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long term corticosteroid management

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https://www.readbyqxmd.com/read/27933734/improved-quality-of-life-in-asthma-patients-under-long-term-therapy-assessed-by-ahq-japan
#1
Yuji Tohda, Takashi Iwanaga, Hiroyuki Sano, Hiroaki Kume, Kazuto Hirata, Noriyuki Ohkura, Isao Tachibana, Yoshihiro Nishimura, Hisako Matsumoto, Yoshiaki Minakata, Masanori Yoshikawa, Masaki Fujimura
BACKGROUND AND OBJECTIVES: Assessment of the effects of long-term management on patient quality of life (QOL) would be extremely useful for determining asthma treatment strategies. However, no studies have evaluated QOL over an extended period of time. This study evaluated the changes in QOL, drug management and disease severity in the same asthma patients at an interval of approximately 9 years. METHODS: We re-surveyed asthma patients enrolled in a survey conducted in 2004 to evaluate the effects of approximately a decade of treatment on disease severity and QOL assessed by the Japanese Asthma Health Questionnaire (AHQ-JAPAN)...
December 9, 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27933204/risk-factors-for-developing-colorectal-cancer-in-japanese-patients-with-ulcerative-colitis-a-retrospective-observational-study-capital-cohort-and-practice-for-ibd-total-management-in-kyoto-shiga-links-study-i
#2
Takuya Yoshino, Hiroshi Nakase, Tomohisa Takagi, Shigeki Bamba, Yusuke Okuyama, Takuji Kawamura, Teruki Oki, Hirozumi Obata, Chiharu Kawanami, Shinji Katsushima, Toshihiro Kusaka, Tomoyuki Tsujikawa, Yuji Naito, Akira Andoh, Takafumi Kogawa
BACKGROUND AND AIMS: Patients with ulcerative colitis (UC) are at risk for developing colorectal cancer (CRC), despite the development of new therapeutic agents. Stratification of the individual UC-patient's risk would be helpful to validate the risk factors for CRC. The aim of this study was to evaluate the risk factors for the development of CRC in a large cohort of patients with UC. METHODS: Data were obtained from 12 hospitals in the Kyoto-Shiga region during 2003-2013...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/27928727/benefits-and-risks-of-long-term-asthma-management-in-children-where-are-we-heading
#3
Hengameh H Raissy, H William Kelly
International guidelines provide recommendations for a stepwise approach to the management of asthma in children 0-4 years old, 5-11 years old, and adolescents who are treated as adults. Therapy is aimed at two domains of control: current impairment and future risk. The long-term controller medications, inhaled corticosteroids (ICSs), ICSs in combination with long-acting β2 agonists, leukotriene receptor antagonists, and immunomodulators, exhibit different efficacies for these domains. The risk:benefit ratios of the available medications need to be carefully assessed...
December 7, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#4
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27826703/leukotriene-receptor-antagonists-and-antiallergy-drugs
#5
Tsutomu Tamada, Masakazu Ichinose
As one of the candidates of the therapeutic strategy for asthma in addition to inhaled corticosteroids (ICS), leukotriene receptor antagonists (LTRAs) are known to be useful for long-term management of asthma patients complicated by allergic rhinitis (AR) or exercise-induced asthma (EIA). Currently available LTRAs are pranlukast hydrate, zafirlukast, and montelukast. These LTRAs have a bronchodilator action and inhibit airway inflammation, resulting in a significant improvement of asthma symptoms, respiratory function, inhalation frequency of as-needed inhaled β2-agonist, airway inflammation, airway hyperresponsiveness, dosage of ICSs, asthma exacerbations, and patients' QOL...
November 9, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27818191/corticosteroids-for-the-management-of-severe-intracranial-hypertension-in-meningoencephalitis-caused-by-cryptococcus-gattii-a-case-report-and-review
#6
R-A Maciel, L-S Ferreira, F Wirth, P-D Rosa, M Aves, E Turra, L-Z Goldani
Immune reconstitution inflammatory syndrome in meningitis caused by Cryptococcus gattii in immunocompetent patients after initiation of antifungal therapy appears to be the result of paradoxical antifungal treatment-induced clinical deterioration due to improved local immune responses to cryptococcal organisms. Recent anecdotal reports have suggested a favorable clinical response to corticosteroids in select patients with C. gattii central nervous system (CNS) infections. In this report, we describe a 65-year-old patient with meningoencephalitis caused by C...
