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https://www.readbyqxmd.com/read/28212153/new-therapies-for-the-prevention-and-treatment-of-exacerbations-of-bronchiectasis
#1
Hani Abo-Leyah, James D Chalmers
PURPOSE OF REVIEW: Exacerbations of bronchiectasis have a major impact on quality of life, healthcare costs, and long-term risk of complications. Preventing exacerbations is one of the major goals of treatment. Bronchiectasis is increasingly recognized and the impact of bronchiectasis exacerbations on daily clinical practice is also increasing. RECENT FINDINGS: Preventing bronchiectasis exacerbations are dependent on appropriate risk assessment, identifying the patients at highest risk to rationally target preventive therapies...
February 16, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28198750/relentless-placoid-chorioretinitis-successful-long-term-treatment-with-intravitreal-triamcinolone
#2
Daniel B Roth, Sheila Ballintine, Dimosthenis Mantopoulos, Jonathan Prenner, Howard F Fine
PURPOSE: To report a case of relentless placoid chorioretinitis (ampiginous choroiditis) treated with intravitreal triamcinolone acetonide (IVTA). METHODS: Interventional case report. RESULTS: A 34-year-old pregnant woman with a history of poor visual acuity in her left eye, secondary to an undetermined cause, developed an acute painless central scotoma and blurred vision in the right eye. The examination revealed decreased visual acuity, active inflammatory placoid choroidal lesions in the posterior pole, and mid-periphery with sharp disk margins and normal-appearing vasculature...
February 14, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28196638/japanese-guidelines-for-adult-asthma-2017
#3
REVIEW
Masakazu Ichinose, Hisatoshi Sugiura, Hiroyuki Nagase, Masao Yamaguchi, Hiromasa Inoue, Hironori Sagara, Jun Tamaoki, Yuji Tohda, Mitsuru Munakata, Kohei Yamauchi, Ken Ohta
Adult bronchial asthma is characterized by chronic airway inflammation, and presents clinically with variable airway narrowing (wheezes and dyspnea) and cough. Long-standing asthma induces airway remodeling, leading to intractable asthma. The number of patients with asthma has increased; however, the number of patients who die of asthma has decreased (1.2 per 100,000 patients in 2015). The goal of asthma treatment is to enable patients with asthma to attain normal pulmonary function and lead a normal life, without any symptoms...
February 11, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28185680/recurrent-pericarditis
#4
M Imazio, A Battaglia, L Gaido, F Gaita
Recurrent pericarditis is the most troublesome complication of pericarditis occurring in 15 to 30% of cases. The pathogenesis is often presumed to be immune-mediated although a specific rheumatologic diagnosis is commonly difficult to find. The clinical diagnosis is based on recurrent pericarditis chest pain and additional objective evidence of disease activity (e.g. pericardial rub, ECG changes, pericardial effusion, elevation of markers of inflammation, and/or imaging evidence of pericardial inflammation by CT or cardiac MR)...
February 6, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28151588/safety-of-long-term-intranasal-budesonide-delivered-via-the-mucosal-atomization-device-for-chronic-rhinosinusitis
#5
Jamil Manji, Gurkaran Singh, Christopher Okpaleke, Anali Dadgostar, Fahad Al-Asousi, Ameen Amanian, Luis Macias-Valle, Andres Finkelstein, Mark Tacey, Andrew Thamboo, Amin Javer
BACKGROUND: Although short-term use (≤2 months) of atomized topical nasal steroids has been shown to be safe and effective, the long-term safety has yet to be demonstrated. The aim of this study was to determine the impact of long-term topical budesonide treatment via the mucosal atomization device (MAD) on the hypothalamic-pituitary-adrenal axis (HPAA) and intraocular pressure (IOP). METHODS: A cross-sectional study of patients with chronic rhinosinusitis (CRS), with or without nasal polyposis, managed with daily nasal budesonide via MAD was conducted at a tertiary rhinology center...
