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long term corticosteroid management

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https://www.readbyqxmd.com/read/29017363/a-survey-on-the-use-of-topical-steroids-in-patients-treated-for-lichen-sclerosus-associated-vulval-squamous-cell-carcinoma
#1
Rachel Pounds, Sanna Tahir, Christopher Dawson, Ciaran Woodman, David Luesley, Jason Yap
Evidence suggests that lichen sclerosus (LS) is the primary aetiological factor for local vulval recurrence (LVR) in vulval squamous cell carcinoma (VSCC). The long-term application of topical corticosteroids is believed to prevent LVR. Patients treated for LS-associated VSCC at a gynaecological cancer centre were invited to complete a questionnaire to evaluate whether they are receiving corticosteroids. 55 of the 95 eligible patients (58%) completed the questionnaire; LS was treated in 69%, with steroids given to 84...
October 10, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28987613/treatment-of-cystoid-macular-edema-secondary-to-retinitis-pigmentosa-a-systematic-review
#2
REVIEW
Malini Bakthavatchalam, Frank H P Lai, Shi Song Rong, Danny S Ng, Marten E Brelen
There are various treatments for cystoid macular edema (CME) secondary to retinitis pigmentosa (RP); however, the evidence for these treatments has not been previously systematically reviewed. Our review that includes 23 studies shows that oral carbonic anhydrase inhibitors (CAI) (including acetazolamide, methazolamide) and topical CAI (dorzolamide and brinzolamide) are effective first line treatments. In patients unresponsive to CAI treatment, intravitreal steroids (triamcinolone acetonide and sustained-release dexamethasone implant), oral corticosteroid (Deflazacort), intravitreal anti-vascular endothelial growth factor agents (ranibizumab and bevacizumab), grid laser photocoagulation, pars plana vitrectomy, or ketorolac were also effective in improving CME secondary to RP...
October 4, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28978963/editorial-deep-remission-in-eosinophilic-esophagitis-with-long-term-steroids-difficult-to-attain-and-maintain
#3
Jeffrey Alexander
The study by Greuter et al. entitled "Long-term treatment of eosinophilic esophagitis and swallowed topical corticosteroids: development and evaluation of a therapeutic concept" follows 351 patients over 6 years. This gives considerable insight into long-term topical steroid management of EoE and establishes the concept of deep remission in EoE.
October 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28965921/therapeutic-approaches-of-asthma-and-copd-overlap
#4
REVIEW
Mitsuko Kondo, Jun Tamaoki
Asthma and COPD overlap (ACO) is an important clinical phenotype, due to the low-health-related quality of life (QOL), rapid decline in lung function, frequent exacerbation, and high economic burden. However, no large-scaled therapeutic trials of ACO have been conducted. At present, ACO is treated according to asthma/COPD guidelines. The goals of ACO treatment are to relieve symptoms and improve QOL and lung functions. Treatment must also prevent disease progression, airway remodeling, exacerbation, complications, and comorbidities...
September 28, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28951345/diabetic-ketoacidosis-in-acromegaly-a-rare-complication-precipitated-by-corticosteroid-use
#5
REVIEW
Jeremy Weiss, Anna J Wood, Jeffrey D Zajac, Mathis Grossmann, Sofianos Andrikopoulos, Elif I Ekinci
Diabetic ketoacidosis has been described in the literature as a rare possible initial presentation of acromegaly before a diagnosis of acromegaly is eventually made. Indeed, diabetic ketoacidosis is a recognised complication of acromegaly. There are a number of factors that can predispose patients with acromegaly to diabetes as well as to diabetic ketoacidosis. These include high levels of growth hormone and insulin-like growth factor 1 in acromegaly and the effect on glycaemia by medications used in the management of acromegaly...
September 19, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28944162/an-update-on-treatment-of-pediatric-chronic-non-infectious-uveitis
#6
Arjun B Sood, Sheila T Angeles-Han
There are no standardized treatment protocols for pediatric non-infectious uveitis. Topical corticosteroids are the typical first-line agent, although systemic corticosteroids are used in intermediate, posterior and panuveitic uveitis. Corticosteroids are not considered to be long-term therapy due to potential ocular and systemic side effects. In children with severe and/or refractory uveitis, timely management with higher dose disease-modifying antirheumatic drugs (DMARDs) and biologic agents is important...
