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https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#1
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/27925796/a-severe-asthma-disease-signature-from-gene-expression-profiling-of-peripheral-blood-from-u-biopred-cohorts
#2
Jeannette Bigler, Michael Boedigheimer, James P R Schofield, Paul J Skipp, Julie Corfield, Anthony Rowe, Ana R Sousa, Martin Timour, Lori Twehues, Xuguang Hu, Graham Roberts, Andrew A Welcher, Wen Yu, Kian F Chung, Ian M Adcock, Peter J Sterk, Ratko Djukanović
RATIONALE: Stratification of asthma at the molecular level, especially using accessible biospecimens, could greatly enable patient selection for targeted therapy. OBJECTIVES: To determine the value of blood to identify transcriptional differences between clinically defined asthmatic and non-asthmatic groups, identify potential patient subgroups based on gene expression, and explore biological pathways associated with identified differences. METHODS: Transcriptomics profiles were generated by microarray analysis of blood from 610 asthmatic and control participants in U-BIOPRED...
December 7, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27925185/effects-of-carbocysteine-and-beclomethasone-on-histone-acetylation-deacetylation-processes-in-cigarette-smoke-exposed-bronchial-epithelial-cells
#3
E Pace, S Di Vincenzo, M Ferraro, L Siena, G Chiappara, P Dino, P Vitulo, A Bertani, F Saibene, L Lanata, M Gjomarkaj
Histone deacetylase expression/activity may control inflammation, cell senescence, and responses to corticosteroids. Cigarette smoke exposure, increasing oxidative stress, may negatively affect deacetylase expression/activity. The effects of cigarette smoke extracts (CSE), carbocysteine, and beclomethasone dipropionate on chromatin remodelling processes in human bronchial epithelial cells are largely unknown. The present study was aimed to assess the effects of cigarette smoke, carbocysteine, and beclomethasone dipropionate on histone deacetylase 3 (HDAC3) expression/activity, N-CoR (nuclear receptor corepressor) expression, histone acetyltransferases (HAT) (p300/CBP) expression, p-CREB and IL-1 m-RNA expression, neutrophil chemotaxis...
December 7, 2016: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27924855/the-efficacy-of-mycophenolate-mofetil-for-the-treatment-of-chinese-takayasu-s-arteritis
#4
Jing Li, Yunjiao Yang, Jiuliang Zhao, Mengtao Li, Xinping Tian, Xiaofeng Zeng
To investigate the therapeutic effect of mycophenolate mofetil(MMF) on Chinese Takayasu's arteritis(TAK) patients. Thirty consecutive TAK outpatients were prospectively enrolled during 2013 to 2015. MMF combined with glucocorticoid was the primary treatment regimen. If clinical stable disease could not be reached, another traditional immunosuppressive agent could be added. All patients were evaluated and followed up every 3 months and vascular image studies by Doppler ultrasonography were repeated every 6 months...
December 7, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27924367/risk-factors-and-outcomes-of-acute-lower-gastrointestinal-bleeding-in-intestinal-beh%C3%A3-et-s-disease
#5
Jihye Park, Jae Hee Cheon, Yong Eun Park, Yoon Jee Lee, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim
BACKGROUND: Intestinal Behçet's disease (BD) can cause acute lower gastrointestinal bleeding, which is sometimes fatal. AIM: We aimed to identify the risk factors and outcomes of acute lower gastrointestinal bleeding and factors associated with rebleeding in intestinal BD patients. METHODS: Of the total of 588 intestinal BD patients, we retrospectively reviewed the medical records of 66 (11.2%) patients with acute lower gastrointestinal bleeding and compared them with those of 132 matched patients without bleeding...
December 6, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27923647/mouse-sensitization-and-exposure-are-associated-with-asthma-severity-in-urban-children
#6
Torie Grant, Charles Aloe, Matthew Perzanowski, Wanda Phipatanakul, Mary E Bollinger, Rachel Miller, Elizabeth C Matsui
BACKGROUND: Mouse sensitization and exposure are associated with uncontrolled asthma, but whether they are associated with asthma severity, an intrinsic disease characteristic and long-term outcome predictor, is unclear. OBJECTIVE: To examine relationships between mouse sensitization and/or exposure and asthma severity in urban children. METHODS: A total of 645 children (5-17 years) with uncontrolled asthma underwent mouse sensitization evaluation...
