RESUMO
Few studies examined the clinicopathologic features of PTLD arising in pediatric SBT patients. Particularly, the association between ATG and PTLD in this population has not been described. Retrospective review of 81 pediatric patient charts with SBT--isolated or in combination with other organs--showed a PTLD incidence of 11%, occurring more frequently in females (median age of four yr) and with clinically advanced disease. Monomorphic PTLD was the most common histological subtype. There was a significant difference in the use of ATG between patients who developed PTLD and those who did not (p < 0.01); a similar difference was seen with the use of sirolimus (p < 0.001). These results suggested a link between the combination of ATG and sirolimus and development of more clinically and histologically advanced PTLD; however, the risk of ATG by itself was not clear. EBV viral loads were higher in patients with PTLD, and median time between detection of EBV to PTLD diagnosis was three months. However, viral loads at the time of PTLD diagnosis were most often lower than at EBV detection, thereby raising questions on the correlation between decreasing viral genomes and risk of PTLD.
Assuntos
Enteropatias/terapia , Intestino Delgado/transplante , Transtornos Linfoproliferativos/etiologia , Complicações Pós-Operatórias , Adolescente , Soro Antilinfocitário/uso terapêutico , Criança , Pré-Escolar , Feminino , Rearranjo Gênico , Genoma Viral , Humanos , Imunossupressores/uso terapêutico , Hibridização In Situ , Lactente , Enteropatias/complicações , Linfoma/complicações , Linfoma/etiologia , Transtornos Linfoproliferativos/complicações , Masculino , Estudos Retrospectivos , Risco , Sirolimo/uso terapêutico , VDJ Recombinases/genética , Carga Viral , Adulto JovemRESUMO
The survival rate of patients undergoing cardiopulmonary resuscitation is 5 to 15%. New cardiopulmonary resuscitation treatment approaches under investigation include the use of vasopressin as a vasopressor, amiodarone for the treatment of ventricular tachyarrhythmias, and adenosine antagonists (i.e., theophylline) for bradyasystolic rhythms. More innovative approaches include the use of thyroid hormone and endothelin.
Assuntos
Antiarrítmicos/uso terapêutico , Reanimação Cardiopulmonar , American Heart Association , Animais , Antiarrítmicos/normas , Reanimação Cardiopulmonar/normas , Doenças Cardiovasculares/terapia , Ensaios Clínicos como Assunto , Terapia Combinada/normas , Endotelina-1/uso terapêutico , Humanos , Guias de Prática Clínica como Assunto , Resultado do Tratamento , Estados Unidos/epidemiologia , United States Food and Drug AdministrationRESUMO
The survival rate of patients undergoing cardiopulmonary resuscitation (CPR) is 5% to 15%. New treatment approaches under investigation for CPR include the use of vasopressin as a vasopressor, amiodarone for the treatment of ventricular tachyarrhythmia, and adenosine antagonists (i.e., theophylline) for bradyasystolic rhythms. More innovative approaches include the use of thyroid hormone and endothelin.