000			02735cam a2200349 a 4500
003			EG-GiCUC
005			20250223031826.0
008			171016s2017 ua h f m 000 0 eng d
040			_aEG-GiCUC _beng _cEG-GiCUC
041	0		_aeng
049			_aDeposite
097			_aPh.D
099			_aCai01.11.28.Ph.D.2017.No.C
100	0		_aNoha Hassan Elanwar Shabaan
245	1	0	_aCourse, approach to initial treatment failure and outcome of critically Ill children with guillain barre syndrome / _cNoha Hassan Elanwar Shabaan ; Supervised Hafez Mahmoud Bazaraa , Hanaa Ibrahim Rady , Shereen Abdelmoniem Mohamed
246	1	5	_aالمسار و النتائج و التعامل مع عدم الاستجابة للعلاج الأولى في الأطفال ذوي الحالات الحرجة الناتجة عن متلازمة جيلان باريه
260			_aCairo : _bNoha Hassan Elanwar Shabaan , _c2017
300			_a180 P. : _bfacsimiles ; _c25cm
502			_aThesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics
520			_aGuillain Barre Syndrome (GBS) is an important cause of pediatric respiratory failure and the most common cause of acute flaccid paralysis in the post-poliomyelitis eradication era. We aimed to determine the benefit of immunosuppressive therapy in children with severe GBS, not improving after first line therapy. Methodology: 40 patients with severe GBS who needed ICU admission for either MV (n=30), bulbar manifestations or rapidly progressive weakness were enrolled and received initial treatment of plasma exchange (PE) sessions or immunoglobulins. Those with initial treatment failure were randomized to receive further PE either alone or with complementary immunotherapy (steroids +/-cyclosporine). Results: Initial treatment was successful in 16 cases (40%) while five patients died. Those with initial treatment failure (n=22) received more PE sessions, of them 15 cases received supplemental steroids. The ability to walk unaided on discharge was regained in 60% of these (n=9/15), vs 28% of those with initial treatment failure who did not receive supplemental immunotherapy (n=2/7). Conclusion: PE with supplemental immunotherapy are proposed to be useful therapies for severe GBS and those with poor initial response
530			_aIssued also as CD
653		4	_aCorticosteroids
653		4	_aCyclosporine
653		4	_aInflammatory demyelinating polyneuropathy
700	0		_aHafez Mahmoud Bazaraa , _eSupervisor
700	0		_aHanaa Ibrahim Rady , _eSupervisor
700	0		_aShereen Abdelmoniem Mohamed , _eSupervisor
856			_uhttp://172.23.153.220/th.pdf
905			_aNazla _eRevisor
905			_aSamia _eCataloger
942			_2ddc _cTH
999			_c62980 _d62980