Abstract:
:The management of idiopathic nephrotic syndrome (INS) in children includes immunosuppressive and symptomatic treatment. The response to corticosteroid therapy is the best prognostic marker of the disease. The majority of children with INS (about 85%) are steroid-sensitive as they normalize proteinuria within 4 weeks of daily, oral prednisone administration. The most of steroid-sensitive patients (94%) has minimal change of nephrotic syndrome, while the majority (80.5%-94.4%) of those who are steroid-resistant has focal segmental glomerulosclerosis or mesangioproliferative glomerulonephritis. Initial therapy of INS consists of 60 mg/m2/day prednisone daily for 4 weeks followed by 40 mg/m2 on alternate days for 4 weeks, thereafter decreasing alternate day therapy every month by 25% over the next 4 months. Thus, the overall duration of the initial corticosteroids course is 6 months that may be significantly protective against the future development of frequent relapses. Approximately 30% of patients experience only one attack and are cured after the first course of therapy; 10-20% have only 3 or 4 steroid-responsive episodes before permanent cure; the remaining 40-50% of patients are frequent relapsers, or steroid-dependent. Standard relapse therapy consists of 60 mg/m2/ day prednisone until urine is protein free for at least 3 days, followed by 40 mg/m2 on alternate days for 4 weeks. The treatment of frequent-relapses and steroid-dependent INS includes several different regimens: maintenance (6 months) alternate steroid therapy just above steroid threshold (0.1-0.5 mg/kg/48h), levamisole, alkylating agents (cyclophosphamide or chlorambucil) or cyclosporine. The worse prognosis is expected in steroid-resistant patients who are the most difficult to treat. Renal biopsy should be performed in them. At present, there is no consensus on therapeutic regimen for steroid-resistant patients. The following immunosuppressive drugs have been used with varying success: cyclosporine, intravenous methyl prednisone pulses alone or combined with or followed by alkylating agents, plasma-exchange, and angiotensin-converting enzyme (ACE) inhibitors. Symptomatic treatment includes: 1) dietary regimen with normal protein intake and salt restriction, 2) calcium and vitamin D are prescribed with steroids, 3) diuretics should be used in case of severe edema, 4) infusion of albumin in case of severe hypovolemia, 5) treatment of hypertension, 6) anticoagulant therapy, and 7) prophylactic antibiotics in high-risk patients.
journal_name
Srp Arh Celok Lekjournal_title
Srpski arhiv za celokupno lekarstvoauthors
Peco-Antić Adoi
10.2298/sarh0410352pkeywords:
subject
Has Abstractpub_date
2004-09-01 00:00:00pages
352-9issue
9-10eissn
0370-8179issn
2406-0895journal_volume
132pub_type
杂志文章,评审abstract:INTRODUCTION:Enlarged axillary lymph nodes are often found during routine examinations. They are usually circular, oval, lobular, smaller than 1 cm, with typically changed fat centers. The condition of axillary lymph nodes in breast cancer is of great importance for timely diagnosis, because its metastatic spread is a ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1997-03-01 00:00:00
abstract::Hernia repair is one of the most common surgical procedures performed in the United States, with 700,000 operations performed each year. Improvements in surgical technique, together with the development of new prosthetic materials and a better understanding of how to use them, have significantly improved outcomes for ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh0302082m
更新日期:2003-01-01 00:00:00
abstract:INTRODUCTION:Obstructive sleep apnoea (OSA) syndrome represents a significant medical problem due to numerous consequences that may follow it. OBJECTIVE:The aim of the study was to analyze morphology of the maxilla in children with mouth breathing, and to assess possible characteristics in persons with marked clinical...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1204159v
更新日期:2012-03-01 00:00:00
abstract:INTRODUCTION:Growth retardation is a hallmark of chronic illnesses such as chronic kidney disease in children, and it is associated with increased morbidity and mortality. The growth hormone (GH) resistance observed in uraemia can be overcome by supraphysiological doses of exogenous GH. OBJECTIVE:We would like to pres...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1004197s
更新日期:2010-03-01 00:00:00
abstract::The occurrence of abnormal Hodgkin's and Reed-Sternberg cells in the peripheral blood in a patient suffering from Hodgkin's disease has been noticed exceptionally rare in a previous period, and especially rare in last ten years primarily due to successful treatment of this disease. The presence of atypical mononuclear...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0310400m
更新日期:2003-09-01 00:00:00
