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long term corticosteroid management

Javiera Hansen S, Patricia Lacourt R
INTRODUCTION: Cushing's syndrome (CS) is an endocrine disease by to glucocorticoids excess, depen dent or independent of adrenocorticotropic hormone (ACTH). The main cause is iatrogenic due to excessive use of glucocorticoids. OBJECTIVE: To show the association between prolonged use of topical corticosteroids and the development of CS. CLINICAL CASE: An infant treated with topical corticosteroids due to seborrheic dermatitis. Due to long-term unsupervised use, he develops Cushing's syndrome characterized by obesity and compromised growth rate...
June 2018: Revista Chilena de Pediatría
Joseph Marchese, Kathleen Coyle, Mark Cote, Jennifer Moriatis Wolf
BACKGROUND: The role of corticosteroid injections in the treatment of radial tunnel syndrome (RTS) has not been evaluated in depth. The purpose of this study was to evaluate the utility of a single corticosteroid injection as a therapeutic modality for RTS. METHODS: We enrolled 40 patients with a clinical diagnosis of RTS. Our primary outcome was the quick Disabilities of the Arm, Shoulder and Hand (qDASH) score at 1 year. Each patient was then treated with a single corticosteroid injection in the proximal forearm at the posterior interosseous nerve (PIN)...
July 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Alexandru Mester, Ondine Lucaciu, Lidia Ciobanu, Dragos Apostu, Aranka Ilea, Radu Septimiu Campian
Oral lichen planus (OLP) is a chronic inflammatory disease characterized by the occurrence of multiple, symmetrical lesions in the oral cavity. Hepatitis C virus (HCV) infection has been suggested as an etiological factor in OLP. The purpose of this review was to summarize the current literature regarding the treatment of OLP in patients with HCV infection. An electronic search of the PubMed database was conducted until January 2018, using the following keywords: OLP, HCV, corticosteroids, retinoids, immunomodulatory agents, surgical interventions, photochemotherapy, laser therapy, interferon, ribavirin, and direct-acting antivirals...
July 7, 2018: Bosnian Journal of Basic Medical Sciences
Jonathan A Bernstein, Lyndon Mansfield
OBJECTIVE: To review therapeutic options for stepwise management of pediatric asthma in the context of this population's unique needs such as potential effects of asthma, treatments, or both on growth and psychosocial development, and caregiver involvement. DATA SOURCES AND STUDY SELECTION: We conducted PubMed searches to identify relevant articles then reviewed resultant articles, guidelines for asthma management in children, and articles from personal files. RESULTS: Stepwise management of asthma, similar to adults, is recommended for children in current global and US guidelines...
July 4, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Chad Hulsopple
Injections often are used in the management of common musculoskeletal conditions. Physicians should understand the disease pathophysiology and evidence supporting available injections when determining appropriate therapy. These therapies include corticosteroid injections (CSIs), hyaluronic acid (HA) injections, hypertonic dextrose prolotherapy, platelet-rich plasma (PRP) injections, mesenchymal stem cell (MSC) injections, and trigger point injections (TPIs). CSIs are recommended conditionally by the American College of Rheumatology for osteoarthritis (OA) management...
July 2018: FP Essentials
Opeyemi O Babatunde, Amardeep Legha, Chris Littlewood, Linda S Chesterton, Martin J Thomas, Hylton B Menz, Danielle van der Windt, Edward Roddy
OBJECTIVE: To evaluate the comparative effectiveness of current treatment options for plantar heel pain (PHP). DESIGN: Systematic review and network meta-analysis (NMA). DATA SOURCES: Medline, EMBASE, CINAHL, AMED, PEDro, Cochrane Database, Web of Science and WHO Clinical Trials Platform were searched from their inception until January 2018. STUDY SELECTION: Randomised controlled trials (RCTs) of adults with PHP investigating common treatments (ie, corticosteroid injection, non-steroidal anti-inflammatory drugs, therapeutic exercise, orthoses and/or extracorporeal shockwave therapy (ESWT)) compared with each other or a no treatment, placebo/sham control...
