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https://www.readbyqxmd.com/read/29120273/triple-therapy-in-copd-what-we-know-and-what-we-don-t
#1
Peter M A Calverley, Helgo Magnussen, Marc Miravitlles, Jadwiga A Wedzicha
Triple inhaled therapy for chronic obstructive pulmonary disease (COPD) consists of an inhaled corticosteroid (ICS), a long-acting β2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) taken in combination. Triple therapy is recommended by the Global initiative for Chronic Obstructive Lung Disease (GOLD) for patients who experience recurrent exacerbations despite treatment with either a dual bronchodilator (preferred initial therapy) or LABA/ICS combination (alternative initial therapy). Although there is evidence for the greater efficacy of triple therapy compared with LABA/ICS and LAMA monotherapy with regards to improved lung function, health status, and exacerbation rate, the efficacy of triple therapy when compared with dual bronchodilation (LABA/LAMA) is as yet unknown...
November 9, 2017: COPD
https://www.readbyqxmd.com/read/29113937/characterization-of-gastrointestinal-adverse-effects-reporting-in-clinical-studies-of-corticosteroid-therapy
#2
Tone Westergren, Sigrid Narum, Marianne Klemp
OBJECTIVE: To examine whether 159 studies included in a previous meta-analysis reported on gastrointestinal bleeding or perforation in accordance with the the CONSORT extension for reporting harms outcomes (CONSORT Harms recommendations checklist), whether differences were associated with funding source, journal or publication year, and whether the CONSORT Harms checklist is a suitable tool for evaluation of adverse effects reporting. STUDY DESIGN AND SETTING: Articles were assessed for fulfilment of the CONSORT Harms recommendations, funding source, publication type and year...
November 4, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29058249/a-2-year-step-down-withdrawal-from-inhaled-corticosteroids-in-asthmatic-children-receiving-immunotherapy
#3
Chun-Hui He, Xing Li, Jun-Hong Lin, Qiang Xiao, Jia-Lu Yu, Ying-Fen Liu, Wen-Hui Jiang, Chen Chen, Li Deng, Jie Zhou
BACKGROUND: Inhaled corticosteroids (ICSs) for treating asthma are controversial because of their negative effects on the growth of asthmatic children and without clearly defined withdrawal strategy. A 2-year ICS step-down and withdrawal strategy has been developed for asthmatic children receiving 3-year subcutaneous immunotherapy (SCIT). METHODS: Eleven children were included into the SCIT group and 13 children into the ICS group. ICSs were discontinued when children met the following criteria: requiring only 1 puffper day, with good control, for at least 6 months; having a forced expiratory volume in 1 second (FEV1)/forced vital capacity ≥80%; and SCIT discontinued for ≥24 months...
December 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29053578/treatment-with-synthetic-glucocorticoids-and-the-hypothalamus-pituitary-adrenal-axis
#4
REVIEW
Rosa Maria Paragliola, Giampaolo Papi, Alfredo Pontecorvi, Salvatore Maria Corsello
Chronic glucocorticoid (GC) treatment represents a widely-prescribed therapy for several diseases in consideration of both anti-inflammatory and immunosuppressive activity but, if used at high doses for prolonged periods, it can determine the systemic effects characteristic of Cushing's syndrome. In addition to signs and symptoms of hypercortisolism, patients on chronic GC therapy are at risk to develop tertiary adrenal insufficiency after the reduction or the withdrawal of corticosteroids or during acute stress...
October 20, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29044640/a-step-down-protocol-for-omalizumab-treatment-in-oral-corticosteroid-dependent-allergic-asthma-patients
#5
Christian Domingo, Xavier Pomares, Albert Navarro, María José Amengual, Concepción Montón, Ana Sogo, Rosa M Mirapeix
BACKGROUND: there are no specific criteria for a step-down or withdrawal dose of omalizumab. Our purpose was to evaluate the viability of a protocol for OMAlizumab DOse REduction (the OMADORE study) in severe allergic asthma (SAA). METHODS: the study population included 35 SAA patients treated during a minimum period of one year with oral corticosteroids (OC) equivalent to a mean daily dose of 4 mg of methyl-prednisolone. To qualify for the protocol, the patients had to have received treatment with OMA ≥ one year and a half, OC dose had to have reached the lowest tolerated dose and spirometry had to be ≥ at entry...