abstract::Topics of this report concerns the existing elements of informatics related to education of graduate students of the Medical Faculty in Belgrade. The already used practice of this system makes possible effectiveness and quality in this work. System itself contains quite a few data bases: for students, for teaching stu...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
abstract:INTRODUCTION:Acantholytic squamous cell (adenosquamous) carcinoma of the skin are relatively rare subtype of squamous cell carcinoma, usually found in elderly on sun-exposed areas of the skin, predominately head, neck and upper extremities. Incidence of metastasis is 2-14%. CASE OUTLINE:A case of a 76-year-old male, w...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1510599j
更新日期:2015-09-01 00:00:00
abstract::Eighty years are passed after the catastrophic epidemics of Typhus and Relapsing Fever in 1915 in Serbia was stopped and put under control. This remarkable achievment was realized in cooperation of the British Military Mission and Serbian health services, one month before the usual seasonal maximum of epidemic wave. T...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 历史文章,杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract::Peritonitis is a serious clinical complication in patients with terminal chronic renal failure (CRF) on peritoneal dialysis (PD). The incidence of peritonitis varies from center to center, and during the last decade it occurs approximately in one patient during 24-60 therapeutical months, which is the result of good e...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:
更新日期:2005-03-01 00:00:00
abstract::Research in recent years has documented more exactly the genetic and immunopathogenetic basis of insulin-dependent diabetes mellitus. Also, in some genetically susceptible subjects, a triggering event activates both cellular and humoral immunity, with diminishing of b cellular mass. Early intervention to prevent diabe...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:The seroprevalence study was performed in Vojvodina during May and June 2010 in order to asses the effects of the 2009 pandemic influenza A(H1N1)v epidemic on herd immunity. It was a part of the Serbian Ministry of Health funded nationwide study. OBJECTIVE:Prevalence of antibodies against 2009 pandemic in...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract::Cardiovascular disorders are the most frequent cause of death (46-60%) among patients with advanced chronic renal failure (CRF), and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD) and anemia are the most important contributing factors. Associa...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh1412747p
更新日期:2014-11-01 00:00:00
abstract::Pharmacotherapy of autoimmune thyroid disease (AITD) is complex. Apart from the replacement hormone therapy, antithyroid agents, beta adrenoceptor blockers and other drugs, in regard to the present symptoms, it also includes the administration of glucocorticoids and immunosuppressive agents. Physiological actions of g...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh05s1067g
更新日期:2005-10-01 00:00:00
abstract:Introduction:The anterior and middle superior alveolar nerve block was claimed to be unpredictably efficient for clinical application. Objective:The aim of this report was to establish the efficacy of the anterior and middle superior alveolar nerve block, applied with a computer-controlled injection system or a conven...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2016-09-01 00:00:00
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journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:10.2298/sarh1108540v
更新日期:2011-07-01 00:00:00
abstract:INTRODUCTION:The obstruction of blood vessels or heart chambers with fat globules, reached by circulation, is fat embolism [1, 2]. Clinical manifestation of the presence of fat emboli in vital organs is Fat Embolism Syndrome (FES). This syndrome is characterized by neurologic, respiratory and cutaneous signs and differ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:INTRODUCTION:Antioxidant systems are important factors affecting the oxidation of lipoproteins and thereby the progression of atherosclerotic disease. It has been suggested that physical activity might maintain and promote the antioxidant defence capacity against the oxidative stress. Left ventricular dysfunction (LVDD...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0904146k
更新日期:2009-03-01 00:00:00
abstract:INTRODUCTION:Subarachnoidal hemorrhage (SAH) is the fourth most common intracranial cause of death. Approximately 50 to 85 percent of non-traumatic SAH is caused by rupture of congenital berry aneurysm. Symptoms of rupture are typically sudden and without any heralds. In most SAH cases, the vasospasm following the rupt...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0408236n
