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long term corticosteroid management

E Azria
OBJECTIVES: To evaluate the maternal, perinatal and long-term prognosis in the event of previable premature rupture of the membranes (PROM) and to specify the interventions likely to reduce the risks and improve the prognosis. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Previable PROM is a rare event whose frequency varies from 0...
November 5, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Harriet M Kluger, Veronica Chiang, Amit Mahajan, Christopher R Zito, Mario Sznol, Thuy Tran, Sarah A Weiss, Justine V Cohen, James Yu, Upendra Hegde, Elizabeth Perrotti, Gail Anderson, Amanda Ralabate, Yuval Kluger, Wei Wei, Sarah B Goldberg, Lucia B Jilaveanu
PURPOSE: Pembrolizumab is active in melanoma, but activity in patients with untreated brain metastasis is less established. We present long-term follow-up of pembrolizumab-treated patients with new or progressing brain metastases treated on a phase II clinical trial ( identifier: NCT02085070). PATIENTS AND METHODS: We enrolled 23 patients with melanoma with one or more asymptomatic, untreated 5- to 20-mm brain metastasis not requiring corticosteroids; 70% of patients had prior systemic therapy...
November 8, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Radhika Raj C G, Suresh B
Castleman Disease (CD) is a rare, heterogeneous group of hyperimmune lymphoproliferative disorders, not very familiar to surgeons. Unicentric Castleman Disease (UCCD) at one end of the spectrum is a localized disease, with little or no systemic symptoms. It may be an incidental radiological finding or detected while investigating for a symptomatic lymph node mass. Surgery is the primary treatment and has good long term prognosis. Multicentric Castleman Disease (MCCD) is a more serious systemic condition, often associated with constitutional symptoms...
October 29, 2018: International Journal of Surgery Case Reports
Roni Weisshof, Katia El Jurdi, Nada Zmeter, David T Rubin
Inflammatory bowel disease (IBD) is a chronic heterogeneous group of diseases that has undergone major advances in the understanding of its etiology and pathogenesis in recent years. The development of biologics had resulted in better overall management of the disease, including lower rates of surgery and better long-term clinical and patient-reported outcomes. Treatment modalities have either been newly developed or extrapolated from their approved use for a different indication. Modes of action and treatment targets have varied as well...
October 29, 2018: Advances in Therapy
Jaco Voorham, Nicolas Roche, Hicham Benhaddi, Marianka van der Tol, Victoria Carter, Job F M van Boven, Leif Bjermer, Marc Miravitlles, David B Price
OBJECTIVES: Budesonide/formoterol (BF) Spiromax ® is an inhaled corticosteroid/long-acting β2 -agonist fixed-dose combination (FDC) inhaler, designed to minimise common inhaler errors and provide reliable and consistent dose delivery in asthma and chronic obstructive pulmonary disease (COPD). We evaluated non-inferiority of BF Spiromax after changing from another FDC inhaler, compared with continuing the original inhaler. METHODS: Patients with asthma and/or COPD who switched to BF Spiromax were matched (1:3) with non-switchers...
October 27, 2018: BMJ Open
Kerclin Danielle de Klerk, Steffen Bau, Gunar Günther
Tuberculosis is still one of the most common respiratory diseases in Africa and worldwide and miliary tuberculosis is a regular manifestation of it. Idiopathic pulmonary hemosiderosis is a rare disease entity, presenting in children as well as adults. It is characterized by the triad of recurrent episodes of alveolar hemorrhage, presenting as hemoptysis, iron deficiency anemia and bilateral pulmonary infiltrates seen on chest X-ray. These symptoms and signs can easily be confused for other diseases i.e. miliary tuberculosis, delaying appropriate management...
2018: Pan African Medical Journal
Elisa Gomez Torrijos, Rosario Gonzalez-Mendiola, Manuela Alvarado, Robledo Avila, Alicia Prieto-Garcia, Teresa Valbuena, Jesus Borja, Sonsoles Infante, M Pilar Lopez, Eva Marchan, Patricia Prieto, Mar Moro, Ana Rosado, Vanessa Saiz, M Luisa Somoza, Olga Uriel, Angelina Vazquez, Pilar Mur, Paloma Poza-Guedes, Joan Bartra
Background: Eosinophilic esophagitis (EoE) was first described in the 1990s, showing an increasing incidence and prevalence since then, being the leading cause of food impaction and the major cause of dysphagia. Probably, in a few years, EoE may no longer be considered a rare disease. Methods: This article discusses new aspects of the pathogenesis, symptoms, diagnosis, and treatment of EoE according to the last published guidelines. Results: The epidemiological studies indicate a multifactorial origin for EoE, where environmental and genetic factors take part...