February 2, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28141913/systemic-corticosteroid-regimens-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#6
REVIEW
Wes Onland, Anne Pmc De Jaegere, Martin Offringa, Anton van Kaam
BACKGROUND: Cochrane systematic reviews show that systemic postnatal corticosteroids reduce the risk of bronchopulmonary dysplasia (BPD) in preterm infants. However, corticosteroids have also been associated with an increased risk of neurodevelopmental impairment. It is unknown whether these beneficial and adverse effects are modulated by differences in corticosteroid treatment regimens. OBJECTIVES: To assess the effects of different corticosteroid treatment regimens on mortality, pulmonary morbidity, and neurodevelopmental outcome in very low birth weight (VLBW) infants...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28131750/efficacy-of-eplerenone-in-the-management-of-mineralocorticoid-excess-in-men-with-metastatic-castration-resistant-prostate-cancer-treated-with-abiraterone-without-prednisone
#7
David Gill, David Gaston, Erin Bailey, Andrew Hahn, Sumati Gupta, Julia Batten, Anitha Alex, Kenneth Boucher, David Stenehjem, Neeraj Agarwal
BACKGROUND: Abiraterone acetate has been approved for metastatic castration-resistant prostate cancer (mCRPC). Coadministration with prednisone has been recommended to prevent the toxicity from secondary mineralocorticoid excess, such as hypertension, hypokalemia, and edema. However, the use of prednisone is often not desired by patients because of the potential for detrimental effects of long-term therapy with corticosteroids, especially in those with comorbidities such as diabetes or who have received previous immunotherapeutic agents...
January 5, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28117876/interventions-to-prevent-and-treat-corticosteroid-induced-osteoporosis-and-prevent-osteoporotic-fractures-in-duchenne-muscular-dystrophy
#8
REVIEW
Jennifer M Bell, Michael D Shields, Janet Watters, Alistair Hamilton, Timothy Beringer, Mark Elliott, Rosaline Quinlivan, Sandya Tirupathi, Bronagh Blackwood
BACKGROUND: Corticosteroid treatment is considered the 'gold standard' for Duchenne muscular dystrophy (DMD); however, it is also known to induce osteoporosis and thus increase the risk of vertebral fragility fractures. Good practice in the care of those with DMD requires prevention of these adverse effects. Treatments to increase bone mineral density include bisphosphonates and vitamin D and calcium supplements, and in adolescents with pubertal delay, testosterone. Bone health management is an important part of lifelong care for patients with DMD...
January 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28117615/investigational-beta-2-adrenergic-agonists-for-the-treatment-of-chronic-obstructive-pulmonary-disease
#9
Mario Malerba, Alessandro Radaeli, Paolo Montuschi, Kesavan S Babu, Jaymin B Morjaria
Long-acting bronchodilators are pivotal in the therapeutic management of COPD patients with moderate-to-severe airflow obstruction. New ultra-long-acting β2-agnoists (ultra-LABAs) have been developed, some of which have been licensed for use as monotherapy and/or in combination with other bronchodilators or inhaled corticosteroids, for use in COPD patients with persistent symptoms and worsening airflow limitation. These new agents are faster in onset and have a prolonged duration of action, with a similar safety profile to the traditional twice-daily bronchodilators which may have an impact on patient concordance...
February 6, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28108245/japanese-guidelines-for-childhood-asthma-2017
#10
REVIEW
Hirokazu Arakawa, Yuhei Hamasaki, Yoichi Kohno, Motohiro Ebisawa, Naomi Kondo, Sankei Nishima, Toshiyuki Nishimuta, Akihiro Morikawa
The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2017 (JAGL 2017) includes a minor revision of the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012) by the Japanese Society of Pediatric Allergy and Clinical Immunology. The section on child asthma in JAGL 2017 provides information on how to diagnose asthma between infancy and adolescence (0-15 years of age). It makes recommendations for best practices in the management of childhood asthma, including management of acute exacerbations and non-pharmacological and pharmacological management...
January 18, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28078646/mucosal-healing-in-ulcerative-colitis-a-comprehensive-review
#11
REVIEW
Pedro Boal Carvalho, José Cotter
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by periods of remission and periods of relapse. Patients often present with symptoms such as rectal bleeding, diarrhea and weight loss, and may require hospitalization and even colectomy. Long-term complications of UC include decreased quality of life and productivity and an increased risk of colorectal cancer. Mucosal healing (MH) has gained progressive importance in the management of UC patients. In this article, we review the endoscopic findings that define both mucosal injury and MH, and the strengths and limitations of the scoring systems currently available in clinical practice...
