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1.
Am J Case Rep ; 21: e922567, 2020 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-32361709

RESUMO

BACKGROUND Hemolytic uremic syndrome (HUS) can be categorized as primary (typical or atypical) or secondary (with a coexisting diseases). Typical HUS usually means shiga-toxin-medicated and thrombotic thrombocytopenic purpura. Secondary HUS is often initiated by coexisting diseases or conditions such as infections, transplantation, cancer, and autoimmune disease. Atypical HUS (aHUS) is usually induced by genetic mutations of one or several complement-regulating genes and associated with dysregulated complement activation. In the era of compliment-inhibiting therapy, early recognition of aHUS is important for patient prognosis. However, compliment-inhibiting therapy is not always beneficial in patients with secondary HUS. CASE REPORT We present a case of a 49-year-old woman with aHUS, which was caused by a novel genetic point mutation of complement factor H gene (p.Gly1110Ala) mimicking secondary HUS with scleroderma. Instead of administering eculizumab treatment for C5 polymorphism, the patient was successfully treated with mycophenolate mofetil. CONCLUSIONS HUS has complex and mixed etiologies and requires genetic testing. Attention should be paid to new point mutations in aHUS.

3.
Infect Chemother ; 52(1): 113-122, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32239813

RESUMO

Strong policies were established to maintain vaccination rate at ≥95% to expedite the eradication and elimination of measles outbreaks; nationwide survey of measles immunity to determine the susceptibility and the mandatory submission of second measles vaccination records when entering primary school. The measles control policies were also implemented to help achieve the goal of eliminating measles after the catch-up vaccination and they can be summarized as strategies for classifying measles patients based on their clinical symptoms while anticipating that weaker symptoms than those in typical cases would be seen; improving the operation of laboratories to world-class level for diagnosis of measles and identification of epidemiological circumstances for strengthen the detection of patients suspected of having measles; and immediate response through a rapid reporting system. With these efforts, Korea became the country to make the declaration of measles elimination by complying with all standards presented by the World Health Organization in 2006, re-verified in 2014. However, sporadic outbreaks of measles have repeatedly occurred even after the declaration of measles elimination. This indicates the need for continued control of imported cases and possible re-outbreaks. Also, it will be necessary to find and implement measures to continuously maintain the policy.

4.
J Control Release ; 323: 110-124, 2020 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-32302760

RESUMO

Food and oral pharmaceutical products containing probiotics have tremendous health benefits and have recently attracted a great amount of attention. However, the delivery and controlled release of core probiotics to the target site is a complicated process that must be considered when constructing carrier systems. The encapsulation of probiotics on the basis of polysaccharides is frequently applied to overcome this problem and has acquired remarkable results. Despite this, intrinsic disadvantages, including porosity and indigestibility, exist in most reported plant- and animal-derived polysaccharides during this process. Thus, the development of effective alternatives of polysaccharides is urgently required. The polysaccharides produced by Lactobacillus are assumed to be more suitable for the efficient delivery and controlled release of probiotics when compared with plant- and animal-derived polysaccharides. However, in-depth research relating to such polysaccharides is currently limited. In this review, we extensively analyze the structure and characteristics of the polysaccharides derived from Lactobacillus, and compare them with other additional successfully applied polysaccharides for the encapsulation of probiotics. We then, discuss the application of Lactobacillus polysaccharides for encapsulated probiotics, and in particular, the delivery and controlled release of oral probiotics.

