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https://www.readbyqxmd.com/read/28918400/healthcare-resource-use-and-costs-of-severe-uncontrolled-eosinophilic-asthma-in-the-uk-general-population
#1
Marjan Kerkhof, Trung N Tran, Joan B Soriano, Sarowar Golam, Danny Gibson, Elizabeth V Hillyer, David B Price
BACKGROUND: Little is known about the prevalence of severe, uncontrolled eosinophilic asthma (SUEA) and associated costs. AIMS: We sought to determine the prevalence of SUEA and compare asthma-related healthcare resource use (HCRU) and associated costs with overall means for a general asthma population. METHODS: This cohort study evaluated anonymised medical record data (December 1989 through June 2015) from the Clinical Practice Research Datalink and the Optimum Patient Care Research Database to study UK patients with active asthma (diagnostic code and one or more drug prescriptions in the baseline year), aged 5 years and older, without concomitant COPD, and with recorded eosinophil count...
September 16, 2017: Thorax
https://www.readbyqxmd.com/read/28917657/oral-all-trans-retinoic-acid-plus-danazol-versus-danazol-as-second-line-treatment-in-adults-with-primary-immune-thrombocytopenia-a-multicentre-randomised-open-label-phase-2-trial
#2
Fei-Er Feng, Ru Feng, Min Wang, Jia-Min Zhang, Hao Jiang, Qian Jiang, Jin Lu, Hui Liu, Jun Peng, Ming Hou, Jian-Liang Shen, Jing-Wen Wang, Lan-Ping Xu, Kai-Yan Liu, Xiao-Jun Huang, Xiao-Hui Zhang
BACKGROUND: Primary immune thrombocytopenia is a severe bleeding disorder. About 50-85% of patients achieve initial remission from first-line therapies, but optimal second-line treatment remains a challenge. All-trans retinoic acid (ATRA) has an immunomodulatory effect on haemopoiesis, making it a possible treatment option. We aimed to evaluate the efficacy and safety of ATRA plus danazol versus danazol in non-splenectomised patients with corticosteroid-resistant or relapsed primary immune thrombocytopenia...
September 13, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28917574/-apparent-worsening-of-psoriasis-lesions-revealing-methotrexate-overdosage
#3
R Haber, B Baroudjian, M Battistella, M Bagot, A Petit
BACKGROUND: Methotrexate (MTX) is an antimetabolite drug used in the treatment of cancers and autoimmune diseases and frequently in dermatology for cutaneous and/or arthritic psoriasis. Toxicities due to MTX overdosage are mainly cutaneous, hepatic and hematologic. Herein, we report a case of MTX overdosage presenting as an erosive and an inflammatory flare of preexisting psoriatic plaques and with new palmar lesions. PATIENTS AND METHODS: A 51-year-old male with a 6-year history of plaque psoriasis resistant to topical corticosteroids was started for the first time on MTX 20mg weekly...
September 13, 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/28917404/clinical-course-and-outcomes-in-patients-with-mooren-ulcer-who-had-cataract-surgery
#4
Shilpa Das, Ashik Mohamed, Virender S Sangwan
PURPOSE: To report outcomes of cataract surgery in patients with Mooren ulcer. SETTING: L.V. Prasad Eye Institute, Hyderabad, India. DESIGN: Retrospective case series. METHODS: The medical records of patients with Mooren ulcer who had cataract surgery between 2000 and 2015 were assessed. The main outcome measures were the role of preoperative immunosuppression and disease inactivity, cataract surgery safety, visual outcomes, and postoperative ulcer recurrence...
August 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28916998/emergency-neurologic-life-support-meningitis-and-encephalitis
#5
David F Gaieski, Nicole F O'Brien, Ricardo Hernandez
Bacterial meningitis and viral encephalitis, particularly herpes simplex encephalitis, are severe neurological infections that, if not treated promptly and effectively, lead to poor neurological outcome or death. Because of the value of early recognition and treatment, meningitis and encephalitis was chosen as an Emergency Neurological Life Support protocol. This protocol provides a practical approach to recognition and urgent treatment of bacterial meningitis and encephalitis. Appropriate imaging, spinal fluid analysis, and early empiric treatment are discussed...
