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https://www.readbyqxmd.com/read/28923623/mycophenolate-mofetil-withdrawal-with-conversion-to-everolimus-to-treat-bk-virus-infection-in-kidney-transplant-recipients
#1
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
#2
(no author information available yet)
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 greater than or equal to 12 years who were previously treated with a stable dose of inhaled corticosteroid or noncorticosteroid therapy...
September 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28753231/pd-1-inhibitor-associated-lichenoid-inflammation-with-incidental-suprabasilar-acantholysis-or-vesiculation-report-of-4-cases
#9
Shaun Chou, Cathy Zhao, Shelley Ji Eun Hwang, Pablo Fernandez-Penas
BACKGROUND: Immune checkpoint agents targeting programmed cell death-1 protein (PD1) or cytotoxic T-lymphocyte-associated protein-4 (CTLA-4) receptors are increasingly utilized in treatment of advanced malignancies. However, these immunotherapies are commonly associated with idiosyncratic cutaneous adverse reactions. Thus, recognition and awareness of these reactions are necessary. METHODS: We reviewed the skin biopsies of all patients on anti-PD1 therapy with or without ipilimumab who developed lichenoid inflammation and included those with microscopic suprabasal or intraepidermal clefts...
July 28, 2017: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/28745524/should-patients-switched-from-d-to-b-in-the-gold-2017-classification-be-discontinued-from-inhaled-corticosteroids
#10
Matevz Harlander, Miriam Barrecheguren, Matjaz Turel, Marc Miravitlles
Inhaled corticosteroids (ICSs) are the cornerstone of the treatment of asthma, but their role in COPD is limited. Several guidelines recommend their use in patients with severe airflow limitation, frequent exacerbations and asthma-COPD overlap (ACO), while the previous GOLD document recommended ICS for patients with high risk of exacerbations and a high level of symptoms (group D). Following the changes in the GOLD document 2017 update, in which impaired lung function is no longer considered as a determinant of exacerbation risk, a high number of COPD patients can now be labeled as group B (low risk of exacerbations and high level of symptoms) instead of D, and hence, no longer fulfill the indication for ICS...
July 26, 2017: COPD
https://www.readbyqxmd.com/read/28691866/safety-and-pharmacodynamics-of-venetoclax-abt-199-in-a-randomized-single-and-multiple-ascending-dose-study-in-women-with-systemic-lupus-erythematosus
#11
P Lu, R Fleischmann, C Curtis, S Ignatenko, S H Clarke, M Desai, S L Wong, K M Grebe, K Black, J Zeng, J Stolzenbach, J K Medema
Objective The anti-apoptotic protein B-cell lymphoma 2 (Bcl-2) may contribute to the pathogenesis of systemic lupus erythematosus. The safety, tolerability, and pharmacodynamics of the selective Bcl-2 inhibitor venetoclax (ABT-199) were assessed in women with systemic lupus erythematosus. Methods A phase 1, double-blind, randomized, placebo controlled study evaluated single ascending doses (10, 30, 90, 180, 300, and 500 mg) and multiple ascending doses (2 cycles; 30, 60, 120, 240, 400, and 600 mg for 1 week, and then 3 weeks off per cycle) of orally administered venetoclax...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28663790/recent-advances-in-the-management-of-chronic-obstructive-pulmonary-disease
#12
REVIEW
Sharon R Rosenberg, Ravi Kalhan
Novel pharmacotherapies introduce additional options to providers and patients in how to best treat chronic obstructive pulmonary disease (COPD). Emerging data question the role of inhaled corticosteroids in COPD treatment, particularly as combination dual bronchodilator pharmacotherapies demonstrate robust results. For those maximized on pharmacotherapy with continued dyspnea or exacerbations or both, emerging bronchoscopic procedures may offer additional therapy in select patients. This review focuses on data supporting the use of novel ultra bronchodilators, particularly in combination, and on the role for inhaled corticosteroid withdrawal and new bronchoscopic procedures...
2017: F1000Research
https://www.readbyqxmd.com/read/28644565/long-term-risk-of-infection-in-patients-with-crohn-s-disease-on-anti-tnf-treatment-a-prospective-single-center-cohort-study-in-china
#13
Yue Li, Hui Jun Shu, Hong Lu, Hong Yang, Ji Li, Bei Tan, Jia Ming Qian
OBJECTIVE: The aim of this study was to explore the long-term risk of infection in patients with Crohn's disease (CD) on infliximab (IFX) therapy. METHODS: All CD patients treated with IFX were recruited from January 2008 to December 2015. Their characteristics and infectious events during IFX therapy were prospectively collected, and the risk of infection was evaluated using Cox regression. RESULTS: Seventy CD patients receiving IFX were consecutively recruited...
July 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28639542/fluticasone-propionate-and-fluticasone-propionate-salmeterol-multidose-dry-powder-inhalers-compared-with-placebo-for-persistent-asthma
#14
Lawrence D Sher, Gloria Yiu, Anat Sakov, Siyu Liu, Cynthia F Caracta
BACKGROUND: A novel, inhalation-driven, multidose dry powder inhaler (MDPI) has been developed, which allows for lower doses of fluticasone propionate (Fp) and Fp/salmeterol (FS) for the treatment of patients with asthma. OBJECTIVE: This phase III, multicenter, double-blind, parallel-group study (NCT02141854) evaluated the efficacy and safety of Fp MDPI and FS MDPI versus placebo MDPI. METHODS: Patients aged ≥12 years with persistent asthma who previously took an inhaled corticosteroid with or without a long-acting beta-agonist entered a 14- to 21-day run-in period, during which they received single-blind, low-dose Fp MDPI 50 μg (1 inhalation twice daily [b...
