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Find video protocols related to scientific articles indexed in Pubmed.
Clinical and laboratory predictors of chronic immune thrombocytopenia in children: a systematic review and meta-analysis.
Blood
PUBLISHED: 10-10-2014
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Childhood immune thrombocytopenia (ITP) is a rare autoimmune bleeding disorder. Most children recover within 6-12 months, but individual course is difficult to predict. We performed a systematic review and meta-analysis to identify predictors of chronic ITP. We found 1399 articles; after critical appraisal 54 studies were included. The following predictors of chronic ITP in children, assessed in at least three studies, have been identified: female gender (OR 1.17, 95% CI 1.04-1.31), older age at presentation (age ?11 years OR 2.47, 95% CI 1.94-3.15), no preceding infection or vaccination (OR 3.08, 95 CI 2.19-4.32), insidious onset (OR 11.27, 95% CI 6.27-20.27), higher platelet counts at presentation (?20 x10(9)/L: OR 2.15, 95% CI 1.63-2.83) presence of anti-nuclear antibodies (OR 2.87, 95% 1.57-5.24) and treatment with a combination of methylprednisolone and intravenous immunoglobulin (OR 2.67, 95% CI 1.44-4.96). Children with mucosal bleeding at diagnosis or treatment with intravenous immunoglobulin alone developed less often chronic ITP (OR 0.39; 95% CI 0.28-0.54 and OR 0.71; 95% CI 0.52-0.97, respectively). The protective effect of intravenous immunoglobulin is remarkable and needs confirmation in prospective randomized trials as well as future laboratory studies to elucidate the mechanism of this effect.
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The negative impact of underweight and weight loss on survival of children with acute lymphoblastic leukemia.
Haematologica
PUBLISHED: 10-10-2014
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Body mass index and change in body mass index during treatment may influence treatment outcome of pediatric patients with acute lymphoblastic leukemia. However, previous studies in pediatric acute lymphoblastic leukemia reported contradictory results. We prospectively collected data on body composition from a cohort of newly diagnosed Dutch pediatric patients with acute lymphoblastic leukemia (N=762, age 2-17 years). Patients were treated from 1997-2004 and the median follow-up was 9 (range: 0-10) years. Body mass index at diagnosis was expressed as age- and gender-matched standard deviation scores and categorized into underweight, and normal or overweight. Multivariate analyses showed that patients with underweight (8%) had an increased risk of relapse (hazard ratio: 1.88, 95% confidence interval (1.13-3.13)), but they had a similar overall survival and event free survival as compared to patients with normal or overweight. Patients with loss of body mass index during the first 32 weeks of treatment had a similar risk of relapse and event free survival, but a decreased overall survival (hazard ratio: 2.10, 95% confidence interval (1.14-3.87)) compared to patients without a loss of body mass index. In addition, dual X-ray absorptiometry scans were performed in a nested single center cohort. Data from these scans revealed that a loss of body mass index mainly consisted of a loss of lean body mass, while there was a gain in %fat. In conclusion, underweight at diagnosis is a risk factor for relapse, and a body mass index loss early during treatment is associated with decreased survival. In addition, loss of body mass index during treatment seems to mainly consist of a loss of lean body mass. The Medical Ethical Committee approved the study in 1996 (trial number NTR460/SNWLK-ALL-9). Key message: Underweight at diagnosis increased the likelihood of relapse in children with acute lymphoblastic leukemia. A BMI loss during 32 weeks of treatment seems to consist of a loss of lean body mass and a gain in %fat. This BMI loss is associated with a decreased overall survival in children with acute lymphoblastic leukemia.
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Health-related quality of life in children with newly diagnosed immune thrombocytopenia.
Haematologica
PUBLISHED: 06-20-2014
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Despite its generally transient and benign course, childhood immune thrombocytopenia has a large impact on health-related quality of life. Recently published guidelines state that quality of life should be taken into account while making decisions on management in childhood immune thrombocytopenia. We, therefore, assessed health-related quality of life in children with newly diagnosed immune thrombocytopenia in a prospective multicenter study. One hundred and seven children aged 6 months-16 years (mean age 5.57 years) were included. We used Pediatric Quality of Life Inventory™ and Kids' ITP Tools questionnaires at diagnosis and during standardized follow-up. Scores on the Pediatric Quality of Life Inventory™ Core Scales were compared with those of healthy children. Relationships between health-related quality of life scores and treatment modality, bleeding tendency and course of the disease were examined. Kids' ITP Tools proxy reports and parent self-reports showed significant higher health-related quality of life scores in children who recovered than in children with persistent immune thrombocytopenia (at 3 months: Kids' ITP Tools parent self-report score 80.85 for recovered patients (n=69) versus 58.98 for patients with persistent disease (n=21), P<0.001). No significant differences in health-related quality of life were found between children with mild or moderate bleeding or between children who received intravenous immunoglobulin or children who were carefully observed. In conclusion, health-related quality of life of children with newly diagnosed immune thrombocytopenia is not influenced by treatment modality or bleeding severity, but only by clinical course of the disease. (Dutch Trial Register identifier: NTR TC1563).
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Functional platelet defects in children with severe chronic ITP as tested with 2 novel assays applicable for low platelet counts.