2018: Frontiers in Medicine
Rosalia Emma, Jaymin B Morjaria, Virginia Fuochi, Riccardo Polosa, Massimo Caruso
Asthma is a chronic inflammatory condition involving the airways with varying pathophysiological mechanisms, clinical symptoms and outcomes, generally controlled by conventional therapies including inhaled corticosteroids and long-acting β2 agonists. However, these therapies are unable to successfully control symptoms in about 5-10% of severe asthma patients. Atopic asthma, characterized by high immunoglobulin (Ig)E or eosinophilia, represents about 50% of asthmatic patients. Interleukin (IL)-5 is the main cytokine responsible of activation of eosinophils, hence therapeutic strategies have been investigated and developed for clinical use...
January 2018: Therapeutic Advances in Respiratory Disease
Cinzia Solinas, Michele Porcu, Pushpamali De Silva, Marco Musi, Sandrine Aspeslagh, Mario Scartozzi, Karen Willard-Gallo, Stefano Mariotti, Luca Saba
Side effects of immune checkpoint blockade are often said to be infrequent and usually mild. The uniqueness of endocrine immune-related adverse events is their non-reversibility, with incidence and prevalence destined to increase in the coming years, particularly if immunotherapy is used at earlier stages of neoplastic disease. Immune-related hypophysitis is one of these observed endocrine adverse events. It is often difficult to diagnose, sometimes occurring without specific symptoms. It can lead to irreversibly altered functioning of diverse endocrine glands...
October 20, 2018: Seminars in Oncology
Oded Sagiv, Sudip D Thakar, Thomas J Kandl, Joshua Ford, Matthew C Sniegowski, Wen-Jen Hwu, Bita Esmaeli
Importance: Conjunctival melanoma has the potential for regional lymphatic and distant metastasis. There is an urgent need for effective treatment for patients with metastatic or locally advanced conjunctival melanoma. Objective: To describe the use of immune checkpoint inhibitors for the treatment of conjunctival melanoma in 5 adult patients. Design, Setting, and Participants: A retrospective review was conducted of the medical records of 5 patients with conjunctival melanoma who were treated with immune checkpoint inhibitors from March 6, 2013, to July 7, 2017...
November 1, 2018: JAMA Ophthalmology
Kjell Tullus, Hazel Webb, Arvind Bagga
More than 85% of children and adolescents (majority between 1-12 years old) with idiopathic nephrotic syndrome show complete remission of proteinuria following daily treatment with corticosteroids. Patients who do not show remission after 4 weeks' treatment with daily prednisolone are considered to have steroid-resistant nephrotic syndrome (SRNS). Renal histology in most patients shows presence of focal segmental glomerulosclerosis, minimal change disease, and (rarely) mesangioproliferative glomerulonephritis...
October 17, 2018: Lancet Child & Adolescent Health
Pieter Evenepoel, Kathleen Claes, Björn Meijers, Michaël R Laurent, Bert Bammens, Maarten Naesens, Ben Sprangers, Etienne Cavalier, Dirk Kuypers
The skeletal effects of renal transplantation are not completely understood, especially in patients managed with a steroid minimization immunosuppressive protocol and long term. We enrolled 69 adult transplant recipients (39 males; ages 51.1 ± 12.2 years), free of antiresorptive therapy and managed with a steroid minimization immunosuppressive protocol, into a 5-year prospective observational study to evaluate changes in areal bone mineral density (aBMD), mineral metabolism and bone remodelling. Dual energy X-ray absorptiometry, laboratory parameters of mineral metabolism (including parathyroid hormone, sclerostin and fibroblast growth factor 23) and non-renal cleared bone turnover markers (BTMs) (bone-specific alkaline phosphatase, trimeric N-terminal propeptide and tartrate-resistant acid phosphatase 5b) were assessed at baseline and 1 and 5 years post-transplantation...
October 17, 2018: Nephrology, Dialysis, Transplantation
Asiya K Shakir, Zhongxin Yu, Muhammad Adnan Altaf
Multifocal lymphangioendotheliomatosis with thrombocytopenia is a rare disease characterized by multiple cutaneous and gastrointestinal (GI) vascular lesions and thrombocytopenia refractory to platelet and blood cell transfusions. GI bleeding can become life-threatening in this condition. We report a case of multifocal lymphangioendotheliomatosis with thrombocytopenia in a male infant with isolated GI involvement, diagnosed when he was 3 months old. The patient was managed with daily aminocaproic acid, octreotide drip, and corticosteroids for 13 months after diagnosis; he had complete resolution of symptoms by 2 years of age and showed adequate height and gain by 5 years of age...