5.
Hum Vaccin Immunother ; : 1-8, 2020 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-32330397

RESUMO

This study was conducted to assess the nasopharyngeal (NP) carriage and acute otitis media (AOM) occurrence in Korean children who received pneumococcal conjugate vaccines (PCVs). The longitudinal study was conducted through four consecutive visits. At each visit, NP aspirates were obtained and subjects were asked to visit if AOM occurred. A total of 305 subjects were enrolled and received PCV13 (n = 182) or PCV10 (n = 123). In the PCV13 group, the NP carriage of Streptococcus pneumoniae at each visit was 2.7%, 14.8%, 18.7%, and 15.9%, respectively. Non-typeable Haemophilus influenzae (NTHi) was 3.3%, 2.7%, 2.7%, and 5.5%, and that of Moraxella catarrhalis was 1.1%, 9.3%, 4.9%, and 0.5%. In the PCV10 group, the NP carriage of S. pneumoniae at each visit was 3.3%, 7.3%, 6.5%, and 4.1%, respectively. That of NTHi was 2.4%, 4.1%, 1.6%, and 0.8%, and that of M. catarrhalis was 4.1%, 0.8%, 0.8%, and 0.0%. AOM occurrence in the PCV13 group observed after the primary dose and before booster dose was 20.9%, occurrence after booster dose was 11.0%, and the incidence of two or more AOM was 11.0%. In the PCV10 group, AOM occurrence was 9.8%, 7.3%, respectively, and the incidence of two or more AOM was 2.4%. The predominant S. pneumoniae isolated were non-vaccine type (10A, 15A, and 15B). In this study, AOM occurrence was lower in the PCV10 group than in the PCV13 group. This seems to be related to ecological changes that lead to differences in NP carriage, especially S. pneumoniae and NTHi.

6.
Artigo em Inglês | MEDLINE | ID: mdl-32247305

RESUMO

BACKGROUND: Although vaccination against hepatitis B virus (HBV) is recommended for hematopoietic cell transplantation (HCT) recipients, previous studies evaluating serologic status and immunologic response to HBV vaccination in pediatric allogeneic HCT recipients are not enough. OBJECTIVE: This study aimed to evaluate serologic status against HBV and immunologic responses to HBV vaccination in children and adolescents receiving allogeneic HCTs. METHODS: Medical records of the enrolled 61 pediatric patients < 19 years of age who received their first allogeneic HCTs were retrospectively reviewed. RESULTS: Twenty-two (36.1%) of the enrolled patients were positive for hepatitis B surface antibody (HBsAb) after HCT. Chronic graft-versus-host disease was significantly associated with negative HBsAb status after HCT (p = 0.01). With one dose of HBV vaccination after HCT, 40.5% of the vaccinated patients became positive for HBsAb. No clinical factor was associated with the positive conversion of HBsAb after vaccination. CONCLUSIONS: Considering the unsatisfactory seropositive rate and vaccine response against HBV and the lack of significant clinical and laboratory factors predicting serostatus in HCT recipients, universal three doses of HBV vaccination should be necessary after allogeneic HCT.

7.
Chem Commun (Camb) ; 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32163077

RESUMO

A new ligand H2L with pyridine and salen moieties and its coordination polymers (CPs) [Mn(L)Cl]·DMF (1) and [Fe(L)Cl]·DMF (2) were synthesized and their photocatalytic activity for the conversion of CO2 into CO under visible-light irradiation was investigated. This is the first instance of pyridyl-salen-ligand based CPs for photocatalyzing CO2 reduction.

8.
Med Sci Monit ; 26: e920725, 2020 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-32214060

RESUMO

BACKGROUND Wilms tumor, or nephroblastoma, is a malignant pediatric embryonal renal tumor that has a poor prognosis. This study aimed to use bioinformatics data, RNA-sequencing, connectivity mapping, molecular docking, and ligand-protein binding to identify potential targets for drug therapy in Wilms tumor. MATERIAL AND METHODS Wilms tumor and non-tumor samples were obtained from high throughput gene expression databases, and differentially expressed genes (DEGs) were analyzed using the voom method in the limma package. The overlapping DEGs were obtained from the intersecting drug target genes using the Connectivity Map (CMap) database, and systemsDock was used for molecular docking. Gene databases were searched for gene expression profiles for complementary analysis, analysis of clinical significance, and prognosis analysis to refine the study. RESULTS From 177 cases of Wilms tumor, there were 648 upregulated genes and 342 down-regulated genes. Gene Ontology (GO) enrichment analysis showed that the identified DEGs that affected the cell cycle. After obtaining 21 candidate drugs, there were seven overlapping genes with 75 drug target genes and DEGs. Molecular docking results showed that relatively high scores were obtained when retinoic acid and the cyclin-dependent kinase inhibitor, alsterpaullone, were docked to the overlapping genes. There were significant standardized mean differences for three overlapping genes, CDK2, MAP4K4, and CRABP2. However, four upregulated overlapping genes, CDK2, MAP4K4, CRABP2, and SIRT1 had no prognostic significance. CONCLUSIONS RNA-sequencing, connectivity mapping, and molecular docking to investigate ligand-protein binding identified retinoic acid and alsterpaullone as potential drug candidates for the treatment of Wilms tumor.