September 15, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28916122/myasthenia-gravis-and-crisis-evaluation-and-management-in-the-emergency-department
#6
Jamie Roper, M Emily Fleming, Brit Long, Alex Koyfman
BACKGROUND: Myasthenia gravis (MG) is an uncommon autoimmune disorder affecting the neuromuscular junction and manifesting as muscle weakness. A multitude of stressors can exacerbate MG. When symptoms are exacerbated, muscle weakness can be severe enough to result in respiratory failure, a condition known as myasthenic crisis (MC). OBJECTIVE: This review discusses risk factors, diagnosis, management, and iatrogenic avoidance of MC. DISCUSSION: MC can affect any age, ethnicity, or sex and can be precipitated with any stressor, infection being the most common...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28916121/controversies-in-corticosteroid-use-for-sepsis
#7
Brit Long, Alex Koyfman
BACKGROUND: Severe sepsis and septic shock are potentially deadly conditions managed in the emergency department (ED). Management centers on source control, fluid resuscitation, broad-spectrum antimicrobials, and vasopressors as needed. The use of corticosteroids is controversial. OBJECTIVE: To evaluate the evidence behind corticosteroid therapy in patients with septic shock. DISCUSSION: Septic shock is associated with severe mortality and morbidity...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28915330/impact-of-adrenal-steroids-on-regulation-of-adipose-tissue
#8
Marco Infante, Andrea Armani, Caterina Mammi, Andrea Fabbri, Massimiliano Caprio
Corticosteroids are secreted by the adrenal glands and control the functions of adipose tissue via the activation of mineralocorticoid receptor (MR) and glucocorticoid receptor (GR). In turn, adipocytes release a large variety of adipokines into the bloodstream, regulating the function of several organs and tissues, including the adrenal glands, hereby controlling corticosteroid production. In adipose tissue, the activation of the MR by glucocorticoids (GC) and aldosterone affects important processes such as adipocyte differentiation, oxidative stress, autophagic flux, adipokine expression as well as local production of GC through upregulation of the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1)...
September 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28915287/efficacy-and-safety-of-desoximetasone-0-25-spray-in-adult-atopic-dermatitis-subjects-pilot-study
#9
Lauren K Hoffman, Leon Kircik
BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disorder. One of the most disturbing symptoms of AD is pruritus. The first line treatment for AD is topical corticosteroids, topical immunomodulators, topical barrier creams, oral antihistamines, and systemic treatments. Desoximetasone 0.25% spray is a superpotent topical corticosteroid delivered in a novel way and it may be a suitable option for the treatment of pruritus in adult atopic dermatitis patients...
September 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28914687/prevention-of-macular-edema-after-cataract-surgery
#10
Laura H P Wielders, Jan S A G Schouten, Rudy M M A Nuijts
PURPOSE OF REVIEW: Although cataract surgery can effectively restore visual function in many patients with cataract, pseudophakic cystoid macular edema (PCME) remains an important cause of suboptimal visual acuity. The present review provides an overview of the current literature on the prevention and treatment of PCME. RECENT FINDINGS: Optimal prevention of PCME starts preoperatively with a personalized risk assessment. Diabetes mellitus, retinal vein occlusion, epiretinal membrane, macular hole, and uveitis are the most important risk factors for developing cystoid macular edema after cataract surgery...
September 12, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28914559/bilateral-posterior-scleritis-associated-with-giant-cell-arteritis-a-case-report
#11
Mehmet Erdogan, Nihat Sayin, Dilbade Yıldız Ekinci, Sadik Bayramoglu
AIM: To report a case of bilateral posterior scleritis associated with giant cell arteritis Case Report: A 62-year-old female patient presented with bilateral progressive vision loss was diagnosed with bilateral posterior scleritis. According to clinical signs and symptoms and laboratory testing, Giant cell arteritis was also diagnosed. Within 8 weeks of the corticosteroid treatment, the serous retinal detachments completely resolved and choroidal thickness decreased in both eyes. Visual acuity increased, and the symtoms related to Giant cell arteritis improved...
September 15, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28914194/diabetic-retinopathy-recent-updates-on-different-biomarkers-and-some-therapeutic-agents
#12
Amjad Ali Khan, Arshad Husain Rahmani, Yousef Homood Aldebasi
BACKGROUND: Diabetic Retinopathy is a leading cause of sight-threatening complication, which occurs due to a number of physiological and metabolic abnormalities during later stages of diabetes. Many of these abnormal changes are consistent with altered oxidative stress, inflammation, genetic set up, advanced glycation end products, and hematological changes. So the altered levels of different biomolecules related to these changes serve as important biomarkers to assess better evaluation and early treatment of this disease...
September 15, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28913986/chronic-spontaneous-urticaria-pathogenesis-and-treatment-considerations
#13
REVIEW
Allen P Kaplan
The treatment of chronic spontaneous urticaria begins with antihistamines; however, the dose required typically exceeds that recommended for allergic rhinitis. Second-generation, relatively non-sedating H₁-receptor blockers are typically employed up to 4 times a day. First-generation antihistamines, such as hydroxyzine or diphenhydramine (Atarax or Benadryl), were employed similarly in the past. Should high-dose antihistamines fail to control symptoms (at least 50%), omalizumab at 300 mg/month is the next step...
November 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28913596/-perioperative-management-of-immunosuppressive-treatment-in-patients-undergoing-joint-surgery
#14
K Krüger
The perioperative management of patients on immunosuppressive drugs is uncertain due to a lack of controlled studies. Continuation of medication without a pause may increase the risk of postoperative infections and wound healing disorders and when the pause is too long this can induce a flare of the underlying rheumatic disease. Additional factors, such as rheumatic disease activity, comorbidities, previous infections and the type of surgical procedure also modulate the risk. The highest risk of infection is associated with corticosteroids depending on the dose, so that a dosage as low as possible but stable in the perioperative period is recommended...