January 11, 2017: Drugs
https://www.readbyqxmd.com/read/28052185/early-administration-of-inhaled-corticosteroids-for-preventing-chronic-lung-disease-in-very-low-birth-weight-preterm-neonates
#12
REVIEW
Vibhuti S Shah, Arne Ohlsson, Henry L Halliday, Michael Dunn
BACKGROUND: Chronic lung disease (CLD) remains a common complication among preterm infants. There is increasing evidence that inflammation plays an important role in the pathogenesis of CLD. Due to their strong anti-inflammatory properties, corticosteroids are an attractive intervention strategy. However, there are growing concerns regarding short- and long-term effects of systemic corticosteroids. Theoretically, administration of inhaled corticosteroids may allow for beneficial effects on the pulmonary system with a lower risk of undesirable systemic side effects...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28045322/orofacial-granulomatosis-as-early-manifestation-of-crohn-s-disease-report-of-a-case-in-a-paediatric-patient
#13
A Sarra, N G Nikitakis, A Daskalopoulos, G Chouliaras, A Sklavounou-Andrikopoulou, K Athanasaki
BACKGROUND: Orofacial granulomatosis (OFG) is a controversial entity mainly characterised by recurrent or permanent soft tissue swelling of sudden onset in the orofacial area with a histologic appearance of granulomatous inflammation. Differential diagnosis includes local diseases and systemic conditions, such as Crohn's disease (CD). A case of OFG in a paediatric patient is reported here, focusing on the clinical features, diagnostic procedures, treatment and long-term outcome. CASE REPORT: A 7 year-old boy presented with persistent and prominent lip swelling and painful oral mucosa lesions of six months duration...
December 2016: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/28034281/is-there-any-role-for-splenectomy-in-adulthood-onset-chronic-immune-thrombocytopenia-in-the-era-of-tpo-receptors-agonists-a-critical-overview
#14
Vibor Milunovic, Inga Mandac Rogulj, Slobodanka Kolonic Ostojic
Immune thrombocytopenia (ITP) in adulthood is characterized by chronic relapsing course. Despite the efficacious first line treatment (corticosteroid, intravenous immunoglobulin), majority of patients will enter the chronic phase warranting another treatment approach. Until recently, splenectomy performed in ITP chronic phase represented the standard of care with long-term remissions in more than 70% of patients, but however has never been tested in clinical trials. However, with the advances of our understanding of ITP pathophysiology and the shifting focus on megakaryocyte impairment, novel drugs were introduced in treatment paradigm, mainly trombopoietin receptor agonists (TPO-RAs); romiplostim and eltrombopag...
December 29, 2016: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28031708/trend-of-cost-and-utilization-of-copd-medication-in-korea
#15
Jongmin Lee, Jae Ha Lee, Jee-Ae Kim, Chin Kook Rhee
BACKGROUND: There are only a few longitudinal studies regarding medical utilization and costs for patients with COPD. The purpose of this study was to analyze the trend of medical utilization and costs on a long-term basis. METHODS: Using the Korean Health Insurance Review and Assessment Service (HIRA) data from 2008 to 2013, COPD patients were identified. The trend of medical utilization and costs was also analyzed. RESULTS: The number of COPD patients increased by 13...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28018458/successful-treatment-of-tubulointerstitial-nephritis-and-uveitis-with-steroid-and-azathioprine-in-a-12-year-old-boy
#16
Ji Eun Kim, Se Jin Park, Ji Young Oh, Hyeon Joo Jeong, Ji Hong Kim, Jae Il Shin
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease, often underdiagnosed or misdiagnosed in children. We describe the case of a 12-year-old boy who presented to Severance Hospital with a 1-month history of bilateral conjunctival injection. He was first evaluated by an Ophthalmologist in another hospital and diagnosed with panuveitis. Laboratory tests indicated renal failure, and a renal biopsy confirmed the diagnosis of acute tubulointerstitial nephritis. An extensive exclusion of all possible causes allowed a diagnosis of TINU syndrome...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28012104/intravitreal-dexamethasone-implant-for-the-treatment-of-cystoid-macular-oedema-associated-with-acute-retinal-necrosis
#17
Parthopratim Dutta Majumder, Jyotirmay Biswas, Asra Ambreen, Rowayda Amin, Zahedur Rahman Pannu, Ahmed Magdy Bedda
BACKGROUND: Acute retinal necrosis is a rare but devastating ocular condition. We report two cases of acute retinal necrosis in immunocompetent patients, complicated by cystoid macular oedema and treated with intravitreal dexamethasone (OZURDEX®) implant. RESULTS: Two patients diagnosed with acute retinal necrosis were treated with intravenous acyclovir. Both of them developed cystoid macular oedema following resolution of viral retinitis. Ocular condition of the first patient was further complicated by central serous chorioretinopathy...