9.
Clin Otolaryngol ; 45(3): 394-401, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32058675

RESUMO

OBJECTIVES: To evaluate the clinical efficacy of a high-efficiency air purifier in patients with allergic rhinitis. DESIGN: We conducted a randomised, double-blind, clinical controlled trial with active and inactive versions of an air purifier. Our study included patients with allergic rhinitis who were sensitive to Artemisia pollen and treatment of the indoor environment using air filtration at night. We evaluated the clinical efficacy of indoor air filtration during the Artemisia pollen scattering season in Yulin City in Shanxi Province, China. SETTING: The First Hospital of Yulin (Yulin City, Shanxi Province, China). PARTICIPANTS: A total of 90 patients with allergic rhinitis who were sensitive to allergens of Artemisia pollen were randomly assigned to one of two groups in equal numbers. MAIN OUTCOME MEASURES: The primary outcome measure was the difference in visual analogue scale scores from baseline. Secondary outcomes were changes from baseline in nasal symptoms, allergy symptom scores, responses to the Rhinoconjunctivitis Quality of Life Questionnaire, Epworth Sleepiness Scale scores and tolerability scores for the air purifier. RESULTS: Based on the allergy symptom score, we found significant differences in rhinitis symptoms between the groups who used the active versus the inactive air purifier. CONCLUSIONS: The results of our investigation demonstrated the health benefits of particle filtration.

10.
ACS Sens ; 5(2): 571-579, 2020 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-32013398

RESUMO

During the detection of industrial toxic gases, such as triethylamine (TEA), poor selectivity and negative humidity impact are still challenging issues. A frequently reported strategy is to employ molecular sieves or metal-organic framework (MOF) membranes so that interference derived from surrounding gases or water vapor can be blocked. Nevertheless, the decline in the response signal was also observed after coating these membranes. Herein, an alternative strategy that is based on a hydrophobic, TEA adsorption-selective p-n conjunction core-shell heterostructure is proposed and is speculated to simultaneously enhance selectivity, sensitivity, and humidity resistance. To verify the practicability of the proposed strategy, a thickness-tunable nitrogen-doped carbon (N-C) shell-coated α-Fe2O3 nano-olive (N-C@α-Fe2O3 NO)-based core-shell heterostructure that is obtained via a unique all-vapor-phase processing method is selected as the research example. After forming the core-shell heterostructure, a relatively hydrophobic and TEA adsorption-selective N-C@α-Fe2O3 NO surface was experimentally confirmed. Particularly, a chemiresistive sensor that comprises N-C@α-Fe2O3 NOs exhibits satisfactory selectivity and response magnitude to TEA when compared with the sensor using α-Fe2O3 NOs. The detection limit can even reduce to be 400 ppb at 250 °C. Furthermore, the sensor based on N-C@α-Fe2O3 NOs shows desirable humidity resistance within the relative humidity (RH) range of 30-90%. For practical usage, a sensing prototype based on the N-C@α-Fe2O3 NO probe is fabricated, and its satisfactory sensing performance further confirms the potential for future applications in industrial organic amine detection. These promising results show a bright future in enhancing the humidity resistance and selectivity as well as sensitivity of chemiresistive sensors by simply designing a hydrophobic and target gas adsorption (e.g., TEA) preferred p-n junction core-shell heterostructure.