March 2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/28940193/prevalence-of-long-term-opioid-use-in-long-stay-nursing-home-residents
#7
Jacob N Hunnicutt, Stavroula A Chrysanthopoulou, Christine M Ulbricht, Anne L Hume, Jennifer Tjia, Kate L Lapane
BACKGROUND/OBJECTIVES: Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs). DESIGN: Cross-sectional. SETTING: U.S. NHs (N = 13,522). PARTICIPANTS: Long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow-up (N = 315,949). MEASUREMENTS: We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short-term: ≤30 days, medium-term: >30-89 days, long-term: ≥90 days), adjuvants (e...
September 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#8
(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
#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/28931662/-i-have-lost-in-every-facet-of-my-life-the-hidden-burden-of-severe-asthma
#10
Juliet M Foster, Vanessa M McDonald, Michael Guo, Helen K Reddel
People with severe asthma are thought to face a sizeable daily disease burden. This study aimed to explore the little-known life experiences of people living with severe asthma.Adults with severe asthma were invited for telephone interview. Semistructured interviews were conducted until no new themes emerged. The 25 interviews were recorded, transcribed and analysed thematically.Four themes emerged. 1) "The body as a hindrance": severe asthma placed broad limits on life from daily chores to career, relationships and family life that left interviewees feeling emotionally distressed...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#11
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28889846/acupuncture-for-management-of-type-2-diabetes-mellitus-in-a-patient-with-myasthenia-gravis-a-case-report
#12
Yun Jin Kim
Myasthenia gravis (MG) is an acquired disease of the neuromuscular junctions characterized by muscular weakness and fatigue, with a prevalence of 50-125 cases per million population in western countries. In men, it usually appears after the age of 60 years, while in women, it usually appears before the age of 40 years. Long-term immunosuppression with corticosteroids is the mainstay treatment for patients with MG; however, the use of corticosteroids is a well-documented risk factor for type 2 diabetes mellitus, which has also been reported in steroid-treated patients with MG...
August 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28878824/cma-analysis-identifies-homozygous-deletion-of-mcph1-in-2-brothers-with-primary-microcephaly-1
#13
Morteza Hemmat, Melissa J Rumple, Loretta W Mahon, Melanie Morrow, Tamara Zach, Arturo Anguiano, Mohamed M Elnaggar, Boris T Wang, Fatih Z Boyar
BACKGROUND: Homozygous mutations and deletions of the microcephalin gene (MCPH1; OMIM *607117) have been identified as a cause of autosomal recessive primary microcephaly and intellectual disability (MIM #251200). Previous studies in families of Asian descent suggest that the severity of the phenotype may vary based on the extent of the genomic alteration. We report chromosome microarray (CMA) findings and the first described family study of a patient with primary microcephaly in a consanguineous Hispanic family...
2017: Molecular Cytogenetics
https://www.readbyqxmd.com/read/28874727/effectiveness-of-glenohumeral-joint-dilatation-for-treatment-of-frozen-shoulder-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
Wei-Ting Wu, Ke-Vin Chang, Der-Sheng Han, Chung-Hsun Chang, Fu-Sui Yang, Chih-Peng Lin
The objective was to explore the effectiveness of glenohumeral joint distension for the treatment of frozen shoulder. We searched electronic data sources including PubMed, Scopus, and Embase from the earliest records available to February 2017. Eleven randomized controlled trials including at least one pair of comparisons between capsular distension and a reference treatment were included, comprising 747 participants. Patients' characteristics, details of reference treatments, aspects of capsular distension therapy, and outcome measurement were evaluated at three points in time: baseline, early following intervention, and at the trial's end...
September 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28869044/stroke-and-temporal-arteritis-a-study-of-6-cases
#15
A Lago, J I Tembl, G Fortea, L Morales, C Nieves, M Campins, F Aparici
INTRODUCTION: Though uncommon, ischaemic stroke due to temporal arteritis carries serious difficulties for diagnosis and subsequent management and requires a high level of suspicion. METHODS: We analysed a series of 6 patients with biopsy-proven temporal arteritis presenting with ischaemic stroke. We discuss clinical characteristics, difficulties of assessment, short- and long-term progression, treatment, and the usefulness of new diagnostic techniques. RESULTS: Our sample of 6 patients had a mean age of 68...
