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long term corticosteroid management

Eshan Oderuth, Mohammed Ali, Ismael Atchia, Ajay Malviya
BACKGROUND: Greater trochanteric pain syndrome (GTPS) is a painful condition characterised by pain around the greater trochanter usually affecting middle-aged women. The majority of patients will improve with conservative management such as physiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs); however, if this fails then more invasive treatments including corticosteroid injections and surgery may be required. Platelet-rich plasma (PRP) is an autologous blood product, which has a higher concentration of growth factors postulated to provide enhanced healing and anti-inflammatory properties...
September 21, 2018: Trials
Gokoulakrichenane Loganadane, Frédéric Dhermain, Guillaume Louvel, Paul Kauv, Eric Deutsch, Cécile Le Péchoux, Antonin Levy
As the prognosis of metastatic non-small cell lung cancer (NSCLC) patients is constantly improving with advances in systemic therapies (immune checkpoint blockers and new generation of targeted molecular compounds), more attention should be paid to the diagnosis and management of treatments-related long-term secondary effects. Brain metastases (BM) occur frequently in the natural history of NSCLC and stereotactic radiation therapy (SRT) is one of the main efficient local non-invasive therapeutic methods. However, SRT may have some disabling side effects...
2018: Frontiers in Oncology
Zhenchao Wu, Dong Yang, Zhengwei Ge, Mengdie Yan, Nan Wu, Yi Liu
Background: Chronic obstructive pulmonary disease (COPD) is prevalent in China. The role of body mass index (BMI) in COPD progression and prognosis is unclear. We analyzed the association between BMI and pulmonary function, inflammation levels and exacerbation in Chinese COPD patients. Methods: Our retrospective real world research included 744 patients with COPD diagnosed by spirometry and hospitalized from January 1st, 2014 to December 31st, 2016. The indicators were gathered from hospital records database and frequency of exacerbation in the three years were followed up...
August 2018: Journal of Thoracic Disease
Vibeke Backer, Adam Ellery, Sylvia Borzova, Stephen Lane, Magda Kleiberova, Peter Bengtsson, Tadeusz Tomala, Dominique Basset-Stheme, Carla Bennett, Dirk Lindner, Arthur Meiners, Tim Overend
INTRODUCTION: In recognition of the value of long-term real-world data, a postauthorization safety study of the inhaled corticosteroid (ICS) fluticasone propionate and long-acting β2 -agonist (LABA) formoterol fumarate (fluticasone/formoterol; Flutiform® ) was conducted. METHODS: This was a 12-month observational study of outpatients with asthma aged ⩾ 12 years in eight European countries. Patients were prescribed fluticasone/formoterol according to the licensed indication, and independently of their subsequent enrolment in the study...
January 2018: Therapeutic Advances in Respiratory Disease
Eugene H Wong, Timothy Q Do, Richard J Harvey, Carolyn A Orgain, Raymond Sacks, Larry Kalish
OBJECTIVES: The Draf III frontal sinusotomy is an established surgical procedure with an important role in the surgical management of recalcitrant chronic rhinosinusitis (CRS). In 2012, the outside-in approach to the Draf III was described as a safe and efficient procedure. Smell recovery in inflammatory CRS is challenging, and to date there is limited evidence suggesting that Draf III improves patient-reported olfactory dysfunction from CRS. METHODS: A consecutive series of patients who underwent an outside-in Draf III for inflammatory CRS by a single, tertiary rhinologist were reviewed...
September 19, 2018: Laryngoscope
Jessica K Dyson, Lin Lee Wong, Theophile Bigirumurame, Gideon M Hirschfield, Stuart Kendrick, Ye H Oo, Ansgar W Lohse, Michael A Heneghan, David E J Jones
BACKGROUND: Treatment paradigms in autoimmune hepatitis (AIH) have remained largely unchanged for decades. Studies report ≤20% of patients have sub-optimal treatment response with most requiring long-term therapy. AIM: The United Kingdom Autoimmune Hepatitis (UK-AIH) study was established to evaluate current treatment practice and outcomes, determine the unmet needs of patients, and develop and implement improved treatment approaches. METHODS: The United Kingdom Autoimmune Hepatitis study is a cross-sectional cohort study examining secondary care management of prevalent adult patients with a clinical diagnosis of autoimmune hepatitis...
September 18, 2018: Alimentary Pharmacology & Therapeutics
Matthew Howard, Anthony Hall
Topical corticosteroids are currently recommended only for short-term management of flares of lichen sclerosus, with efficacy in halting disease progression. Given the chronic nature of this condition, there is a lack of literature surrounding the chronic effects of topical corticosteroids on the male genitalia with many dermatologists avoiding prescribing long term. This case report aims to provide anecdotal observation for the long-term use of topical corticosteroids and details the long-term follow-up of an individual who used potent and superpotent topical corticosteroids for over 25 years without significant demonstrable side effects...