11.
J Clin Neurosci ; 72: 360-364, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31892496

RESUMO

Tuberous sclerosis complex (TSC) is an inherited genetic disorder caused by mutations in the TSC1 or TSC2 genes, encoding hamartin and tuberin. We aimed to evaluate structural volumes and connectivity of patients with TSC compared to those of healthy subjects. We consecutively enrolled 13 patients with a diagnosis of TSC and 15 age- and sex-matched healthy control subjects. Subjects underwent three-dimensional volumetric T1-weighted imaging, suitable for a quantitative analysis. Structural volumes were investigated using FreeSurfer image analysis software, and structural connectivity was calculated from a connectivity matrix, which was estimated from the correlation analysis of structural volumes using the Brain Analysis using Graph Theory software package. Differences in structural volumes and connectivity were analyzed between patients with TSC and healthy subjects. There were no differences of cortical volumes between the patients with TSC and healthy controls. However, we found decreased gray matter volumes in several subcortical regions in the patients with TSC compared to those in healthy controls, specifically in the putamen (0.3212 vs. 0.3841%, p = 0.001), even after multiple corrections. Regarding global structural connectivity, the small-worldness index was significantly decreased in patients with TSC compared to that in healthy controls (0.907 vs. 0.977, p = 0.049). This study revealed structural volumes and connectivity in patients with TSC that are significantly different from those in healthy controls. These alterations have implications for the pathogenesis of TSC.

12.
J Cell Physiol ; 235(4): 3823-3834, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31612488

RESUMO

Neuroblastoma (NBL) is the most frequently encountered extracranial solid neoplasm and impacts significantly on the survival of patients, especially in cases of advanced tumor stage or relapse. A long noncoding RNA (lncRNA) signature to predict the survival of patients with NBL is proposed in this paper. Differentially expressed lncRNA (DElncRNA) was selected using the Limma plus Voom package in R based on the RNA-sequencing data downloaded from the Therapeutically Applicable Research To Generate Effective Treatments database and Genotype-Tissue Expression database. Univariate cox regression analysis, least absolute shrinkage and selection operator regression analysis, and multivariate cox regression analysis were conducted to identify candidate DElncRNAs for the risk signature. Consequently, 10 DElncRNAs were designated as candidate DElncRNAs for the risk signature. Time-dependent receiver operating characteristic curves and Kapan-Meier survival curves confirmed the efficacy of the risk signature in predicting the survival of patients with NBL (area under the curve = 0.941; p ≤ .001). One of the DElncRNA constituent subparts (LINC01010) was significantly associated with the survival outcome of patients with NBL in GSE62564 (p = .004). Thus, a risk signature comprising 10 DElncRNAs was identified as effective for individual risk stratification and the survival prediction outcomes of patients with NBL.

13.
Ultrasonography ; 39(1): 94-101, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786906

RESUMO

The conventional radiologic method for liver segmentation is based on the position of the hepatic and portal veins. However, during surgery, liver segments are resected based on the distribution of hepatic portal blood flow. This discrepancy can lead to a number of problems, such as miscommunication among clinicians, missing the location of the segment with the hepatic mass, and the risk of extended hepatic resection. We suggest a novel method to determine hepatic segments based on portal blood flow, as in the surgical approach, but by using high and low mechanical indexes in contrast-enhanced ultrasonography with Sonazoid. This approach is helpful for preoperatively determining hepatic segments and reducing the risk of missing the location of a hepatic tumor or extended hepatic resection.

14.
Clin Exp Otorhinolaryngol ; 13(1): 77-82, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31599139

RESUMO

OBJECTIVES: Deep neck infections (DNIs) can cause life-threatening complications, and prompt diagnosis and management are necessary. Kawasaki disease (KD) may be accompanied by deep neck inflammation; making it difficult to distinguish from DNIs. This study was performed to evaluate clinical features and outcomes of children with parapharyngeal and retropharyngeal inflammation. METHODS: Medical records of the children diagnosed with parapharyngeal and retropharyngeal cellulitis or abscess using cervical computed tomography (CT) between 2013 and 2017 were retrospectively reviewed. RESULTS: A total of 47 children were diagnosed with parapharyngeal and retropharyngeal inflammation. Eleven (23.4%) of them were eventually diagnosed with KD, and 36 (76.6%) were diagnosed with DNIs. There were no significantly different clinical and laboratory characteristics on admission between children diagnosed with KD and DNIs; however, significantly more children with KD were febrile for ≥3 days after admission compared to those with DNIs (P=0.009). Deep neck abscesses on CT were observed in 16 children with DNIs (44.4%) and in no child with KD (P=0.009). Among the 36 children with DNIs, 30 (83.3%) were cured with antibiotic therapy only. CONCLUSION: A quarter of children presenting with deep neck inflammation were diagnosed with KD. KD should be considered in children showing deep neck inflammation unresponsive to empirical antibiotic therapy after 3 days, especially in those presenting with deep neck cellulitis rather than deep neck abscess.