June 28, 2018: British Journal of Sports Medicine
Arjun B Sood, Ghazala O'Keefe, Diem Bui, Nieraj Jain
PURPOSE: To report a case of Vogt-Koyanagi-Harada (VKH) disease associated with hepatitis B vaccination. METHODS: Case report. RESULTS: A 43-year-old Caucasian male presented with a three-week history of blurry vision, pain, photophobia, and redness in both eyes. Three days prior to the onset of symptoms, he had received the hepatitis B virus vaccine. Clinical evaluation revealed multifocal placoid lesions in the posterior pole, choroidal thickening, and serous macular detachment...
June 28, 2018: Ocular Immunology and Inflammation
Katarzyna Pawlak-Bus, Piotr Leszczynski, Mateusz Kokot, Włodzimierz Samborski
Hematologic disorders, including thrombocytopenia, are a common symptom of systemic lupus - Systemic Lupus Erythematosus (SLE). An important diagnostic and therapeutic issue is the severe and recurrent thrombocytopenia resistant to standard treatment. It requires extensive diagnostics and a multi-directional view on its causes beyond the autoimmune process. Currently, there is no single treatment regimen for these disorders. Corticosteroids (CS) are the first-line drugs, but their chronic use is a big problem, they are not always successful and often generate a number of complications, especially in moderate to high doses...
November 21, 2017: Annals of Agricultural and Environmental Medicine: AAEM
Mamitaro Ohtsuki, Hiroshi Morimoto, Hidemi Nakagawa
Atopic dermatitis (AD) requires long-term management, mainly with topical anti-inflammatory agents. Topical corticosteroids (TCS) and tacrolimus ointment (TAC-O) are recommended as first-line treatments for AD. However, the long-term use of TCS is limited by cutaneous adverse events such as skin atrophy. For TAC-O, Japanese and US labelings were updated in 2003 and 2006, respectively, to include a boxed warning about a theoretical risk of skin cancer and lymphoma in patients treated with topical calcineurin inhibitors...
June 21, 2018: Journal of Dermatology
Diego Strianese
PURPOSE: To present an update on the efficacy and safety of immunosuppressive therapy for thyroid eye disease (TED) and to offer a general recommendation for management of TED, in light of these reports. METHODS: Data were retrieved from a literature search on PubMed, using the following words: thyroid eye disease, immunosuppressant, corticosteroid, methotrexate, azathioprine, cyclosporine, cyclophosphamide, rituximab, etanercept, adalimumab, tocilizumab, teprotumumab, adverse effects, side effects, and complications...
June 18, 2018: Ophthalmic Plastic and Reconstructive Surgery
Valerie Jomphe, Larry C Lands, Genevieve Mailhot
An optimal nutritional status is associated with better post-transplant outcomes and survival. Post-lung transplant nutrition management is however particularly challenging as lung recipients represent a very heterogeneous group of patients in terms of age, underlying diseases, weight status and presence of comorbidities. Furthermore, the post-transplant period encompasses several stages characterized by physiological and pathophysiological changes that affect nutritional status of patients and necessitate tailored nutrition management...
June 19, 2018: Nutrients
Yvonne Nguyen, Jennifer Bradford, Gayle Fischer
Vulval lichen sclerosus (VLS) is a chronic inflammatory skin condition affecting the anogenital area in women. Serious long-term consequences of VLS include the risk of developing squamous cell carcinoma of the vulva as well as of scarring and alteration of vulval architecture. The treatment of choice for genital lichen sclerosus in females is potent to very potent topical corticosteroids. There are few published data on the course of VLS in pregnancy. We present our experience of managing 33 pregnancies in 29 women with VLS...
June 19, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Yurie Shimoda-Komatsu, Misaki Kinoshita-Ise, Hiroaki Shimoyamada, Manabu Ohyama
Granuloma faciale (GF) is a rare chronic dermatosis with still unknown etiopathology, which usually presents a solitary, asymptomatic, smooth reddish-brown to violaceous plaques or nodules on the face. Various therapeutic approaches, including topical application of corticosteroid or tacrolimus and removal with laser, cryotherapy and surgery have been attempted; however, the outcome has been inconsistent. Herein, we report a case of perinasal nodular GF who repeatedly underwent surgical excisions after the failure of laser treatment...
June 15, 2018: Journal of Dermatology
Leila Etemad, Mohammad Moshiri, Mahdi Balali-Mood
The present study aimed to review and discuss the recommended and recently suggested protocols by Iranian researchers for a long-term treatment of delayed complications of sulfur mustard (DCSM) in veterans. As indicated clinically, patients who suffer from delayed ocular complications of sulfur mustard (DOCS) benefit from treatments for dry eyes, therapeutic contact lenses, amniotic membrane transplantation; blepharorrhaphy, tarsorrhaphy, limbal stem cell transplantation; corneal transplantation, topical steroids, and immunosuppressive...