November 3, 2016: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/27812050/clinical-outcomes-of-pneumocystis-pneumonia-from-a-tertiary-care-centre-in-pakistan
#7
Ali Bin Sarwar Zubairi, Hira Shahzad, Afia Zafar
OBJECTIVE: To assess the predisposing immunocompromised states, administration of pneumocystis jirovecii pneumonia prophylaxis, the disease course and outcomes of patients with pneumocystis jirovecii pneumonia. METHODS: The retrospective study was conducted at the Aga Khan University Hospital in Karachi. The medical records of patients diagnosed with pneumocystis jirovecii pneumonia from January 1995 to October 2015 were retrieved. Baseline characteristics, clinical course, treatment, and mortality rates were noted...
November 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27802508/management-of-acute-and-recurrent-gout-a-clinical-practice-guideline-from-the-american-college-of-physicians
#8
Amir Qaseem, Russell P Harris, Mary Ann Forciea
Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of gout. Methods: Using the ACP grading system, the committee based these recommendations on a systematic review of randomized, controlled trials; systematic reviews; and large observational studies published between January 2010 and March 2016. Clinical outcomes evaluated included pain, joint swelling and tenderness, activities of daily living, patient global assessment, recurrence, intermediate outcomes of serum urate levels, and harms...
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27802478/management-of-gout-a-systematic-review-in-support-of-an-american-college-of-physicians-clinical-practice-guideline
#9
Paul G Shekelle, Sydne J Newberry, John D FitzGerald, Aneesa Motala, Claire E O'Hanlon, Abdul Tariq, Adeyemi Okunogbe, Dan Han, Roberta Shanman
Background: Gout is a common type of inflammatory arthritis in patients seen by primary care physicians. Purpose: To review evidence about treatment of acute gout attacks, management of hyperuricemia to prevent attacks, and discontinuation of medications for chronic gout in adults. Data Sources: Multiple electronic databases from January 2010 to March 2016, reference mining, and pharmaceutical manufacturers. Study Selection: Studies of drugs approved by the U...
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27801321/-clinical-characteristics-and-long-term-therapeutic-effects-of-60-patients-with-idiopathic-hypereosinophilic-syndrome-in-a-single-center
#10
S Q Qu, T J Qin, Z F Xu, Y Zhang, X F Ai, B Li, H L Zhang, L W Fang, L J Pan, N B Hu, Z J Xiao
Objective: To analyze the long term outcome of patients with hypereosinophilic syndrome(HES). Methods: The clinical characteristics and efficacy of 60 newly diagnosed HES patients who received corticosteroids(CS)monotherapy were retrospectively analyzed. The survival and death causes of patients were obtained by follow- up. Results: Of all 60 HES patients, 45 were male and 15 female. The median age was 38(11-80)years old. The most frequent organ involvement of HES occurred in cutaneous(55.0%), gastrointestinal(40...
October 14, 2016: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/27746620/acute-on-chronic-liver-failure-what-is-in-a-definition
#11
REVIEW
Anil C Anand, Radha K Dhiman
Acute on chronic liver failure (ACLF) is a recently recognized syndrome and its definition has been evolving over last two decades. Currently, there is no universal consensus about the definition as kind of cases being seen in the Western world appear to be somewhat different from those that are seen in Asia Pacific region. But every one agrees that definition of ACLF should include following components. (a) The status of pre-existing liver disease, (b) defining the acute insult that leads to rapid deterioration of liver status, (c) time frame during which the acute insult can lead to rapid deterioration, (d) the quantification and definition of liver failure status after deterioration, which will determine the severity of ACLF, and (e) prediction of prognosis after analyzing first four components in the short and long terms...
September 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/27729254/opioid-dependence-and-pregnancy-minimizing-stress-on-the-fetal-brain
#12
REVIEW
John J McCarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid-dependent pregnant women delivering babies at risk for neonatal abstinence syndrome prompted a US Government Accountability Office report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are 3 general sources of dependence: untreated opioid use disorder, pain management, and medication-assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27725173/recurrent-pericarditis
#13
Massimo Imazio, Elena Gribaudo, Fiorenzo Gaita
Recurrent pericarditis is the most common and troublesome complication of pericarditis affecting 20 to 50% of patients. Its pathogenesis is often presumed to be immune-mediated, but additional investigations are needed to clarify the pathogenesis in order to develop etiology-oriented therapies. Imaging with Computed Tomography and especially Cardiac Magnetic Resonance holds promise to help in the identification of more difficult cases and improve their management. Refractory recurrent pericarditis with corticosteroid dependence and colchicine resistance remain still an unsolved issue in search of new therapies, although old drugs such as azathioprine, intravenous immunoglobulins, and biological agents seem promising, but new randomized clinical trials are needed to confirm their role...