15.
Ying Yong Sheng Tai Xue Bao ; 30(11): 3863-3874, 2019 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-31833700

RESUMO

Geo-informatic spectrum analysis method was used to understand the complex geogra-phical phenomena concisely in graphic language. It is important for the integration research on spatial pattern and temporal process of land use change over multiple temporal and space scales. Based on remote sensing images in 1975, 1990, 1995, 2000, 2005, 2010 and 2015, we built the geo-spectrum of land use/cover change (LUCC) and quantitatively analyzed both the process and rend of LUCC in Manas River Basin. Results showed that the range of land use change in this basin was gradually decreasing, and land use structure tended to be simplistic, then tended to stable in later stage during 1975-1990. At the same period, the area of grassland increased greatly, which was mainly derived from unused land. The area of cultivated land expanded from 1990 to 2015, which mainly converted from unused land, forestland, and grassland. The geo-spectrum of land use change model showed that prophase change type, anaphase change type and continuous change type accounted for 1.3% of the total basin area. The overall characteristics of geo-spectrum unit were dominated by unused land converted to cultivated land, forestland and grassland. The land use change process was relatively stable. The Manas River Basin was covered 61.2% by region with comparatively stable spatial pattern. The most frequent way of land use change was increasingly expanding of cultivated land, which was displayed as: Liumaowan Bay Town of Shawan County and Liuhudi Town of Manas County were the center, then expanded to the two sides and spread to the Gurbantunggut Desert. The construct geo-spectrum of LUCC enriched the LUCC spatial-temporal analysis method system and provided an effective approach for the future research of LUCC under multiple temporal and spatial scales.


Assuntos
Conservação dos Recursos Naturais , Rios , China , Cidades , Análise Espectral
16.
Nanoscale ; 11(48): 23502, 2019 12 28.
Artigo em Inglês | MEDLINE | ID: mdl-31782457

RESUMO

Correction for 'Doping-free bandgap tuning in one-dimensional Magnéli-phase nanorods of Mo4O11' by Duy Van Pham et al., Nanoscale, 2016, 8, 5559-5566.

17.
Science ; 366(6468): 990-994, 2019 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-31753998

RESUMO

Aliphatic amines strongly coordinate, and therefore easily inhibit, the activity of transition-metal catalysts, posing a marked challenge to nitrogen-hydrogen (N-H) insertion reactions. Here, we report highly enantioselective carbene insertion into N-H bonds of aliphatic amines using two catalysts in tandem: an achiral copper complex and chiral amino-thiourea. Coordination by a homoscorpionate ligand protects the copper center that activates the carbene precursor. The chiral amino-thiourea catalyst then promotes enantioselective proton transfer to generate the stereocenter of the insertion product. This reaction couples a wide variety of diazo esters and amines to produce chiral α-alkyl α-amino acid derivatives.

