Приказ основних података о дисертацији
Ispitivanje efikasnosti i bezbednosti kombinovane sistemske i lokalne kortikosteroidne terapije u lečenju teških formi alopecije areate kod dece
The efficacy and safety of combined systemic and topical corticosteroid therapy in the treatment of severe alopecia areata in children
dc.contributor.advisor | Nikolić, Miloš | |
dc.contributor.other | Dragović-Lukić, Gordana | |
dc.contributor.other | Gojković-Bukarica, Ljiljana | |
dc.contributor.other | Gajić-Veljić, Mirjana | |
dc.contributor.other | Jovanović, Dragan | |
dc.creator | Lalošević, Jovan | |
dc.date.accessioned | 2022-12-03T08:31:24Z | |
dc.date.available | 2022-12-03T08:31:24Z | |
dc.date.issued | 2022-07-04 | |
dc.identifier.uri | https://eteze.bg.ac.rs/application/showtheses?thesesId=8835 | |
dc.identifier.uri | https://fedorabg.bg.ac.rs/fedora/get/o:27029/bdef:Content/download | |
dc.identifier.uri | https://plus.cobiss.net/cobiss/sr/sr/bib/77964297 | |
dc.identifier.uri | https://nardus.mpn.gov.rs/handle/123456789/20907 | |
dc.description.abstract | Alopecia areata (AA) je autoimunsko oboljenje u čijem lečenju nema opšteprihvaćenih protokola. Dugotrajna primena sistemskih kortikosteroida, iako terapijski efikasna, sa sobom potencijalno nosi niz neželjenih efekata. Cilj: Ispitati efekte različitih modaliteta pulsne kortikosteroidne terapije u kombinaciji sa lokalnom kortikosteroidnom terapijom na različite forme AA. Materijal i metode: U ispitivanje je uključeno 138 pacijenata sa AA, mlađih od 18 godina, sa zahvaćenošću kapilicijuma (SALT) >30%. Pacijenti su aplikovali lokalno 0,05% klobetazol propionat mast sa polietilenskom okluzijom noću, a sistemski su primali ili jednodnevnu oralnu pulsnu terapiju (OPT), jednodnevnu intravensku (1IVP) ili trodnevnu intravensku pulsnu terapiju (3IVP). Dobar terapijski odgovor definisan je kao porast terminalne dlake >50% u odnosu na status pre uvođenja terapije. Pacijenti su praćeni najmanje 12 meseci po završetku terapijskog protokola. Rezultati: 3IVP kod pacijenata sa SALT ≥50, daje statistički značajno bolji terapijski odgovor u poređenju sa 1IVP (61% prema 25%) i OPT (61% prema 26%). Dobri prognostički faktori, nezavisno od tipa pulsne terapije bili su blaža forma AA, trajanje AA <6 meseci; dok je loš prognostički faktor bila pridružena autoimunska bolest štitaste žlezde. Kod pacijenata koji su na kraju terapije imali porast ≥50%, odnosno ≥75% i kompletan porast, pri dugotrajnom praćenju zadržan je postignuti efekat u 85, 84, i 65% slučajeva. Zaključci: 3IVP pokazuje statistički signifikantno najbolje rezultate u poređenju sa ostalim modalitetima terapije kod pacijenata sa SALT ≥50. Kod većine pacijenata sa SALT skorom <50, efekat terapije je bio održan i na dugoročnom praćenju (91%). Kod pacijenata čiji je inicijalni SALT bio ≥50, efekat terapije je bio najbolje održan kod 3IVP pacijenata (79%), potom kod 1IVP (60%), a najlošije kod OPT pacijenata (50%). | sr |
dc.description.abstract | Alopecia areata (AA) is an autoimmune disease without widely accepted treatment protocols. Systemic steroids are effective, but their long-term use provokes numerous side-effects. Goal: To evaluate the effects of combined pulse corticosteroid therapy and topical corticosteroids in severe forms of AA. Material and methods: The study included 138 patients younger than 18 years. SALT score in all patients was >30. The patients applied topical 0.05% clobetasol propionate ointment under plastic wrap occlusion overnight with either one-day oral pulse therapy (OPT), one-day intravenous pulse therapy (1IVP) or three-day intravenous pulse therapy (3IVP). Regrowth 50% of the initial status was considered the good therapeutic outcome. Patients were followed at least for 12 months after the treatment completion. Results: 3IVP in patients with SALT 50 had statistically significant higher percentage of good therapeutic outcomes in comparison with 1IVP (61% vs. 25%) and OPT patients (61% vs. 26%). Good prognostic factors, independent of the type of pulse therapy, were: milder AA form, previous AA duration <6 months. Bad prognostic factor was an associated thyroid autoimmune disease. Patients who achieved terminal hair regrowth 50%, 75% and 100%, maintained their status at the long-term follow-up in 85, 84 and 65% of patients, respectively. Conclusions: 3IVP treatment protocol, in patients with SALT ≥50, achieved statistically significant better results in comparison with other pulse modalities. In patients with SALT score <50, the effects of therapy where maintained at the long-term follow-up (in 91%). In patients with SALT score ≥50, the achieved hair growth was best maintained in the 3IVP group (79%), while in the 1IVP and OPT group, the achieved therapeutic effect was maintained in 60% and 50%, respectively. | en |
dc.format | application/pdf | |
dc.language | sr | |
dc.publisher | Универзитет у Београду, Медицински факултет | sr |
dc.rights | openAccess | en |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.source | Универзитет у Београду | sr |
dc.subject | alopecija areata | sr |
dc.subject | alopecia areata | en |
dc.subject | pulse corticosteroid therapy | en |
dc.subject | children | en |
dc.subject | pulsna kortikosteroidna terapija | sr |
dc.subject | deca | sr |
dc.title | Ispitivanje efikasnosti i bezbednosti kombinovane sistemske i lokalne kortikosteroidne terapije u lečenju teških formi alopecije areate kod dece | sr |
dc.title.alternative | The efficacy and safety of combined systemic and topical corticosteroid therapy in the treatment of severe alopecia areata in children | en |
dc.type | doctoralThesis | |
dc.rights.license | BY-NC-ND | |
dc.identifier.fulltext | http://nardus.mpn.gov.rs/bitstream/id/147458/Referat_Lalosevic.pdf | |
dc.identifier.fulltext | http://nardus.mpn.gov.rs/bitstream/id/147457/Disertacija_12842.pdf | |
dc.identifier.rcub | https://hdl.handle.net/21.15107/rcub_nardus_20907 |