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At least 1,099 records · Page 61Linked to original sources
PubMed2000

An evidence-based approach to prescribing NSAIDs in the treatment of osteoarthritis and rheumatoid arthritis: The Second Canadian Consensus Conference.

The Second Canadian Consensus Conference was convened to discuss the latest developments in the management of osteoarthritis (OA) and rheumatoid arthritis (RA), and to make evidence-based recommendations, specifically regarding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for these indications in primary care practice. The recent availability of cyclo-oxygenase-2-specific inhibitors has raised questions as to their role in the pharmacological management of OA and RA, particularly in relation to conventional treatments such as acetaminophen and nonspecific NSAIDs (with or without misoprostol or proton pump inhibitors). The recommendations in this document, which were arrived at through critical review of data from published randomized, clinical trials, deal with treatments of choice, information to discuss with patients, use of NSAIDs in patients at risk for serious upper gastrointestinal complications, renal or hepatic impairment or congestive heart failure, appropriate follow-up, and the use of NSAIDs with anti- hypertensives, warfarin, low dose acetylsalicylic acid and other medications. The goal of these recommendations is to improve patient outcomes in the primary care setting by maximizing treatment efficacy and minimizing rates of adverse events.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2000

[Consensus for infliximab treatment of patients with Crohn's disease].

Very recently infliximab--a tumour necrosis factor blocking antibody--was registered as an important novel immunomodulating therapy for active Crohn's disease in the Netherlands. Although this treatment can have a very significant and sometimes dramatic effect (on remission induction), its longterm effects are still uncertain and the high cost is a major drawback. An expert committee of specialists in inflammatory bowel disease (IBD) in the Netherlands therefore produced a consensus report on specific treatment indications for its use. It is stated that only immunosuppressive-resistant patients or patients with incompatibilities and allergies to prednisone, azathioprine and methotrexate should be candidates, a second indication being patients with serious enterocutaneous fistulae not reacting to a full course of conventional therapy. Its use is not indicated in patients with stenosing disease. It is also stated that the effect of longterm repeated therapy in active Crohn's disease still has to be established. Since budget limitations for medications are a major disadvantage, the formation of expert committees (with an expert in the treatment of complicated inflammatory bowel disease) in each hospital should be stimulated to limit the treatment to only cases with real immunosuppressive-resistant disease.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Classification of acute leukemias according to the first latin-american consensus conference for the immunophenotyping of leukemias].

OBJECTIVE: To evaluate the recommendations of the First Latinamerican Consensus Conference for the Immunophenotyping of Acute Leukemia in untreated patients with de novo disease immunologically classified employing flow cytometry and an extended panel of monoclonal antibodies. MATERIAL AND METHODS: In that conference it was recommended the use of the following antibodies: cytoplasmic CD79a (cCD79a) and CD19 to define B-progenitor acute lymphoblastic leukemia (B-ALL); cCD3 and CD7 for T-cell ALL (T-ALL), and CD13, CD33 and myeloperoxidase (cMPO) for acute myeloblastic leukemia (AML). We analyzed the expression of these cellular antigens in 91 non-consecutive patients classified with the extended panel as: B-ALL 28 cases; T-ALL 7; B-T-ALL 2; AML 47; and mixed-lineage acute leukemia 7 cases. RESULTS: All 28 B-ALL cases were positive with each of the two recommended antibodies cCD79a and CD19, whereas in 24 AML cases (the expression of cCD79a was not assayed in 23 cases) and in 7 T-ALL patients both antigens were absent. cCD3 and CD7 antigens were identified in 71% and 100% of T-ALL, respectively. CD7 antigen was not detected in any of the 28 patients with B-ALL but it was expressed in 6 of 47 AML cases, while none of 75 B-ALL and AML cases were positive to cCD3. Forty nine percent of AML were positive for the three recommended markers: cMPO, CD13 and CD33, and 51% of AML cases reacted with one or two of these three monoclonal antibodies. Six out of 28 cases of B-ALL had aberrant expression of myeloid antigen (CD33 in 3 cases and CD13 in 3 cases). CONCLUSIONS: There was no difference in the definition of AL lineage between employing the extended antibody panel and that recommended by the Latinamerican consensus.

Acute Disease↗
PubMed2001

Renal cortical scintigraphy and diuresis renography in infants and children.

Renal scintigraphy is performed frequently in infants and children. Renal cortical scintigraphy using 99mTc dimercaptosuccinic acid is predominantly performed to assess the renal sequelae of urinary tract infection. It is most commonly performed for the evaluation of chronic renal scars, although it is also undertaken in the assessment of acute pyelonephritis. Diuresis renography using 99mTc mercaptoacetyltriglycine is of great use in the evaluation of renal tract obstruction, which may occur at a variety of levels, but most commonly occurs at the ureteropelvic junction. Consensus statements have been formulated in an attempt to standardize methods of performing these investigations. However, several areas of controversy exist in the performance of these studies, and these are outlined. Radionuclide cystography and renal function estimation using clearance calculations are not covered in this article.

Child, Preschool↗
PubMed2001

Introduction. Vasculitis.

The vasculitides commonly create diagnostic and management problems, and a biopsy diagnosis of vasculitis usually does not stand alone in the proper medical management of a patient. Indeed, a conclusive diagnosis usually cannot be made without correlation with the patient's clinical history, physical findings, and/or angiographic findings. Nonetheless, a definitive diagnosis depends on histologic examination because few vasculitic syndromes have specific clinical and laboratory findings. Moreover, the histopathologic diagnosis depends on pathologist experience, tissue selection, sample size, chronologic age of the biopsied lesion(s), and effects of prior treatment. In this issue of Seminars in Diagnostic Pathology the important systemic vasculities are reviewed and updated. These include: polyarteritis nodosa, microscopic polyangiitis (microscopic polyarteritis), cutaneous leukocytoclastic vasculitis, Wegener's granulomatosis, giant-cell vasculitides, localized vasculitis, and angiocentric lymphomas (lymphomatous vasculitis).

Consensus Statements as Topic↗