2018: SAGE Open Medical Case Reports
Shasha Chen, Qing Yin, Song Ren, Xiang Zhong, Wei Wang, Guisen Li, Li Wang
To compare the long-term efficacy of corticosteroids (P) alone or in combination with cyclophosphamide (CTX), leflunomide (LEF), or Angiotensin-convertase inhibitors or angiotensin II receptor blockers (ACEI/ARB) in treatment for IgA nephropathy (IgAN), 311 patients with IgAN were identified. Therapeutic effectiveness (including progression, partial remission, complete remission) and combined renal endpoint (defined as 30% reduction in eGFR or ESRD) were compared based on different therapies. After immunosuppressive and ACEI/ARB treatment, the levels of eGFR, proteinuria and albumin were significantly improved at the last follow-up, the extent of improvement of eGFR, proteinuria, and albumin was more notable in P + CTX group and P + LEF group...
September 12, 2018: Scientific Reports
Jose L Mattos, Zachary M Soler, Luke Rudmik, Peter R Manes, Thomas S Higgins, Jivianne Lee, John Schneider, Michael Setzen, Arjun K Parasher, Timothy L Smith, Janalee K Stokken
BACKGROUND: Quality improvement (QI) in the management of chronic rhinosinusitis (CRS) is garnering increasing attention. Defining frameworks and metrics to assess the quality of key components in CRS management could assist in reducing unwarranted practice variation and increase high-quality care. METHODS: A panel of the American Rhinologic Society (ARS) QI committee reviewed the literature to determine important presurgical components of CRS care that warrant QI...
September 3, 2018: International Forum of Allergy & Rhinology
Spyridon Michopoulos, Gregorios Paspatis, Konstantinos Triantafyllou, Spyridon Potamianos, Vassiliki Nikolopoulou, Evangelos Akriviadis, John A Karagiannis, Spyridon Ladas, Maria Tampaki, Charalambos Tzathas
Background: Real-world data on management patterns and long-term outcomes of patients with inadequately controlled Crohn's disease (CD) in Greece are scarce. Methods: This was a multicenter, prospective observational study of 18-65-year-old CD patients whose physicians judged that their current therapy was inadequate to control their condition and therefore decided to switch treatment. Data were collected at enrollment (time of switch), and 30, 54 and 104 weeks post-enrollment...
September 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Durga P Misra, Godasi S R S N K Naidu, Vikas Agarwal, Aman Sharma
We discuss recent and prospective research in small and large vessel vasculitis. Large cohorts of Takayasu arteritis (TA) have been recently published from across the world, clarifying our understanding of this uncommon disease. Novel open-ended approaches like large-scale genotyping, proteomics and metabolomics have helped gain novel insights into TA, giant cell arteritis (GCA) and anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). Recent advances in the imaging of TA and GCA offer promise for earlier diagnosis and better monitoring of response to therapy...
August 30, 2018: International Journal of Rheumatic Diseases
Wilson C Lai, Armin Arshi, Dean Wang, Leanne L Seeger, Kambiz Motamedi, Benjamin D Levine, Sharon L Hame
OBJECTIVE: Our study aimed to determine the duration of pain relief from intraarticular hip corticosteroid injections and identify patient predictive factors on injection response. We also sought to determine the subsequent rate of hip surgery and whether severity of hip osteoarthritis or injection response correlated with the decision to undergo surgery. MATERIALS AND METHODS: All intraarticular hip steroid injections performed for osteoarthritis under fluoroscopic guidance at a single institution between January 2010 to December 2012 were retrospectively reviewed...
August 28, 2018: Skeletal Radiology
Melody Maarouf, Chantal Saberian, Peter A Lio, Vivian Y Shi
Head-and-neck dermatitis is a variant of atopic dermatitis (AD) often seen in children and is challenging to diagnose, as it frequently overlaps with other eczematous dermatoses. Successful head-and-neck dermatitis (HND) treatment requires identification of common triggers and clinical mimickers, such as airborne dermatitis, periorificial dermatitis, and steroid-induced rosacea. Head-and-neck involvement negatively impacts quality of life and is often harder to treat than other body parts, as long-term topical corticosteroid use carries higher risks for skin atrophy on the face...
August 28, 2018: Pediatric Dermatology
K Guenter, T Boeselt, J Kroenig, O Hildebrandt, N Koehler, C Viniol, U Koehler
Medication management of asthma is based on level of asthma control. GINA defined criteria for asthma control include asking about daytime symptoms, limitation of activity, nocturnal symptoms/awakenings and need for reliever treatment. Effective asthma control is necessary for preventing exacerbations and worsening of lung function. Standardized and validated questionnaires such as asthma control test (ACT) help to assess the level of asthma control. Asthma control is classified as controlled, partially controlled or uncontrolled...