August 28, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28868633/a-5-year-randomized-trial-on-the-safety-and-efficacy-of-pimecrolimus-in-atopic-dermatitis-a-critical-appraisal
#16
S Weidinger, H Baurecht, J Schmitt
AIM: The PETITE study (Sigurgeirsson et al.) aimed to compare safety and efficacy of pimecrolimus 1% cream (PIM) and low-to-medium-potency topical corticosteroids (TCS) in children with mild-to-moderate atopic dermatitis (AD). SETTING AND DESIGN: Participants of this 5-year drug-company sponsored multicentre, open-label, parallel-group trial were recruited between April 2004 and October 2005. No details are reported regarding the study sites. STUDY EXPOSURE: Infants aged ≥ 3 to < 12 months with mild-to-moderate AD were randomly assigned in a 1 : 1 ratio to receive either PIM or a low- or medium-potency TCS cream/ointment for 5 years...
September 4, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28862414/asthma-copd-overlap-syndrome-recent-advances-in-diagnostic-criteria-and-prognostic-significance
#17
Claudio Sorino, Nicola Scichilone, Maria D'Amato, Vincenzo Patella, Fabiano DI Marco
The term asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) has been proposed for individuals with features of both asthma and COPD. Several attempts have been done to define ACOS on the basis of medical history, symptoms, and functional findings. The main diagnostic criteria include airflow obstruction with a strong although incomplete reversibility to bronchodilation tests, a significant exposure to cigarette or biomass smoke, and a history of atopy or asthma. Additional diagnostic elements include eosinophilic airway and systemic inflammation, a good response to corticosteroid treatment, and a high concentration of exhaled nitric oxide...
June 2017: Minerva Medica
https://www.readbyqxmd.com/read/28843363/pembrolizumab-induced-encephalopathy-a-review-of-neurological-toxicities-with-immune-checkpoint-inhibitors
#18
Sophie Feng, Jermaine Coward, Elizabeth McCaffrey, John Coucher, Paul Kalokerinos, Kenneth O'Byrne
The use of immune checkpoint inhibitor (ICI) therapy in the treatment of solid organ malignancies is becoming increasingly common. This has prompted the recognition of a new class of immune related adverse effects (irAEs) which stem from the upregulation of T cell activity causing autoimmunity. Neurological irAEs are a rare complication of ICIs that can lead to long term morbidity. We report a rare case of encephalopathy following treatment with pembrolizumab, where the patient achieved durable disease response despite discontinuation of therapy...
August 23, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28836266/late-%C3%A2-7-days-inhalation-corticosteroids-to-reduce-bronchopulmonary-dysplasia-in-preterm-infants
#19
REVIEW
Wes Onland, Martin Offringa, Anton van Kaam
BACKGROUND: Bronchopulmonary dysplasia (BPD), defined as oxygen dependence at 36 weeks postmenstrual age (PMA), remains an important complication of prematurity. Pulmonary inflammation plays a central role in the pathogenesis of BPD. Attenuating pulmonary inflammation with postnatal systemic corticosteroids reduces the incidence of BPD in preterm infants but may be associated with an increased risk of adverse neurodevelopmental outcomes. Local administration of corticosteroids via inhalation might be an effective and safe alternative...
August 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28835778/effectiveness-of-intra-articular-therapies-in-osteoarthritis-a-literature-review
#20
REVIEW
Peter Wehling, Christopher Evans, Jana Wehling, William Maixner
Osteoarthritis is a painful, chronic disease with widespread burden on patients, communities, health and social care systems. Conservative therapies, such as nonpharmacological interventions, systemic drug treatment and intra-articular therapies are used before resorting to surgery; nonetheless, disease control often remains inadequate. Recent advances in osteoarthritis management have aimed to provide greater variety of treatment options. Here, we summarize a targeted literature review evaluating efficacy and safety of intra-articular therapies for osteoarthritis...
August 2017: Therapeutic Advances in Musculoskeletal Disease
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