118 research outputs found

    A randomized, placebo-controlled trial of prednisone in early Henoch Schönlein Purpura [ISRCTN85109383]

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    BACKGROUND: Henoch Schönlein Purpura (HSP) is the most common systemic vasculitis of childhood. There is considerable controversy over whether children with HSP should be treated with corticosteroids. The goal of this study was to investigate whether early corticosteroid administration could reduce the rate of renal or gastrointestinal complications in children with HSP. METHODS: Forty children with HSP, seen in the emergency room of a tertiary-care, paediatric centre, entered a randomized, double-blind, placebo controlled study. The treatment group (n = 21) received oral prednisone, 2 mg/kg/day for one week, with weaning over a second week, while the placebo group (n = 19) received an identical appearing placebo. Co-primary outcomes were the rate of renal involvement at one year and the rate of acute gastrointestinal complications. Co-primary outcomes were analysed using Fisher's Exact test. RESULTS: At one year, there was no difference in the rate of renal involvement (3/21 prednisone group vs. 2/19 placebo group, P = 1.0). There was also no statistically significant difference in the rate of acute gastrointestinal complications (2/21 prednisone group vs. 3/19 placebo group, P = 0.7). Two children in the placebo group did experience intussusceptions compared with none in the prednisone group (P = 0.2). CONCLUSIONS: Early prednisone therapy in HSP does not appear to reduce the risk of renal involvement at one year, or the risk of acute gastrointestinal complications. There may be a reduced risk of intussusception. The routine, early use of prednisone in uncomplicated HSP cannot be recommended at this time

    Time to focus on outcome assessment tools for childhood vasculitis

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    Childhood systemic vasculitides are a group of rare diseases with multi-organ involvement and potentially devastating consequences. After establishment of new classification criteria (Ankara consensus conference in 2008), it is now time to establish measures for proper definition of activity and damage in childhood primary vasculitis. By comparison to adult vasculitis, there is no consensus for indices of activity and damage assessment in childhood vasculitis. Assessment of disease activity is likely to become a major area of interest in pediatric rheumatology in the near future. After defining the classification criteria for primary systemic childhood vasculitis, the next step was to perform a validation study using the original Birmingham vasculitis activity score as well as the disease extent index to measure disease activity in childhood vasculitis. Presently, there are efforts in place to develop a pediatric vasculitis activity score. This paper reviews the current understanding about the assessment tools (i.e., clinical features, laboratory tests, radiologic assessments, etc.) widely used for evaluation of the disease activity and damage status of the children with vasculitis

    Active memory controller

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    Inability to hide main memory latency has been increasingly limiting the performance of modern processors. The problem is worse in large-scale shared memory systems, where remote memory latencies are hundreds, and soon thousands, of processor cycles. To mitigate this problem, we propose an intelligent memory and cache coherence controller (AMC) that can execute Active Memory Operations (AMOs). AMOs are select operations sent to and executed on the home memory controller of data. AMOs can eliminate a significant number of coherence messages, minimize intranode and internode memory traffic, and create opportunities for parallelism. Our implementation of AMOs is cache-coherent and requires no changes to the processor core or DRAM chips. In this paper, we present the microarchitecture design of AMC, and the programming model of AMOs. We compare AMOs\u27 performance to that of several other memory architectures on a variety of scientific and commercial benchmarks. Through simulation, we show that AMOs offer dramatic performance improvements for an important set of data-intensive operations, e.g., up to 50x faster barriers, 12x faster spinlocks, 8.5x-15x faster stream/array operations, and 3x faster database queries. We also present an analytical model that can predict the performance benefits of using AMOs with decent accuracy. The silicon cost required to support AMOs is less than 1% of the die area of a typical high performance processor, based on a standard cell implementation

    Native Hawaiian ethnographic study for the Hawaii Geothermal Project proposed for Puna and Southeast Maui

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    Prepared for U.S. Department of Energy, Oak Ridge Operations Office by Oak Ridge National Laboratory. Report Number: ORNL/Sub--93-SN381; OSTI ID: 463547; Legacy ID: DE97051268; Other: ON: DE97051268This report makes available and archives the background scientific data and related information collected for an ethnographic study of selected areas on the islands of Hawaii and Maui. The task was undertaken during preparation of an environmental impact statement for Phases 3 and 4 of the Hawaii Geothermal Project (HGP) as defined by the state of Hawaii in its April 1989 proposal to Congress. Since the state of Hawaii is no longer pursuing or planning to pursue the HGP, DOE considers the project to be terminated. Information is included on the ethnohistory of Puna and southeast Maui; ethnographic fieldwork comparing Puna and southeast Maui; and Pele beliefs, customs, and practices.U.S. Department of EnergyDOE Contract Number AC05-96OR2246
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