October 18, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29022964/nocardia-arthritidis-keratitis-case-report-and-review-of-the-literature
#6
Andrew Gieger, Stephen Waller, Joseph Pasternak
INTRODUCTION: Keratitis due to Nocardia infection is not commonly encountered in clinical practice and may therefore be mistaken for fungal or viral keratitis leading to delayed treatment and increased risk of permanent visual impairment. CASE: An otherwise healthy 27 years old Caucasian Active Duty military member presented to the clinic with three days of light sensitivity and irritation of his right eye. He carried a history of PRK in both eyes six years prior and admitted to recent contact lens overuse...
January 2017: Nepalese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28994265/recognition-of-giant-cell-arteritis-in-patients-with-polymyalgia-rheumatica-who-have-a-stroke-a-cautionary-tale
#7
Donald H Gutteridge, Frank L Mastaglia
An 82-year-old woman with polymyalgia rheumatica (PMR) on prednisone 7 mg daily was admitted to an acute stroke unit with a right homonymous hemianopia, a left posterior cerebral artery occlusion and occipital lobe infarct. She had raised inflammatory markers, did not have a temporal artery biopsy, and was discharged on the same dose of prednisone. After 21 months, off prednisone, her ophthalmologist, concerned about giant cell arteritis (GCA), restarted prednisone 40 mg daily, with rapid, profound visual improvement...
October 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28969152/azathioprine-in-chronic-recalcitrant-erythema-nodosum-leprosum-a-case-report
#8
Singh Shailendra Vikram Jitendra, Romita Bachaspatimayum, A Subhalakshmi Devi, S Rita
Erythema Nodosum Leprosum (ENL) may have a chronic course which may be recalcitrant to treatment. Preferred treatment modalities are systemic corticosteroids and thalidomide. Azathioprine, methotrexate and cyclosporine are immunosuppressants which may also be used as a steroid sparing agent. We report the case of a 48-year-old male diagnosed as lepromatous leprosy that developed ENL after four months of Multibacillary Multi-Drug Therapy (MB-MDT). He was treated with oral prednisolone (1 mg/kg/day) which was gradually tapered upto a dose of 7...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#9
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937567/obstetric-care-consensus-no-6-summary-periviable-birth
#10
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28933516/anti-il5-therapies-for-asthma
#11
REVIEW
Hugo A Farne, Amanda Wilson, Colin Powell, Lynne Bax, Stephen J Milan
BACKGROUND: This review is the first update of a previously published review in The Cochrane Library (Issue 7, 2015). Interleukin-5 (IL-5) is the main cytokine involved in the activation of eosinophils, which cause airway inflammation and are a classic feature of asthma. Monoclonal antibodies targeting IL-5 or its receptor (IL-5R) have been developed, with recent studies suggesting that they reduce asthma exacerbations, improve health-related quality of life (HRQoL) and lung function...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28932784/topical-corticosteroid-withdrawal-in-a-pediatric-patient
#12
Julie Dhossche, Eric Simpson, Tamar Hajar
No abstract text is available yet for this article.
September 2017: JAAD Case Reports
https://www.readbyqxmd.com/read/28923623/mycophenolate-mofetil-withdrawal-with-conversion-to-everolimus-to-treat-bk-virus-infection-in-kidney-transplant-recipients
#13
D Wojciechowski, S Chandran, A Webber, R Hirose, F Vincenti
BACKGROUND: BK virus (BKV) is a significant post-transplant infection. Mammalian target of rapamycin inhibitors (mTORis) reduce BKV large T antigen expression in vitro and are associated with lower rates of BKV infection when used as de novo immunosuppression in clinical studies. METHODS: We performed a prospective, single-center, randomized, open label pilot trial to evaluate the impact of mycophenolate mofetil (MMF) withdrawal with conversion to the mTORi everolimus versus a 50% reduction of the MMF dose for the treatment of BKV infection after kidney transplantation...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28886758/evaluation-of-beclomethasone-dipropionate-80-and-160-micrograms-day-delivered-via-a-breath-actuated-inhaler-for-persistent-asthma
#14
Frank C Hampel, Warner Carr, Michael Gillespie, Calvin J Small
BACKGROUND: Breath-actuated inhalers (BAI) may simplify the delivery of inhaled medications compared with other devices. OBJECTIVE: To evaluate the efficacy and safety of beclomethasone dipropionate BAI versus matching placebo in adolescent and adult patients with persistent asthma. METHODS: This phase III, 12-week, double-blind study enrolled patients with asthma aged ≥12 years who were previously treated with a stable dose of inhaled corticosteroid or noncorticosteroid therapy...