May 2018: Iranian Journal of Medical Sciences
Claudio Tana, Luca Busetto, Angelo di Vincenzo, Fabrizio Ricci, Andrea Ticinesi, Fulvio Lauretani, Antonio Nouvenne, Maria Adele Giamberardino, Francesco Cipollone, Roberto Vettor, Tiziana Meschi
Background Hyperuricemia and gout represent important issues in the obese patients. Considering the epidemic trend of overweight and obesity in developed countries, the impact of these conditions is likely to increase. At present, bariatric surgery represents the most effective treatment for the management of severe obesity for reducing weight and the impact of associated comorbidities, but its effects on hyperuricemia and gout have not been fully elucidated. Methods In this narrative review, we discuss the current knowledge about hyperuricemia and gout in obese patients undergoing bariatric surgery...
June 9, 2018: Postgraduate Medicine
J T Lin, W Q Wang, C Y Han, L Yan, B Xing, R F Qiu, H W Li, Y F Wang, L Li, X Y Li, M Y Zhang
Objective: To investigate the outcome of long-term asthma management of China-Japan Friendship Hospital. Methods: A face-to-face, questionnaire-based survey was carried out in outpatient department in 30 general hospital (including China-Japan Friendship Hospital) from Oct 2015 to May 2016. Data of demographic characteristics, asthma control, asthma management, asthma attacks and self-management, disease perception was collected. Results from China-Japan Friendship Hospital were compared to the national mean level within the same period...
May 29, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Michelle Ma, Katie Falloon, Po-Hung Chen, Behnam Saberi, Aliaksei Pustavoitau, Elif Ozdogan, Zhiping Li, Benjamin Philosophe, Andrew M Cameron, Ahmet Gurakar
Acute alcoholic hepatitis is a syndrome of jaundice and hepatic decompensation that occurs with excessive alcohol consumption. The diagnosis can be made with a combination of clinical characteristics and laboratory studies, though biopsy may be required in unclear cases. Acute alcoholic hepatitis can range from mild to severe disease, as determined by a Maddrey discriminant function ≥32. Mild forms can be managed with supportive care and abstinence from alcohol. While mild form has an overall good prognosis, severe alcoholic hepatitis is associated with an extremely high short-term mortality of up to 50%...
January 1, 2018: Journal of Intensive Care Medicine
Marcel Vetter, Markus F Neurath
BACKGROUND: Crohn's disease (CD) is a chronic immune-mediated disorder of the gastrointestinal tract. The pathophysiological understanding of this disease is limited and no curative therapy is available so far. Therefore, most patients require long-lasting or even life-long immunosuppressive therapies for the suppression of symptoms to improve quality of life and reduction of long-term risks. However, in a relevant subgroup of patients, these therapeutic goals cannot be sufficiently attained...
June 5, 2018: Digestion
Michael J Ammar, Anton M Kolomeyer, Nirali Bhatt, Madhura A Tamhankar, Michael T Mullen, Alexander J Brucker
PURPOSE: We report a patient with branch retinal artery occlusion predominant Susac syndrome and review the literature on current diagnostic modalities and therapeutic approaches for this rare condition. METHODS: Case report. RESULTS: A 23-year-old white male presented with a 5-month history of a scotoma in his right eye vision, headaches, and intermittent paresthesias of the lower extremities. Ophthalmic examination was normal with the exception of a hypopigmented small retinal area inferonasal to the fovea in the right eye...
May 30, 2018: Retinal Cases & Brief Reports
Giorgio Costagliola, Marta Mosca, Paola Migliorini, Rita Consolini
Background: Pediatric systemic lupus erythematosus (pSLE) is a rare condition, representing approximately 10% of SLE cases. The aim of this study was to identify variables to improve the diagnostic awareness and management of pSLE patients. Methods: This retrospective study included 25 patients diagnosed with pSLE and followed at the University of Pisa. We collected data about clinical profile at disease onset and during a long-term follow-up, including disease activity, organ damage development, and treatments received...
2018: Frontiers in Pediatrics
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