October 7, 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27723234/a-combination-of-corticosteroid-sirolimus-and-intradialytic-parenteral-nutrition-in-encapsulating-peritoneal-sclerosis-case-report-and-literature-review
#14
Alexandre Minetto Brabo, Nayrana Soares Do Carmo Reis, Pasqual Barretti, Daniela Ponce
Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis that carries a high morbidity and mortality. Although its pathogenesis is still not clear, the "two hit theory" suggests that long term deterioration of the peritoneum combined with intraperitoneal inflammation is needed in the pathogenesis of EPS. To date, there is no proven effective therapy with an absence of randomized controlled trials. Individual case reports and small case series have reported on the use of tamoxifen and corticosteroids for medical management of EPS...
October 9, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27716159/the-clinical-and-cost-effectiveness-of-steroid-injection-compared-with-night-splints-for-carpal-tunnel-syndrome-the-instincts-randomised-clinical-trial-study-protocol
#15
Linda S Chesterton, Krysia S Dziedzic, Danielle A van der Windt, Graham Davenport, Helen L Myers, Trishna Rathod, Milica Blagojevic-Bucknall, Sue M Jowet, Claire Burton, Edward Roddy, Elaine M Hay
BACKGROUND: Patients diagnosed with idiopathic mild to moderate carpal tunnel syndrome (CTS) are usually managed in primary care and commonly treated with night splints and/or corticosteroid injection. The comparative effectiveness of these interventions has not been reliably established nor investigated in the medium and long term. The primary objective of this trial is to investigate whether corticosteroid injection is effective in reducing symptoms and improving hand function in mild to moderate CTS over 6 weeks when compared with night splints...
October 6, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27712949/assessing-usability-of-the-adherence-starts-with-knowledge-20-ask-20-questionnaire-for-japanese-adults-with-bronchial-asthma-receiving-inhaled-corticosteroids-long-term
#16
Ryo Atsuta, Yasuo To, Susumu Sakamoto, Isao Mukai, Akihiro Kobayashi, Arisa Kinoshita, Kazuhisa Takahashi
BACKGROUND: Maintaining high treatment adherence levels is critical for effective management of chronic diseases. The Adherence Starts with Knowledge 20 (ASK-20) questionnaire is the only linguistically validated patient-reported treatment adherence tool available in Japan. We conducted additional analyses on ASK-20 data from Japanese adults with asthma. METHODS: This was a prospective, non-interventional, single-visit, multi-centre study in Japanese adults (n = 300) with asthma receiving long-term treatment with inhaled corticosteroids (ICS) or ICS/long-acting beta-agonists...
October 3, 2016: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/27704496/myasthenia-gravis
#17
Daniel B Drachman
The basic abnormality in myasthenia gravis (MG) is a reduction in acetylcholine receptors (AChRs) at neuromuscular junctions due to the effects of autoantibodies that are directed against the AChRs in most patients, or against neighboring proteins involved in the clustering of AChRs (MuSK, LRP-4, or agrin). Clinically, MG is characterized by muscle weakness and fatigue, often in typical patterns. The diagnosis may be missed early, and depends on the recognition of clinical manifestations, the measurement of autoantibodies, and/or electrophysiological features...
October 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27689763/the-role-of-topical-anesthetics-in-the-management-of-chronic-pruritus
#18
Alice He, Divya Sharma, Kazuki M Matsuda, Shawn G Kwatra
Chronic itch is a debilitating symptom that significant decreases patients' quality of life. Topical corticosteroids and antihistamines are commonly used for itch. However, these therapies are not long-term solutions for chronic pruritus because of their feared side effects, including skin atrophy and cognitive impairment, respectively. As such, dermatologists require additional therapies for long-term management of chronic pruritus. Topical anesthetics have been shown in many studies to be effective antipruritic agents...
September 30, 2016: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/27663040/membranous-lupus-nephritis-the-same-but-different
#19
Frank Ward, Joanne M Bargman
Membranous lupus nephritis (MLN) has a favorable prognosis compared to proliferative lupus nephritis (PLN) or combined MLN/PLN, although a significant proportion of cases will progress to end-stage kidney disease. There is considerable morbidity associated with thrombotic complications and treatment. Nondirected care includes renin-angiotensin-aldosterone system blockade, cardiovascular risk management, and antimalarial agents. There may be a role for corticosteroid monotherapy in some patients, but this requires further investigation...
September 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27622228/topical-corticosteroid-addiction-and-withdrawal-an-overview-for-gps
#20
Belinda Sheary
BACKGROUND: Topical corticosteroid (TCS) withdrawal (addiction) is a potential complication of TCS treatment, particularly where there has been an inappropriate long-term use of moderate-to-potent TCS on the face or genital area. TCS addiction and withdrawal is increasingly being discussed in social and mainstream media; however, it has received little attention in medical publications. Australian general practitioners (GPs) may come into contact with patients who have read material or watched videos about this condition...
June 2016: Australian Family Physician
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