November 8, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28853699/successful-therapy-with-mycophenolic-acid-in%C3%A2-a-membranous-glomerulonephritis-due-to%C3%A2-kimura-disease%C3%A2
#15
Julien Gaillard, Samuel Rotman, Christophe Girardet, François Spertini
Kimura disease (KD) is a rare inflammatory soft tissue disorder of unknown origin most frequent in Asians, the prevalence of which is growing in Western countries. Painless papules and/or nodules with a predilection for the head and the neck region, lymphadenopathies, parotid gland involvement, eosinophilia, and raised IgE levels are parts of its presentation. Renal involvement with various forms of glomerulonephritis, including membranous nephropathy (MN), can occur and is generally associated with a proteinuria that encompasses nephrotic syndrome...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28831373/chronic-eosinophilic-pneumonia-after-radiation-therapy-for-squamous-cell-lung-cancer
#16
Hiromasa Nakayasu, Toshihiro Shirai, Yuko Tanaka, Mika Saigusa
Reports of chronic eosinophilic pneumonia (CEP) after radiation therapy are limited to breast cancer. We herein describe a case of CEP after radiation therapy for lung cancer. The patient was a 65-year-old man who had asymptomatic peripheral blood eosinophilia but no history of asthma or allergy. One month after completion of radiation therapy, chest CT scan revealed infiltrates inside the irradiated area, leading to the diagnosis of radiation pneumonitis. His condition improved after receiving corticosteroids...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28805142/intravenous-immunoglobulins-modify-relapsing-membranous-glomerulonephritis-after-kidney-transplantation-a-case-report
#17
Sanne Steyaert, Jo Van Dorpe, Anne Hoorens, Wim Van Biesen, Steven Van Laecke
OBJECTIVES: Recurrence of membranous glomerulonephritis after transplant is common and is an important cause of loss of renal graft. This case supports the effect of immunoglobulins in the treatment of this disease after transplantation. It is the first report in the literature with a follow-up of more than 10 years and because of the sustained effect of the immunoglobulins, it strengthens the idea that this can alter long-term outcome. METHODS: Single case study and search of the literature...
August 14, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28781303/an-elderly-woman-with-anti-neutrophil-antibody-positive-agranulocytosis-who-responded-to-high-dose-intravenous-methylprednisolone
#18
Shiro Koh, Hideo Koh, Yuki Kubo, Maiko Kuroda, Mitsutaka Nishimoto, Takuro Yoshimura, Yasuhiro Nakashima, Takahiko Nakane, Hirohisa Nakamae, Masahiko Ohsawa, Masayuki Hino
Although anti-neutrophil antibodies (ANAs) often exist and immunoreaction may be involved in agranulocytosis, few reports have so far described ANA-positive cases of agranulocytosis with an unknown etiology. We herein describe the case of a 69-year-old woman who presented with ANA-positive agranulocytosis. In this case, both the withdrawal of the drugs that had possibly caused neutropenia and the use of granulocyte-colony stimulating factor (G-CSF) were ineffective treatment measures. Approximately 2 weeks after the discontinuation of the suspected drugs, we initiated corticosteroid pulse therapy; the neutrophil count recovered by day 19 of steroid therapy...
August 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28780657/combination-therapy-of-rituximab-and-mycophenolate-mofetil-in-childhood-lupus-nephritis
#19
Julien Hogan, Astrid Godron, Véronique Baudouin, Theresa Kwon, Jérôme Harambat, Georges Deschênes, Olivier Niel
BACKGROUND: In clinical trials, the addition of rituximab (RTX) to the combination therapeutic regimen of mycophenolate mofetil (MMF) and corticosteroids failed to improve outcome in lupus nephritis (LN). However, recent data suggest that RTX may have steroid-sparing beneficial effects with an efficacy similar to that of conventional regimens. We report our experience with RTX in the treatment of children with LN. METHODS: Patients treated with RTX for first occurrence of LN class III to V were enrolled in the study...
August 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28771932/acute-liver-failure-induced-by-idiosyncratic-reaction-to-drugs-challenges-in-diagnosis-and-therapy
#20
REVIEW
Shannan R Tujios, William M Lee
Acute liver failure (ALF) requires urgent attention to identify etiology and determine prognosis, in order to assess likelihood of survival or need for transplantation. Identifying idiosyncratic drug-induced liver injury (iDILI) may be particularly difficult, but the illness generally follows a subacute course, allowing time to assess outcome and find a liver graft if needed. Not all drugs that cause iDILI lead to ALF; the most common are antibiotics including anti-tuberculous medications, non-steroidal anti-inflammatory agents and herbal and dietary supplements (HDS)...
August 3, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
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