39 Risk factors: a systematic review 2 Measurement outcome Risk factor Measurement risk factor Results Risk of bias: QUIPS domains Toxicity questions Type of steroid Assigned by protocol Dex: 6 events (dysesthesia and agitation) Pred: 0 events (not tested) 4/6 high Reported grade III/IV toxicity (WHO criteria) Type of steroid Assigned by protocol Dex: 2.5% Pred: 3.0% (NS) 2/6 high Conners Parent-Teacher Hyperkinesis Index - Steroid dose - Age (<4 / >4) - Sex - Assigned by protocol - Patient record - Patient record High dose pred: higher listlessness (p<.04). No other disturbances. Age: no difference Sex: girls listlessness (p<.01). No other disturbances. 4/6 high Collected retrospectively - SNP: N363S - Age (<2 / 2–11 / 12–18) - Sex - Allele specific PCR - Patient record - Patient record N363S: 8.6% vs 6.3% (carriers vs non-carriers) (p=1.0) Age and sex: NS 4/6 high Collected retrospectively SNPs: - N363S - Bcl1 - ER22/23EK - Allele specific PCR - Allele specific PCR - Melting curve analysis N363S: NS (p=1.0) Bcl1: NS (p=.405) ER22/23EK: NS (p=.695) 4/6 high Child Difficulties Questionnaire Type of steroid Assigned by protocol No significant difference 3/6 high CBCL - Type of steroid -Hormone levels -Neuronal cell destruction - SNPs: ER22/23EK N363S Bcl1 - Per protocol - Venous blood samples - 14-3-3 protein level in CSF - TaqMan PCR Dex: OR 2.2 (CI 0.5-9.1) High cortisol and/or ACTH: OR 5.0 (CI 0.9-28.1) Neuronal cell destruction: no evidence SNPs: no correlation 3/6 high
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