August 27, 2018: Pneumologie
Agnieszka Sliwka, Milosz Jankowski, Iwona Gross-Sondej, Monika Storman, Roman Nowobilski, Malgorzata M Bala
BACKGROUND: Three classes of inhaler medication are used to manage chronic obstructive pulmonary disease (COPD): long-acting beta₂-agonists (LABA); long-acting muscarinic antagonists (LAMA); and inhaled corticosteroids (ICS). To encourage patient adherence, two classes of medication are often combined in a single medication device; it seems that once-daily dosing offers greatest convenience to patients and may markedly influence adherence. OBJECTIVES: To compare a once-daily combination of inhaled corticosteroid and long-acting beta₂-agonist inhalers (ICS/LABA) versus inhaled long-acting muscarinic antagonists alone (LAMA) for people with chronic obstructive pulmonary disease (COPD)...
August 24, 2018: Cochrane Database of Systematic Reviews
Miguel Tortajada-Girbés, Rosa Bousquet, Montserrat Bosque, Jesús Joaquín Carrera Martínez, María Dolores Ibáñez, Ana Moreira, Antonio Nieto, Ana María Plaza, Cristina Rivas, Gloria Requena, Manuel Sánchez-Solis, Ana Tabar, Javier Torres-Borrego, Lydia Zapatero
Omalizumab is a monoclonal antibody that binds and inhibits free serum immunoglobulin E, a mediator involved in the clinical manifestations of allergic asthma. Evidence for its efficacy and safety in the treatment of moderate-to-severe allergic asthma is based primarily on studies in adolescents and adults. However, there is increasing evidence of its utility in children with allergic asthma aged 6-12 years. Areas covered: This article reviews efficacy, safety, and effectiveness of omalizumab in the treatment of moderate-to-severe allergic asthma in children aged 6-12 years in clinical trials and in studies in clinical practice...
September 2018: Expert Review of Respiratory Medicine
Brian G Ballios, Maxwell Weisbrod, Clara C Chan, Armand Borovik, Jeffrey R Schiff, Kathryn J Tinckam, Atul Humar, S Joseph Kim, Edward H Cole, Allan R Slomovic
The objective of this study was to evaluate systemic immunosuppression regimens used for patients undergoing ocular surface stem cell transplantation, including their benefits and adverse effects in the adjunctive management of limbal stem cell deficiency (LSCD). A systematic literature review was conducted using the MEDLINE and EMBASE databases (1980-2015). Data were collected on surgical intervention(s), type of immunosuppressive agent(s), duration of immunosuppression, percentage with stable ocular surface at last follow-up, mean follow-up time, and demographics...
August 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Simone K Visser, Peter Bye, Lucy Morgan
Once neglected in research and underappreciated in practice, there is renewed interest in bronchiectasis unrelated to cystic fibrosis. Bronchiectasis is a chronic lung disease characterised by chronic cough, sputum production and recurrent pulmonary exacerbations. It is diagnosed radiologically on high resolution computed tomography chest scan by bronchial dilatation (wider than the accompanying artery). The causes of bronchiectasis are diverse and include previous respiratory tract infections, chronic obstructive pulmonary disease, asthma, immunodeficiency and connective tissue diseases...
August 20, 2018: Medical Journal of Australia
Lindsay Horton, Jeffrey L Bennett
The current management of acute optic neuritis (ON) is focused on expediting visual recovery through the use of high-dose intravenous corticosteroids. The recent identification of specific autoantibodies associated with central nervous system inflammatory disorders has provided novel insights into immune targets and mechanisms that impact the prognosis, treatment, and recurrence of ON. Therefore, neurologists and ophthalmologists need to be aware of clinical, laboratory, and imaging findings that may provide important clues to the etiology of ON and the potential need for aggressive management...
September 2018: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Marco Mantero, Dejan Radovanovic, Pierachille Santus, Francesco Blasi
The major determinant of the decline in lung function, quality of life, and the increased mortality risk in patients with COPD is represented by severe acute exacerbations of the disease, that is, those requiring patients' hospitalization, constituting a substantial social and health care burden in terms of morbidity and medical resource utilization. Different long-term therapeutic strategies have been proposed so far in order to prevent and/or reduce the clinical and social impact of these events, the majority of which were extrapolated from trials initially focused on the effect of long-acting muscarinic antagonist and subsequently on the efficacy of long-acting β2-agonists in combination or not with inhaled corticosteroids...
2018: International Journal of Chronic Obstructive Pulmonary Disease
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