9 months (95% CI: 4.1-10.3 months). Of 14 patients with measurable disease at baseline, 3 (21%) achieved a partial response per response evaluation criteria in solid tumors.
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T-cell lymphomas comprise a heterogeneous group of lymphoproliferative disorders that include approximately 10-15% of all lymphomas, and there is a geographic variation in their frequency. With the exception of a few subtypes that are associated with a more indolent course, the majority of T-cell lymphomas are aggressive in nature. Patients with peripheral T-cell lymphomas (PTCL) have an especially poor prognosis, due both to the aggressive disease course as well as the lack of effective treatments. A number of PTCL subtypes have now been defined, although the histologic, immunologic, and cytogenetic distinctions between some subtypes are subtle. Proper diagnosis of the PTCL subtype is important, as each subtype is associated with a varying prognosis and thus may be treated differently. There is no true standard of care for PTCL, and this aggressive disease has historically been treated with therapeutic regimens designed for B-cell lymphomas, such as the cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen. However, studies now show that these regimens are not optimal for most patients with PTCL. Therefore, recent efforts have focused on the development of therapeutic regimens designed to be more effective in PTCL, some of which are specifically targeted against T-cell markers. A number of these agents now show promise in the treatment of both frontline and relapsed/ refractory disease.
Oral abiraterone acetate (Zytiga®), a selective cytochrome P450 17A1 enzyme inhibitor, is used in combination with prednisone or prednisolone to treat patients with metastatic castration-resistant prostate cancer (CRPC) who have previously received docetaxel-containing chemotherapy. In a clinical trial in patients with CRPC, abiraterone acetate plus prednisone significantly prolonged overall survival, the time to prostate-specific antigen progression and progression-free survival compared with placebo plus prednisone.
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Our patient appears to represent a previously unrecognized variant of steroid-responsive minimal change disease (MCD)/focal and segmental glomerulosclerosis (FSGS) in which severe AKI developed even though the serum albumin was essentially normal and proteinuria was minimal. This would be a paradox because the AKI of MCD/FSGS is a manifestation of severe nephrotic syndrome. To explain this paradox, it is suggested that our patient is a rare variant of a phenomenon that is well documented in steroid-responsive MCD/FSGS, specifically, glomerular permeability to large molecules is increased (accounting for the proteinuria) but decreased to small molecules (accounting for the low glomerular filtration rate). Our patient promptly recovered kidney function on steroid therapy even though he had been oliguric and dialysis dependent for nearly 11 months. The possible pathophysiologic mechanisms for this remarkable presentation and outcome are discussed.
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With a median follow up of 45 months, 4-year progression-free survival and overall survival were estimated at 76% (CI: 69-81) and 78% (CI: 72-83), respectively. There was no difference between patients with 2 or 3 International Prognostic Index factors. Four year progression-free survival was significantly higher in R-ACVBP than ACVBP patients (74% vs. 58%; P=0.0005). There was also a significant increase in 4-year overall survival (76% vs. 68%; P=0.0494).
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A patient with refractory KD after surgery and treatment with prednisone was treated with tacrolimus. Tacrolimus (FK-506) was administered at an initial dosage of 1 mg every 12 hours, and FK-506 concentration in the blood was monitored monthly. FK-506 blood concentration was controlled within 5 to 15 μg/L. After 6 months, the dosage of tacrolimus was reduced to 0.5 mg daily for another 2 months and then treatment was stopped.
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We will discuss about cases described in literature about those rare and different kinds of pathogenic agents while considering evolution, topography of lesions in our case, in order to focus on specificities. We shall emphasize the necessity to be careful about cutaneous hurt in immunocompromised patients.
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Thirty patients with progressing CRPC and a rising prostate-specific antigen (PSA) received docetaxel/prednisone in standard conditions for 6 cycles in combination with per os curcumin, 6,000 mg/day (day -4 to day +2 of docetaxel). The co-primary endpoint was the overall response rate determined by PSA and target assessments. An ancillary study assessed the seric values of chromogranin A (CgA) and neuron-specific enolase (NSE).
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This ancillary study provided an opportunity to examine the determinants of 24-month change in parent and child of quality of life within a subset of the CAMP participants. Moderate changes in quality of life occur in clinical studies and have both psychosocial correlates and illness characteristics.
Patients received a median of 3 cycles of methotrexate at a dose of 3.5 gm/m(2) with leucovorin rescue. The complete response rate was 86%, with 6% partial responses. At a median follow-up of 33 months, there were only 2 CNS recurrences (3%) in this high-risk population. The 3-year progression-free and overall survival rates were 76% and 78%, respectively. Complications associated with methotrexate therapy included transient renal dysfunction in 7 patients and a delay in systemic chemotherapy in 8 patients.
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To determine damage presence and predictors factors for its appearance in a cohort of cuban patients with systemic lupus erythematosus (SLE).
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2 U.S. academic centers (National Institutes of Health, Bethesda, Maryland, and University of Texas, Dallas, Texas) and 9 rheumatology subspecialty clinics (in Dallas and Austin, Texas; Tampa and Fort Lauderdale, Florida; Arlington, Virginia; Duncanville, Pennsylvania; Wheaton and Greenbelt, Maryland; and Lansing, Michigan).
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The study population consisted of 28 children from Upper Egypt with classic CAH, their mean age 8.3 ± 2.4 years and 28 age and sex matched healthy control. They were subjected to measurement of BMD of lumbar spines (L1-L4) and femoral neck using dual-energy-X-ray absorptiometry (DXA) and laboratory evaluation of bone turnover markers including Osteocalcin and serum receptor activator of nuclear factor κB-ligand (RANKL).
One hundred forty-six patients with 252 nasal cavities (52.0%) received steroid-impregnated AS, and 128 patients with 233 nasal cavities (48.0%) received NAS. Synechiae formation occurred in 2.0% of cavities with AS and 5.6% of cavities with NAS, but this difference was not statistically significant (OR = 0.34, P = .052). One patient in each cohort had significant postoperative epistaxis requiring additional nasal packing (P > .99).
Experience with tolerance protocols has shown that none is perfect and that each escape from tolerance must be identified early to prevent graft failure. In addition, some test is needed for patients who are weaned off immunosuppression (IS) to forewarn of weaning failure. The usual measures of function--such as serum creatinine levels--are not sensitive enough to detect rejection in a timely manner.
In this multicenter trial, patients with newly diagnosed or relapsing TAK were treated with abatacept 10 mg/kg intravenously on days 1, 15, and 29 and week 8, together with prednisone administered daily. At week 12, patients in remission underwent a double-blinded randomization to continue to receive abatacept monthly or switch to placebo. Patients in both study arms received a standardized prednisone taper, reaching a dosage of 20 mg daily at week 12, with discontinuation of prednisone at week 28. All patients remained on their randomized assignment until meeting criteria for early termination or until 12 months after enrollment of the last patient. The primary end point was duration of remission (relapse-free survival).