September 21, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28632810/hydralazine-associated-cutaneous-casculitis-presenting-with-aerodigestive-tract-involvement
#15
Laura E Levin, Cynthia Magro, James Horowitz, Joanna Harp
Hydralazine-induced small vessel vasculitis is a rare entity with a limited number of cases reported in the dermatologic literature. A characteristic pattern of acral pseudoembolic vesiculopustules with necrosis and ulceration has been suggested along with involvement of the aerodigestive tract, indicating mucosal involvement is an important feature of this disease. We report the case of a patient with hydralazine-induced vasculitis who exemplified this characteristic presentation associated with severe involvement of the aerodigestive tract and gastrointestinal tract bleeding...
May 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28626990/exhaled-breath-profiles-in-the-monitoring-of-loss-of-control-and-clinical-recovery-in-asthma
#16
P Brinkman, M A van de Pol, M G Gerritsen, L D Bos, T Dekker, B S Smids, A Sinha, C J Majoor, M M Sneeboer, H H Knobel, T J Vink, F H de Jongh, R Lutter, P J Sterk, N Fens
BACKGROUND: Asthma is a chronic inflammatory airway disease, associated with episodes of exacerbations. Therapy with inhaled corticosteroids (ICS) targets airway inflammation, which aims to maintain and restore asthma control. Clinical features are only modestly associated with airways inflammation. Therefore, we hypothesized that exhaled volatile metabolites identify longitudinal changes between clinically stable episodes and loss of asthma control. OBJECTIVES: To determine whether exhaled volatile organic compounds (VOCs) as measured by gas-chromatography/mass-spectrometry (GC/MS) and electronic nose (eNose) technology discriminate between clinically stable and unstable episodes of asthma...
June 19, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28624108/modification-of-immunosuppressive-therapy-as-risk-factor-for-complications-after-liver-transplantation
#17
REVIEW
Paolo De Simone, Paola Carrai, Laura Coletti, Davide Ghinolfi, Stefania Petruccelli, Franco Filipponi
Management of complications post-liver transplantation (LT) includes immunosuppressive manipulations with the aim to reduce the overall burden of immunologic suppression and compensate for renal, cardiovascular, metabolic toxicities, and for the increased oncologic risk. Two approaches can be implemented to reduce immunosuppression-related adverse events: upfront schedules tailored to the pretransplant individual patient's risk profile versus downstream modifications in the event of immunosuppression-related complications...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28610760/iatrogenic-kaposi-s-sarcoma-a-retrospective-cohort-study-in-an-italian-tertiary-care-centre
#18
L Brambilla, A Tourlaki, G Genovese
AIMS: Kaposi's sarcoma (KS) is a lymphoangioproliferative multicentric disorder. Among its four distinct clinical variants, iatrogenic KS (iKS) typically affects patients who have received immunosuppressant regimens for organ transplants, proliferative disorders, or immune-mediated diseases. The aim of the current study was to examine the characteristics of a cohort of patients with iKS, evaluating the differences in terms of epidemiological and clinical features, management and outcomes between organ transplant recipients (OTR) and patients immunosuppressed for other medical conditions...
June 10, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28608031/adalimumab-in-refractory-cystoid-macular-edema-associated-with-birdshot-chorioretinopathy
#19
Laura R Steeples, Paul Spry, Richard W J Lee, Ester Carreño
PURPOSE: To report the clinical outcomes of adalimumab therapy in cases of birdshot chorioretinitis (BCR) with cystoid macular edema (CME) refractory to conventional immunotherapy. METHODS: This is a retrospective case series of three BCR patients treated with adalimumab for refractory CME. The main outcome measure was central subfield thickness (CST) on optical coherence tomography. Any patients treated with local steroids and/or receiving systemic steroids higher than 40 mg prednisolone daily during adalimumab therapy were excluded...
June 12, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28606478/withdrawal-of-inhaled-corticosteroids-in-copd-a-meta-analysis
#20
Luigino Calzetta, Maria Gabriella Matera, Fulvio Braido, Marco Contoli, Angelo Corsico, Fabiano Di Marco, Pierachille Santus, Nicola Scichilone, Mario Cazzola, Paola Rogliani
BACKGROUND: Conflicting findings exist on the benefit of withdrawal of inhaled corticosteroid (ICS) in chronic obstructive pulmonary disease (COPD). We performed a quantitative synthesis in order to assess real impact of ICS discontinuation in COPD patients. METHODS: We carried out a meta-analysis via random-effects model on the available clinical evidence to evaluate the effect of ICS discontinuation in COPD. Randomized clinical trials and observational real-life studies investigating the effects of ICS withdrawal on the risk of COPD exacerbation, lung function (forced expiratory volume in 1 s [FEV1]) and quality of life (St...
August 2017: Pulmonary Pharmacology & Therapeutics
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