9 research outputs found

    Bone mineral density and cytokine levels during interferon therapy in children with chronic hepatitis B: does interferon therapy prevent from osteoporosis?

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    BACKGROUND: Our aim was to determinate bone mineral density (BMD), levels of biochemical markers and cytokines in children with chronic hepatitis B treated with interferon (IFN)-alpha and to investigate effect of IFN-alpha therapy on these variables. To the best of our knowledge, this is first study carried out about BMD and cytokine levels in pediatric patients with chronic hepatitis B treated with IFN-alpha. METHODS: BMD, levels of parathyroid hormone (PTH), osteocalcin, C-terminal cross-linking telopeptide of type I collagen (CTX), calcium, alkaline phosphates (ALP), cytokines as TNF-alpha, interleukin (IL)-1(β), IL-2r, IL-6, and IL-8 were studied in 54 children with chronic hepatitis B (4–15 years old) treated with interferon alone (n = 19) or in combination with lamivudine (n = 35) for six months and as controls in 50 age-matched healthy children. RESULTS: There was no significant difference in respect to serum IL-1(β), TNF-α and osteocalcin levels while serum IL-2r (p = 0.002), IL-6 (p = 0.001), IL-8 (p = 0.013), PTH (p = 0.029), and CTX (p = 0.021) levels were higher in children with chronic hepatitis B than in healthy controls. BMD of femur neck (p = 0.012) and trochanter (p = 0.046) in patients were higher than in healthy controls. There was a statistically significant correlation between serum IL-1(β )and osteocalcin (r = -0.355, p < 0.01); between serum IL-8 and CTX levels (r = 0.372, p = 0.01), and ALP (r = 0.361, p = 0.01); between serum ALP and femur neck BMD (r = 0.303, p = 0.05), and trochanter BMD (r = 0.365, p = 0.01); between spine BMD and IL-2R (r = -0.330, p < 0.05). CONCLUSION: In conclusion, our study suggest that BMD of femur, serum IL-2r, IL-6, IL-8, PTH, and CTX levels were higher in children with chronic hepatitis B treated with IFN-alpha alone or combination with lamivudine than in healthy children. High femur BMD measurements found in patients may suggest that IFN-alpha therapy in children with chronic hepatitis B could contribute indirectly to prevent from hip osteoporosis. Additionally, further investigations on effects of IFN-alpha for bone structure in children should be performed in the future

    In: Traumatic Brain Injury

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    Mild traumatic brain injury (mTBI), comprising 70–80% of all TBIs, is the commonest form of TBI, representing those injuries deemed to be at the lower end of the severity spectrum. In the general population, mTBI may occur as a result of a fall, work-related injury, sport or recreational activity, assault, motor vehicle accident, or any other activity that results in an impact to the head, but in military service, members’ blast-related and combat injuries are a further source of such injuries. There are various classification criteria for determining severity of TBI. mTBI is indicated by a Glasgow Coma Scale (GCS) score of 13–15 at the time of assessment, a duration of loss of consciousness (LOC) of less than 30 minutes, and/or a duration of post-traumatic amnesia (PTA) of less than 24 hours. In terms of the clinical pathology, mTBI is characterized by a diverse range of clinical features, demonstrating tremendous heterogeneity of the underlying pathology. Individuals suffering from mTBI may report a range of enduring1+ symptoms for weeks, months, and even years post-injury. In over 90% of mTBI cases, computed tomography (CT) and structural magnetic resonance imaging (MRI) investigation are unremarkable; however, with the more sophisticated brain function-related techniques abnormalities may be detected. While many mTBIs tend to result in a recovery period of days or weeks, this is not the case for all mTBIs. In some instances, the use of the classification “mild” is a misnomer, particularly for the group of patients that experience a prolonged recovery and meet criteria for persistent concussional symptoms/post-concussion syndrome (PCS). This review will focus on the post-injury cognitive sequelae and neuropsychological assessment in the management of mTBI, in the context of pre-injury characteristics and other post-injury sequelae

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    Guidelines for Management of Pregnant Women with Infections at Delivery and Care of Their Newborns

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    Neurochemical Systems Regulating the Hypothalamo-Pituitary-Adrenocortical Axis

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