We sought to measure psychosocial adaptation in children and adolescents with different forms of chronic arthritis and to determine associated factors. Mothers of 68 children aged 8-17 years with juvenile idiopathic a...We sought to measure psychosocial adaptation in children and adolescents with different forms of chronic arthritis and to determine associated factors. Mothers of 68 children aged 8-17 years with juvenile idiopathic arthritis (JIA) or reactive arthritis reported behaviour problems (CBCL), children reported their actual stress level (SSK), functional disability in conducting activities of daily living (CHAQ) and health-related quality of life (HRQOL) including self-esteem (KINDL-R). Children and adolescents with JIA or reactive arthritis reported lower self-esteem compared to normative data. Almost 20%of the samples were reported to have serious behaviour problems,mostly social isolation and depression/anxiety. Children with lower HRQOL, more functional limitations and a higher stress level showed more behaviour problems. Self-esteem and behaviour problems may be relevant outcome measures in children and adolescents with chronic arthritis and useful to monitor psychosocial support in this population.展开更多
Background:Drug-induced hypersensitivity syndrome(DIHS)is a severe multiorgan systemic reaction.Numerous studies have linked reactivation of human herpesvirus(HHV)-6 with the development of DIHS.Recent articles have s...Background:Drug-induced hypersensitivity syndrome(DIHS)is a severe multiorgan systemic reaction.Numerous studies have linked reactivation of human herpesvirus(HHV)-6 with the development of DIHS.Recent articles have suggested that reactivation of other herpesviruses besides HHV-6 might also be involved in the development of DIHS.On the other hand,recent studies have provided evidence for a role of reactivation of various herpesviruses in the development of graft-versushostdisease(GVHD).Objectives:We attempted to determine whether sequential herpesvirus reactivation could be detected in four patients with severe DIHS,as observed in patients with GVHD,and be coincident with various clinical manifestations that developed after discontinuation of the causative drugs.Methods:Detection and quantification of viral DNA [cytomegalovirus(CMV),Epstein-Barr virus(EBV),HHV-6 and HHV-7] in sequential blood samples were performed using real-time polymerase chain reaction assays,based on TaqMan technology.Results:In these patients,the cascade of virus reactivation initiated by HHV-6 or EBV extended to EBV or HHV-7,and eventually to CMV.Clinical manifestations of this syndrome followed by failure of various organs occurring despite discontinuation of the drug were coincident with these herpesvirus reactivations.Conclusions These results suggest that various herpesviruses can reactivate in the setting of severe drug reactions in a similar sequential order to that described in GVHD.The sequential reactivation of these herpesvirusesis responsible for the development of multiorgan failure occurrin gafter discontinuation of the causative drug.展开更多
文摘We sought to measure psychosocial adaptation in children and adolescents with different forms of chronic arthritis and to determine associated factors. Mothers of 68 children aged 8-17 years with juvenile idiopathic arthritis (JIA) or reactive arthritis reported behaviour problems (CBCL), children reported their actual stress level (SSK), functional disability in conducting activities of daily living (CHAQ) and health-related quality of life (HRQOL) including self-esteem (KINDL-R). Children and adolescents with JIA or reactive arthritis reported lower self-esteem compared to normative data. Almost 20%of the samples were reported to have serious behaviour problems,mostly social isolation and depression/anxiety. Children with lower HRQOL, more functional limitations and a higher stress level showed more behaviour problems. Self-esteem and behaviour problems may be relevant outcome measures in children and adolescents with chronic arthritis and useful to monitor psychosocial support in this population.
文摘Background:Drug-induced hypersensitivity syndrome(DIHS)is a severe multiorgan systemic reaction.Numerous studies have linked reactivation of human herpesvirus(HHV)-6 with the development of DIHS.Recent articles have suggested that reactivation of other herpesviruses besides HHV-6 might also be involved in the development of DIHS.On the other hand,recent studies have provided evidence for a role of reactivation of various herpesviruses in the development of graft-versushostdisease(GVHD).Objectives:We attempted to determine whether sequential herpesvirus reactivation could be detected in four patients with severe DIHS,as observed in patients with GVHD,and be coincident with various clinical manifestations that developed after discontinuation of the causative drugs.Methods:Detection and quantification of viral DNA [cytomegalovirus(CMV),Epstein-Barr virus(EBV),HHV-6 and HHV-7] in sequential blood samples were performed using real-time polymerase chain reaction assays,based on TaqMan technology.Results:In these patients,the cascade of virus reactivation initiated by HHV-6 or EBV extended to EBV or HHV-7,and eventually to CMV.Clinical manifestations of this syndrome followed by failure of various organs occurring despite discontinuation of the drug were coincident with these herpesvirus reactivations.Conclusions These results suggest that various herpesviruses can reactivate in the setting of severe drug reactions in a similar sequential order to that described in GVHD.The sequential reactivation of these herpesvirusesis responsible for the development of multiorgan failure occurrin gafter discontinuation of the causative drug.
