LMWH plus LDA was successfully used as an alternative to UFH plus LDA in the management of recurrent abortion secondary to APS. The results highlight the need for a larger randomized controlled trial to determine whether LMWH plus LDA should be the treatment of choice for recurrent abortion secondary to APS. Clinicaltrials.gov NCT01051778.
The aim of this study is to evaluate the serological levels of zinc, copper and iron in Giardia lamblia-infected children and to study the effect of giardiasis on their weight compared to controls. We studied 30 children, 1-10 years old, who attended the outpatient clinics of Cairo University Pediatric Hospital, with gastrointestinal complaints and diagnosed as having giardiasis by stools examination, they were enrolled as a study group. The control group consisted of 30 age- and sex-matched healthy children, free of gastrointestinal complaints and free of giardiasis. Serological levels of zinc, copper, and iron were measured by atomic absorption spectrophotometer. The infected group had significantly lower weight, serum iron, and zinc than controls (P = 0.035, <0.001, and <0.001 respectively) and 63.3% of patients infected with giardiasis were 1-5 years old. In the infected cases, 60% suffered from of abdominal pain, 50% from weight loss, and 40% had intermittent diarrhea. Infected cases with weight percentiles below the fifth had significantly lower serum iron than those with normal percentiles (>5th). In conclusion, most giardiasis-infected children were between 1 and 5 years, with significant affection of weight, abdominal pain, and/or intermittent diarrhea. Serum zinc and iron levels were significantly decreased in the infected group compared to control (P < 0.001).
In order to assess the oxidative stress in newly diagnosed children with primary nephrotic syndrome (PNS), we serially measured serum total antioxidant capacity (TAC) and malondialdehyde (MDA) in 33 children with PNS and ten healthy matched controls. Patients were classified into two groups: those who had steroid-sensitive nephrotic syndrome (SSNS; n = 26) and those who had steroid-resistant nephrotic syndrome (SRNS; n = 7). Of the patients with SSNS, 15 were non-relapsers and 11 were relapsers. At the proteinuric phase, all patients had significantly higher MDA levels and lower TAC than the controls. These changes were more marked in patients with SRNS than in those with SSNS. During remission and still on corticosteroids, patients had higher TAC and similar MDA levels as in the proteinuric phase, but the TAC and MDA levels still significantly differed from those of the controls. More improvement in TAC and MDA levels occurred in patients following the weaning of corticosteroids, but TAC was still lower in the patients than in the controls. Moreover, TAC was higher in non-relapsers than in relapsers. Using a receiver operating characteristic curve, the initial response to corticosteroids could be predicted at serum TAC level > or =0.73 mM/L (sensitivity 89%, specificity 86%), while serum TAC levels < or = 1.14 mM/L after the weaning of corticosteroids could predict that the patient would not relapse (sensitivity 91%, specificity 80%). In conclusion, based on our results, PNS can be considered to be associated with oxidative stress even during remission. This stress may modulate the response to corticosteroids. Further prospective studies using larger numbers of patients are needed to validate these results.
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