Blood
PUBLISHED: 01-02-2014
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Immune thrombocytopenia (ITP) is an autoimmune disease with a complex heterogeneous pathogenesis and a bleeding phenotype that is not necessarily correlated to platelet count. In this study, the platelet function was assessed in a well-defined cohort of 33 pediatric chronic ITP patients. Because regular platelet function test cannot be performed in patients with low platelet counts, 2 new assays were developed to determine platelet function: first, the microaggregation test, measuring in platelets isolated from 10 mL of whole blood the platelet potential to form microaggregates in response to an agonist; second, the platelet reactivity assay, measuring platelet reactivity to adenosine diphosphate (ADP), convulxin (CVX), and thrombin receptor activator peptide in only 150 ?L of unprocessed whole blood. Patients with a severe bleeding phenotype demonstrated a decreased aggregation potential upon phorbol myristate acetate stimulation, decreased platelet degranulation following ADP stimulation, and a higher concentration of ADP and CVX needed to activate the glycoprotein IIbIIIa complex compared with patients with a mild bleeding phenotype. In conclusion, here we have established 2 functional tests that allow for evaluation of platelet function in patients with extremely low platelet counts (<10(9)). These tests show that platelet function is related to bleeding phenotype in chronic ITP.
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Prospective study on incidence, risk factors, and long-term outcome of osteonecrosis in pediatric acute lymphoblastic leukemia.
J. Clin. Oncol.
PUBLISHED: 09-26-2011
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We studied cumulative incidence, risk factors, therapeutic strategies, and outcome of symptomatic osteonecrosis in pediatric patients with acute lymphoblastic leukemia (ALL).
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Dexamethasone-based therapy for childhood acute lymphoblastic leukaemia: results of the prospective Dutch Childhood Oncology Group (DCOG) protocol ALL-9 (1997-2004).
Lancet Oncol.
PUBLISHED: 09-09-2009
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A population-based cohort of children aged 1-18 years with acute lymphoblastic leukaemia (ALL) was treated with a dexamethasone-based protocol (Dutch Childhood Oncology Group [DCOG] ALL-9). We aimed to confirm the results of the most effective DCOG ALL protocol for non-high-risk (NHR) patients to date (ALL-6), compare results with ALL-7 and ALL-8, and study prognostic factors in a non-randomised setting.
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p38 MAP kinase inhibits neutrophil development through phosphorylation of C/EBPalpha on serine 21.
Stem Cells
PUBLISHED: 06-23-2009
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Many extracellular stimuli regulate growth, survival, and differentiation responses through activation of the dual specificity mitogen activated protein kinase (MAPK) kinase three (MKK3) and its downstream effector p38 MAPK. Using CD34+ hematopoietic progenitor cells, here we describe a novel role for MKK3-p38MAPK in the regulation of myelopoiesis. Inhibition of p38MAPK utilizing the pharmacological inhibitor SB203580, enhanced neutrophil development ex vivo, but conversely reduced eosinophil differentiation. In contrast, constitutive activation of MKK3 dramatically inhibited neutrophil differentiation. Transplantation of beta2-microglobulin(-/-) nonobese diabetic/severe combined immune deficient (NOD/SCID) mice with CD34+ cells ectopically expressing constitutively active MKK3 resulted in reduced neutrophil differentiation in vivo, whereas eosinophil development was enhanced. Inhibitory phosphorylation of CCAAT/enhancer binding protein alpha (C/EBPalpha) on serine 21 was induced upon activation of p38MAPK. Moreover, ectopic expression of a non-phosphorylatable C/EBPalpha mutant was sufficient to abrogate MKK3-induced inhibition of neutrophil development. Furthermore, treatment of CD34+ progenitors from patients with severe congenital neutropenia with SB203580 restored neutrophil development. These results establish a novel role for MKK3-p38MAPK in the regulation of lineage choices during myelopoiesis through modulation of C/EBPalpha activity. This signaling module may thus provide an important therapeutic target in the treatment of bone marrow failure.
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Possible lower rate of chronic ITP after IVIG for acute childhood ITP an analysis from registry I of the Intercontinental Cooperative ITP Study Group (ICIS).
Br. J. Haematol.
PUBLISHED: 05-19-2009
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In children, one-third of immune thrombocytopenic purpura (ITP) patients follow a chronic course. The present study investigated whether treatment with intravenous immunoglobulin (IVIG) at the time of diagnosis of ITP is of prognostic significance, using data from 1984 children entered in Registry I of the Intercontinental Cooperative ITP Study Group. A matched pairs analysis compared children with thrombocytopenia (platelet count <150 x 10(9)/l) 6 months following diagnosis with children whose platelet count was normal 6 months after diagnosis. It was found that children initially treated with IVIG were more likely to have a normal platelet count 6 months after diagnosis than children not receiving IVIG (odds ratio 1.81; 95% confidence interval: 1.25-2.64). This result was independent of age, gender, country of origin, platelet count at diagnosis or infection preceding the diagnosis of ITP. In a similar analysis, comparing children with a platelet count <50 x 10(9)/l 6 months after diagnosis with children whose platelet count was > or =50 x 10(9)/l at that time point, the former group was less often treated with IVIG than with steroids (P = 0.02). Prospective studies are required to further explore this potential effect of IVIG.
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JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.