Patients who are on anticoagulents need careful monitoring of their INR, APTT, and fibrinogen while on mPRED therapy. We recommend at least once a week. In patients without evidence for active viral replicating disease, but with past hepatitis B, as judged by the presence of pertinent markers, mPRED pulse therapy for GO does not appear to reactivate hepatitis B.
INTROduCTION Immunosuppression with glucocorticoids is the method of choice in the treatment of active Graves' ophthalmopathy (GO). However, glucocorticoid therapy may have side effects, among others, it affects bone metabolism. ObjECTIvEs The aim of the study was to compare the effect of methylprednisolone pulse therapy (MPPT) with and without alendronate on bone turnover markers in patients with GO with normal and reduced bone mineral density (BMD). PATIENTs ANd mEThOds The study included 53 patients with GO and 20 sex-and age-matched healthy controls. Twenty patients with normal BMD (17 women, 3 men, aged 45 ±1.0 years) received only MPPT (8 g intravenously during 4 weeks). The remaining patients, with reduced BMD, were randomly assigned either to MPPT without alendronate (10 women, 2 men, aged 47 ±1.0 years) or MPPT with alendronate (18 women, 3 men, aged 47 ±1.0 years). BMD of the lumbar spine and femoral neck was assessed using dual energy X-ray absorptiometry (DEXA) before treatment. The markers of bone formation (serum osteocalcin, carboxyterminal propeptide of type I collagen [PICP], alkaline phospatase) and the markers of bone resorption (serum carboxyterminal telopeptide of type I collagen [ICTP], cross-linked C-terminal telopeptide of type I collagen [CTX], serum calcium [Ca] and potassium [P], as well as urinary excretion of deoxypyridinoline, Ca, and P) were determined before and after treatment. REsuLTs MPPT caused a decrease in bone formation markers and an increase in some bone resorption markers. MPPT with alendronate decreased bone formation and bone resorption markers. CONCLusIONs A negative effect of MPPT on bone turnover is observed both in patients with GO with normal and with reduced BMD. Simultaneous use of MPPT and alendronate in patients with GO and reduced BMD suppresses bone resorption caused by methylprednisolone.
Objectives. The aim of the study was to identify potential prognostic factors in Hodgkin's lymphoma-HL patients by means of assessment of the influence of mast cells on clinical characteristics of the disease. Patients adn methods. Tryptase-and chymase-positive mast cell density was assessed in order to correlate it with histological type, staging, sex and age of patients. Tissue specimens were taken from a group of 72 patients treated for Hodgkin's lymphoma in the Department of Internal Medicine and Oncological Chemotherapy of the Silesian Medical Academy in Katowice from 1990 to 2002. The analyzed group consisted of 44 men (age 16-73 years, av. 39.2) and 28 women (age 15-73 years, av. 36.5) presenting 5 histological types of HL according to the WHO classification. Overall survival (OS) for the group ranged from 3 to 169 months (av. 64.5) while disease free survival (DFS) was from 4 to 167 months (av. 44.8). Results. The highest MCD-T and MCD-C was observed in NS while the lowest had characterized LD. A statistically significant difference in MCD-T was noted between NS and LD (p=0.0002). Despite the fact that increased MCD-T and MCD-C was observed in stage III of the disease and the lowest in stage IV. No correlation were found between MCD and stage, sex or age. Overall survival was assessed in correlation with the histological type and showed to be the best in MC and the worst in NS. Conclusions. Tryptase and chymase positive mast cell density is related to the histological type of HL. Increased mast cell density correlates with worse prognosis in patients with HL.
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