September 14, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28913336/anti-interleukin-5-il-5-and-il-5ra-biological-drugs-efficacy-safety-and-future-perspectives-in-severe-eosinophilic-asthma
#15
REVIEW
Diego Bagnasco, Matteo Ferrando, Gilda Varricchi, Francesca Puggioni, Giovanni Passalacqua, Giorgio Walter Canonica
The definition of asthma has changed considerably in recent years, to the extent that asthma is no longer considered a single disease but a heterogeneous disorder that includes several phenotypes and, possibly, endotypes. A more detailed analysis of the immunological mechanisms underlying the pathogenesis of asthma shows interleukin 5 (IL-5) to be a crucial cytokine in several asthma phenotypes. In fact, IL-5 exerts selective action on eosinophils, which, in turn, sustain airway inflammation and worsen asthma symptoms and control...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28912913/paraneoplastic-dermatomyositis-syndrome-presenting-as-dysphagia
#16
Emmanuel Ofori, Daryl Ramai, Mel Ona, Madhavi Reddy
Dermatomyositis (DM) is a rare autoimmune condition which predominantly affects females in the fifth and sixth decades of life. DM presents acutely or progressively as painless proximal skeletal muscle weakness and can be associated with a heliotropic rash around the eyes, and Gottron's papules on extensor surfaces of the hands. While the pathophysiology of DM is still unclear, abnormal T- and B-cell immune activity has been reported. DM has been associated with malignancy and has been shown to appear before, concurrently with, or after diagnosis of cancer...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28910559/the-impact-of-fda-regulatory-activities-on-incident-dispensing-of-laba-containing-medication-2005-2011
#17
Meghan A Baker, Melissa G Butler, Sally Seymour, Fang Zhang, Yute Wu, Ann Chen Wu, Mark S Levenson, Pingsheng Wu, Aarthi Iyer, Sengwee Toh, Solomon Iyasu, Esther H Zhou
BACKGROUND: Evidence of safety issues associated with long-acting beta2-agonist (LABA) treatment has led to multiple regulatory activities by the U.S. Food and Drug Administration (FDA) on this class of medications. OBJECTIVE: This study describes the impact of the regulatory activities on incident LABA-containing medication dispensing. METHODS: A monthly rolling cohort of asthma patients who were eligible to initiate a LABA-containing product was created in the Mini-Sentinel Distributed Database between January 2005 and June 2011...
September 14, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28910552/the-use-of-topical-corticosteroids-for-treatment-of-dry-eye-syndrome
#18
Carlo Alberto Cutolo, Stefano Barabino, Chiara Bonzano, Carlo Enrico Traverso
Dry eye disease (DED) is a multifactorial disease that results in symptoms of discomfort, visual disturbance, and damage to the ocular surface. Because chronic inflammation plays an important role in DED, treatment with topical corticosteroids has been demonstrated to ameliorate the signs and symptoms of the disease. Although these agents have proven short-term efficacy, their long-term use may cause intraocular pressure elevation and cataract progression. A carefully review of the different studies shows that differences between corticosteroids may exist regarding the incidence of side effects and evidence of efficacy in DED patients...
September 14, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28906353/immunomodulatory-treatments-for-persistent-and-chronic-immune-thrombocytopenic-purpura-a-prisma-compliant-systematic-review-and-meta-analysis-of-28-studies
#19
Emmanuelle Weber, Quitterie Reynaud, Romain Fort, Stéphane Durupt, Pascal Cathébras, Isabelle Durieu, Jean-Christophe Lega
BACKGROUND: Corticosteroid sparing is required in 15% to 40% of adults with persistent or chronic primary immune thrombocytopenic purpura (ITP). Herein, the efficacy of immunomodulatory drugs (dapsone, interferon alpha, danazol, and hydroxychloroquine as second-third-line therapies in ITP is investigated. METHODS: MEDLINE was searched for studies that included patients with persistent or chronic primary ITP and published before the end of December 2014. Two investigators independently extracted data regarding study design, patient characteristics, dosage schedule, time to response, and occurrence of adverse events...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906302/chemotherapy-extravasation-management-21-year-experience
#20
Maria Giuseppina Onesti, Sara Carella, Paolo Fioramonti, Nicolò Scuderi
Chemotherapy extravasation may result in serious damage to patients, with irreversible local injures and disability. Evidence-based standardization on extravasation management is lacking and many institutions do not practice adequate procedures to prevent the severer damages. Our aim was to explore the prevention and treatment of extravasation injuries, proposing a standard therapeutic protocol together with a review of the literature. From January 1994 to December 2015, 545 cases were reviewed (age range, 5-87 years; 282 men and 263 women)...
September 12, 2017: Annals of Plastic Surgery
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