tively. For hypertensive patients treated with statins (8 included trials) the standardized effect size of DSBP and DDBP was 0.07 (95%CI: -0.07-0.21; pϭ0.33) and -0.12 (95%CI: -0.36-0.11; pϭ0.31), respectively. CONCLUSIONS: Despite previous suggestions, statin therapy in normotensive or hypertensive patients does not lead to reductions in systolic and diastolic blood pressure. Despite these results, however, the routine use of statins, especially in patients with hypertension should be always considered due to the essential reduction of cardiovascular events. OBJECTIVES:The first coronary drug-eluting stent gained its market approval in Europe 2002. Many different drug-eluting stents came to the market worldwide since then. In Taiwan, National Health Insurance has partially reimbursed drugeluting stents since 2006. The number of claimed usage increased from 521 (year 2006) up to 14,311 (year 2010), and total claimed reimburse went up from NTD 15 million to 300 million. The impact to the NHI has been increasing. The aim of this study is to summarize the results of Taiwan drug-eluting stents studies for future researches. METHODS: We systematically searched three bibliographic databases: EMBASE, PubMed and Taiwan National Central Library for studies utilizing Taiwan local data. In order to collect as many local studies as we can, no restrictions were applied on publication year, study type, disease, patients, intervention, comparator and outcomes. RESULTS: Among the 73 studies we identified in EMBASE and PubMed, only one randomized control trial was found. The authors tried to evaluate the preventive outcome of phosphorycholine-coated dexamethasone stent by observing restenosis rate. We then expanded our analysis scopes to controlled trials, and additional 26 studies were identified and 3 studies matched our research question. Their topics were about "1 year follow-up after PCI with Titan versus TAXUS stents", "gender differences in patients undergoing coronary stenting" and "the effects of starting statin therapy before PCI with drug-eluting stents". On the other part of our research at Taiwan National Central Library, there was no paper matched our including criteria. Most of the papers included there were coronary stents design related articles. CONCLUSIONS: Based on systematically research results, we only found one randomized control trial fully used Taiwan local data. Lack of comparative effectiveness on local stents usage could pose a problem when considering evidence-based decision making.
Letter to the EditorNeonatal leukemia (NL) is very rare and often presents with hepatosplenomegaly (80%), skin infiltration (60%), and hyperleukocytosis (85%). 1 We report a case of neonatal acute lymphoblastic leukemia (ALL) presenting initially with purpuric nodules.Our patient was born full-term to a healthy 36-year-old mother by a Cesarean Section. At birth, two round purpuric lesions, one on the chest (2.2 Â 1.5 cm; Fig. 1A) and the other on the leg (1.7 Â 1.3 cm; Fig. 1B), were noted and considered as hemangiomas. Two weeks later, he developed a blueberry muffin rash on the abdomen (Fig. 1C). A hemogram revealed hyperleukocytosis (white blood cell count: 374.5 Â 10 9 /L) with 0% neutrophils, 4% lymphocytes, and 95% blasts. Tests for congenital infections were negative. Transient leukemoid reaction with trisomy 21 mosaicism was ruled out based on the normal results of karyotyping performed on amniocentesis. In 20 of 20 cells, bone marrow cytogenetics revealed (46, XY) with complex t (7; 11; 9) translocations. Furthermore, immunophenotyping confirmed precursor Bcell ALL with a very immature phenotype (CD19 þ , CD10 À , cytoplasmic immunoglobulin-negative, CD79a þ ; with aberrant CD13 þ in 25.5% of blasts). Although there was no leukemia-associated immunophenotype marker for minimal residual disease (MRD) detection, molecular genetic analyses revealed KMT2A-MLLT3 (MLL-AF9) gene rearrangements (Fig. 1D).After administering the Taiwan Pediatric Oncology Group's four-drug induction regimen (TPOG-ALL-2013) and intrathecal therapy, all skin lesions resolved gradually. MRD test by quantitative reverse-transcriptase polymerase chain reaction was positive at the end of induction (EOI) and became negative after consolidation chemotherapy, which included two cycles of high-dose cytarabine (TPOG-ALL-2002-Infant). He remained in complete remission at 22 months from the start of chemotherapy.
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