18.
Sci Rep ; 9(1): 14547, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31601924

RESUMO

The anti-apoptotic protein myeloid cell leukemia 1 (Mcl-1) plays an important role in survival and differentiation of leukocytes, more specifically of neutrophils. Here, we investigated the impact of myeloid Mcl-1 deletion in atherosclerosis. Western type diet fed LDL receptor-deficient mice were transplanted with either wild-type (WT) or LysMCre Mcl-1fl/fl (Mcl-1-/-) bone marrow. Mcl-1 myeloid deletion resulted in enhanced apoptosis and lipid accumulation in atherosclerotic plaques. In vitro, Mcl-1 deficient macrophages also showed increased lipid accumulation, resulting in increased sensitivity to lipid-induced cell death. However, plaque size, necrotic core and macrophage content were similar in Mcl-1-/- compared to WT mice, most likely due to decreased circulating and plaque-residing neutrophils. Interestingly, Mcl-1-/- peritoneal foam cells formed up to 45% more multinucleated giant cells (MGCs) in vitro compared to WT, which concurred with an increased MGC presence in atherosclerotic lesions of Mcl-1-/- mice. Moreover, analysis of human unstable atherosclerotic lesions also revealed a significant inverse correlation between MGC lesion content and Mcl-1 gene expression, coinciding with the mouse data. Taken together, these findings suggest that myeloid Mcl-1 deletion leads to a more apoptotic, lipid and MGC-enriched phenotype. These potentially pro-atherogenic effects are however counteracted by neutropenia in circulation and plaque.

19.
Phys Med Biol ; 64(23): 23NT04, 2019 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-31648210

RESUMO

A method using both patient geometric and dosimetric information was proposed to predict dose-volume histograms (DVHs) of organs at risk (OARs) for a nasopharyngeal cancer (NPC) intensity-modulated radiation therapy (IMRT) plan. A total of 106 nine-field IMRT NPC plans were used in this study. Twenty-six plans were randomly selected as testing cases, and the remaining plans were used as the training data. A method employing geometric and dosimetric information was developed for OAR DVH prediction. The dosimetric information was derived from an initial dose calculation using a simple unoptimized conformal plan. The DVHs were also predicted using only the geometric information. The DVH prediction model was a generalized regression neural network (GRNN). Mean absolute error (MAE) and R 2 values were introduced to evaluate DVH prediction accuracy. Significant differences in the DVH prediction accuracy were found between the method employing the geometric and dosimetric information and the method utilizing the geometric information for the brainstem (R 2, 0.98 versus 0.95, p  = 0.007; MAE, 3.52% versus 7.19%, p  = 0.002), spinal cord (R 2, 0.98 versus 0.96, p  < 0.001; MAE, 2.80% versus 4.36%, p  < 0.001), left optic nerve (R 2, 0.90 versus 0.77, p  = 0.014; MAE, 3.07% versus 11.29%, p  = 0.025) and other organs. On average, the R 2 value increased by ~6.7% and the MAE value decreased by ~46.7% after adding the dosimetric information to the DVH prediction. We developed a method for predicting DVHs of OARs in NPC IMRT plans by using geometric and dosimetric information. Adding dosimetric information can help predict the DVHs of OARs in NPC IMRT plans.

20.
Mediterr J Hematol Infect Dis ; 11(1): e2019052, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31528318

RESUMO

Background: Vaccination for hepatitis B virus (HBV) after chemotherapy among pediatric patients with acute Leukemia is still a debated issue. We investigated HBV immunity before and after chemotherapy and assessed immune response to re-vaccination after chemotherapy. Methods: We retrospectively analyzed data of children and adolescents aged <19 years requested for vaccination after chemotherapy for acute leukemia to evaluate hepatitis B surface antibody (HBsAb) status before and after chemotherapy and to identify factors related to HBsAb positivity after chemotherapy. Results: Of 89 enrolled patients, 61 (68.5%) with acute leukemia were HBsAb positive before chemotherapy. Of these 61 patients, 48 (78.7%) seroconverted to HBsAb negative status after chemotherapy; there were 76 (85.4%) HBsAb negative patients after chemotherapy. HBsAb positive patients when compared to HBsAb negative patients after chemotherapy had a significantly higher HBsAb positive rate (100.0% vs. 63.2%, p=0.008) before chemotherapy. Following HBsAb testing after one dose of the HBV vaccination, 33 (43.4%) of the 76 HBsAb negative patients seroconverted to an HBsAb positive status. HBsAb positive patients after a single dose of HBV vaccination had a significantly higher HBsAb positive rate at the time of diagnosis compared to HBsAb negative patients (84.8% vs. 48.8%, p=0.001). Conclusions: Based on these results, HBV re-vaccination after chemotherapy is recommended for all children and adolescents with acute leukemia. In addition, further investigation is required to improve the immunogenicity of HBV re-vaccination.

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