December 2016: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/28002861/injectable-corticosteroids-take-precautions-and-use-caution
#18
Véronique Freire, Nathalie J Bureau
Corticosteroids are routinely injected into soft tissues, tendon sheaths, bursae, and joints. These anti-inflammatory agents have different potency and solubility, and solubility is inversely correlated with the duration of action. Corticosteroids carry a low risk of complications but commonly cause systemic and local adverse effects. The use of intra-articular corticosteroid injections in the treatment of inflammatory arthritis and osteoarthritis is well established. Evidence also supports the use of injectable corticosteroids in the treatment of inflammatory tenosynovitis and bursitis associated with rheumatic diseases, trigger finger and de Quervain disease, and carpal tunnel syndrome...
November 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27981463/interleukin-il-1-inhibition-with-anakinra-and-canakinumab-in-beh%C3%A3-et-s-disease-related-uveitis-a-multicenter-retrospective-observational-study
#19
Claudia Fabiani, Antonio Vitale, Giacomo Emmi, Giuseppe Lopalco, Lorenzo Vannozzi, Silvana Guerriero, Stefano Gentileschi, Daniela Bacherini, Rossella Franceschini, Bruno Frediani, Mauro Galeazzi, Florenzo Iannone, Gian Marco Tosi, Luca Cantarini
This study aimed to evaluate the role of interleukin (IL)-1 inhibitors anakinra (ANA) and canakinumab (CAN) in the treatment of Behçet's disease (BD)-related uveitis. Multicenter retrospective observational study includes 19 consecutive BD patients (31 affected eyes) received treatment with anti-IL-1 agents. Data were analyzed at baseline and at 3 and 12 months. The primary endpoint is the reduction of ocular inflammatory flares (OIF). The secondary endpoints are improvement of best corrected visual acuity (BCVA); reduction of macular thickness defined by optical coherence tomography (OCT) and of vasculitis identified with fluorescein angiography (FA); evaluation of statistically significant differences between patients treated with IL-1 inhibitors as monotherapy, subjects also administered with disease modifying anti-rheumatic drugs (DMARDs) and/or corticosteroids as well as between patients administered with IL-1 inhibitors as first line biologic treatment and those previously treated with TNF-α inhibitors...
January 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/27974106/fulminant-bilateral-papilloedema-during-low-dose-steroid-taper-in-a-child-with-systemic-idiopathic-arthritis-treated-with-tocilizumab
#20
Lulu Burstzyn, Simon Levin, Brian Rotenberg, Tamara Van Hooren, Andrew Leung, Roberta Berard, Daniela S Ardelean
Systemic juvenile idiopathic arthritis (SJIA) is one of the most severe forms of arthritis that affects children younger than 16 years of age at onset. SJIA often requires corticosteroids to control the inflammation. However, long-term corticosteroid use may have adverse effects, including intracranial hypertension (IH). Biologic therapies have been used as corticosteroid sparing agents. We report the first case of a child with steroid-dependent SJIA treated with tocilizumab, an IL-6 receptor monoclonal antibody, who developed fulminant IH, bilateral papilloedema and vision loss when oral prednisone was weaned from 2 to 1 mg per day...
December 14, 2016: Clinical and Experimental Rheumatology
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