更新日期:2004-07-01 00:00:00
abstract::Taking into account the important role of oestrogen and NK cells in the process of cancerogenesis, the content of receptors for steroid hormones and NK cell activity was investigated in 31 patients with breast cancer. The analysis of steroid receptors showed the usual distribution with regard to clinical stage. The va...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::During the space flight the cosmonaut is exposed to many stressogenic factors. The science is especially interested in microgravitation as an environmental element affecting the life of the crew in a cosmic vehicle, which is in contrast with human physiology in terrestrial conditions. The space medicine is interested ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 00:00:00
abstract:INTRODUCTION:Ankylosing spondylitis is a chronic progressive autoimmune inflammatory disorder involving mainly the axial skeleton and larger peripheral joints that progressively limits spinal mobility and may lead to irreversible structural changes and consequently to impaired physical function and reduced quality of l...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0910524m
更新日期:2009-09-01 00:00:00
abstract::Nine patients with open fractures of the proximal humerus were treated using an external fixation device. All of them had grade III open fractures resulting from high-velocity missile and explosive injuries with massive foreign body contamination. Radial nerve injury was present in five and two multiply injured patien...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0404092m
更新日期:2004-03-01 00:00:00
abstract:INTRODUCTION:Gastroesophageal reflux is a frequent disease which has a significant influence on the development of dental erosions. OBJECTIVE:The aim of this research was to determine the frequency of dental erosions among the patients with gastroesophageal reflux, as well as to verify the most common symptoms of gast...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1006292s
更新日期:2010-05-01 00:00:00
abstract:INTRODUCTION:A Monteggia lesion is a dislocation of the radial head associated with a fracture with the proximal third of the ulna. It is rare in children and the dislocation of the radial head is often missed at the time of injury. There are a lot of described treatment methods: open reduction of the radial head and r...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1102099v
更新日期:2011-01-01 00:00:00
abstract::Multiple myeloma is the most frequent dysproteinaemica causing renal damage. Renal damage can be manifested as acute or chronic renal failure, Tubular disfunction, urinary tract infection, or as proteinuria. The aim of this study is to present our experience in the treatment of renal failure developed during multiple ...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract:INTRODUCTION:Penetrated injuries are most difficult injuries of the eye. Intraocular foreign body (IOFB) may lodge in any of the structures it encounters, from anterior chamber to the retina and choroid. Notable effects caused by foreign body injury include traumatic cataract, vitreous liquefaction, retinal and subreti...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:Nutritional abnormalities have one of the most important systematic effects on chronic obstructive pulmonary disease (COPD). A relationship between COPD and obesity has been observed and recognised. In COPD patients, beside changes in the total body weight, changes in body composition are also possible wit...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh1106322c
更新日期:2011-05-01 00:00:00
abstract:INTRODUCTION:An algorithm to study hand movements in patients with Parkinson's disease (PD) who experience temporary, involuntary inability to move a hand have been developed. In literature, this rather engimatic phenomenon has been described in gait, speech, handwriting and tapping, and noted as motor blocks (MB) or f...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0212376p
更新日期:2002-11-01 00:00:00
abstract:INTRODUCTION:In the last few years, an increasing number of patients suffering from terminal renal disease of various leading causes was treated with renal replacement therapy. Peritonaeal dialysis involves an exchange of water and solutes between blood in the peritonaeal capillaries and dialysate in the peritonaeal ca...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:10.2298/sarh0512498j
更新日期:2005-11-01 00:00:00
abstract::The ileal pouch-anal operation is the best procedure because it liberates the patient from ulcerative colitis i.e. from diseased mucosa of the large intestine. The ileal pouch forms a new reservoir for the storage of feces. Symptomatic pouch inflammation (pouchitis) appeared in 7-40% of the patients. The authors descr...
journal_title:Srpski arhiv za celokupno lekarstvo
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00