October 16, 2018: Journal of Pediatric Hematology/oncology
John P Bourke, Teofila Bueser, Rosaline Quinlivan
BACKGROUND: The dystrophinopathies include Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), and X-linked dilated cardiomyopathy (XLDCM). In recent years, co-ordinated multidisciplinary management for these diseases has improved the quality of care, with early corticosteroid use prolonging independent ambulation, and the routine use of non-invasive ventilation signficantly increasing survival. The next target to improve outcomes is optimising treatments to delay the onset or slow the progression of cardiac involvement and so prolong survival further...
October 16, 2018: Cochrane Database of Systematic Reviews
Tzu-Lun Huang, Kung-Hung Lin, Jia-Kang Wang, Rong-Kung Tsai
Neuromyelitis optica (NMO) is an autoimmune demyelinating disease with pathogenic autoantibodies that act against the astrocyte water channel protein, i.e. aquaporin-4: the disease is associated with recurrent episodes of optic neuritis (ON) and transverse myelitis, often resulting in severe disability. The main goals in treatment of NMO include acute symptomatic therapy and long-term stabilization of symptoms by preventing relapse. In recent years, ongoing randomized controlled trials in NMO patients have studied evidence for treatment...
October 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
Desmond Yh Yap, Susan Yung, Tak Mao Chan
Immunosuppressive therapies for lupus nephritis (LN) have improved significantly over the past few decades, resulting in growing number of choices for treatment individualization and improved renal and patient outcomes. Corticosteroids combined with mycophenolate or cyclophosphamide induces a satisfactory response in a high proportion of Asian and Caucasian patients, but the rate of improvement varies considerably between patients. Relatively low disease flare rate was observed in Chinese patients receiving low-dose prednisolone and mycophenolate maintenance...
October 2018: Nephrology
David Steybe, Pit Jacob Voss, Michael Andreas Ermer, Marc Anton Fuessinger, Rainer Schmelzeisen, Philipp Poxleitner
BACKGROUND: Necrotizing fasciitis has been reported as a complication secondary to bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a low number of patients. The only report of such a case in an osteoporosis patient found in current literature was related to short-term bisphosphonate but long time corticosteroid and methotrexate treatment. CASE PRESENTATION: In this article, we report a case of necrotizing fasciitis secondary to osteonecrosis of the jaw related to long-term oral bisphosphonate treatment in an osteoporosis patient additionally suffering from poorly controlled type 2 diabetes...
October 5, 2018: Oral and Maxillofacial Surgery
Stergios Boussios, Catherine Hayward, Deirdre Cooke, Nikolaos Zakynthinakis-Kyriakou, Alexandros K Tsiouris, Aikaterini A Chatziantoniou, Foivos S Kanellos, Afroditi Karathanasi
Ewing's sarcoma (ES) of the spine with cord or radicular compression as an initial sign is infrequent. It is unclear, in alleviating a neurological deficit, whether decompressive laminectomy is preferred over chemotherapy. Herein, a literature review of the treatment approaches to the primary or metastatic ES of the spine has been performed. Collected data included clinical features of the patients, treatment, and outcome. There are reported 69 cases with initial presentation of cord or radicular compression of spinal cord, arising from primary or metastatic ES, treated either with initial chemotherapy and/or radiotherapy (RT) (33...
October 2018: Anticancer Research
Pavel Kolkhir, Maria Grakhova, Hanna Bonnekoh, Karoline Krause, Marcus Maurer
Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by the severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic review of the efficacy of current UV treatment options. We searched for relevant studies in 7 databases, including MEDLINE, Scopus, and Web of Science. In total, 261 eligible studies and 789 unique patients with UV were included in the systematic review...
September 27, 2018: Journal of Allergy and Clinical Immunology
Muthu Sendhil Kumaran, Rahul Mahajan, Nupur Goyal, Davinder Parsad
Background: Urticaria is a common dermatosis affecting approximately 25% of the population. Childhood chronic urticaria is frequently encountered, however, epidemiologic data on pediatric urticaria are limited. Aim: The objective of this study was to study the clinico-epidemiological profile of children with chronic urticaria. Methods: A retrospective study including children less than 14 years with chronic urticaria was conducted from January 2010 to December 2015...
September 25, 2018: Indian Journal of Dermatology, Venereology and Leprology
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