December 3, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27923549/assessing-the-value-of-mepolizumab-for-severe-eosinophilic-asthma-a-cost-effectiveness-analysis
#7
Melanie D Whittington, R Brett McQueen, Daniel A Ollendorf, Jeffrey A Tice, Richard H Chapman, Steven D Pearson, Jonathan D Campbell
BACKGROUND: Adding mepolizumab to standard treatment with inhaled corticosteroids and controller medications could decrease asthma exacerbations and use of long-term oral steroids in patients with severe disease and increased eosinophils; however, mepolizumab is costly and its cost effectiveness is unknown. OBJECTIVE: To estimate the cost effectiveness of mepolizumab. METHODS: A Markov model was used to determine the incremental cost per quality-adjusted life year (QALY) gained for mepolizumab plus standard of care (SoC) and for SoC alone...
December 3, 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27923369/protocol-of-a-prospective-study-for-the-combination-treatment-of-shu-gan-jian-pi-decoction-and-steroid-standard-therapy-in-autoimmune-hepatitis-patients
#8
Xiao-Ling Chi, Huan-Ming Xiao, Yu-Bao Xie, Gao-Shu Cai, Jun-Min Jiang, Guang-Jun Tian, Mei-Jie Shi, Shu-Duo Wu, Peng-Tao Zhao, Hui-Jun Chen
BACKGROUND: Prednisone plus azathioprine is considered the mainstay of therapy in the current recommendations for autoimmune hepatitis (AIH). However, it does not provide good benefits for AIH patients because of its serious side effects. Therefore, more and more AIH patients prefer to seek for traditional Chinese medicine (TCM) to manage their symptoms and reduce the side effects of steroids in China. Shu-Gan-Jian-Pi Decoction is a popular used Chinese herbal formula in Guangdong province of China, which has demonstrated the effect of improving efficacy and reducing side effects of corticosteroids in AIH patients...
December 7, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27922741/how-do-dual-long-acting-bronchodilators-prevent-exacerbations-of-chronic-obstructive-pulmonary-disease
#9
Kai M Beeh, Pierre-Regis Burgel, Frits M E Franssen, Jose Luis Lopez-Campos, Stelios Loukides, John R Hurst, Matjaž Fležar, Charlotte Suppli Ulrik, Fabiano Di Marco, Daiana Stolz, Arschang Valipour, Brian Casserly, Björn Ställberg, Konstantinos Kostikas, Jadwiga A Wedzicha
Decreasing the frequency and severity of exacerbations is one of the main goals of treatment for patients with chronic obstructive pulmonary disease (COPD). Several studies have documented that long-acting bronchodilators (LABDs) can reduce exacerbation rate and/or severity, and others have shown that combinations of long-acting 2-adrenergic agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) provide greater reductions in exacerbation frequency than either their monocomponents or LABA/inhaled corticosteroids (LABA/ICS) combinations in patients at low and high risk for these events...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27922587/tinea-incognito-due-to-trichophyton-mentagrophytes-case-report
#10
Camila Quiñones, Paula Hasbún, Walter Gubelin
Tineas are frequent infections caused by dermatophytes that are able to invade keratinized tissue, causing rounded, erythematous, scaly lesions. Nonetheless, in tinea incognito the lesions are modified because of inappropriate use of topical corticosteroids or calcineurin inhibitors, making it difficult to diagnose. We present a case of a 12-year-old male child that presents with erythematous lesions on the right eyebrow, which at first was diagnosed as a contact dermatitis, so corticosteroids were indicated...
November 9, 2016: Medwave
https://www.readbyqxmd.com/read/27922495/toxic-and-endocrine-myopathies
#11
Hans D Katzberg, Charles D Kassardjian
PURPOSE OF REVIEW: This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies. RECENT FINDINGS: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy. Recently proposed mechanisms of injury in patients with critical illness myopathy include inhibition of protein synthesis, mitochondrial dysfunction, disruption of the ubiquitin-proteasome system, oxidative stress, and disruption of intramuscular calcium homeostasis, which can cause a myosin-loss myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922027/a-day-4-lille-model-predicts-response-to-corticosteroids-and-mortality-in-severe-alcoholic-hepatitis
#12
Mauricio Garcia-Saenz-de-Sicilia, Chitharanjan Duvoor, Jose Altamirano, Roberta Chavez-Araujo, Veronica Prado, Ana de Lourdes Candolo-Martinelli, Patricia Holanda-Almeida, Bernardo Becerra-Martins-de-Oliveira, Simony Fernandez-de-Almeida, Ramón Bataller, Juan Caballeria, Andres Duarte-Rojo
OBJECTIVES: Prednisolone therapy increases the risk of infections in patients with severe alcoholic hepatitis (SAH). We evaluated whether the use of the Lille Model at day 4 (LM4) is useful to predict response to prednisolone compared with the classic day 7 (LM7) in order to limit a futile exposure to corticosteroids. METHODS: We performed a retrospective analysis of a large multinational cohort of patients with SAH with Maddrey's discriminant function (DF) ≥32...
December 6, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27921443/platelet-rich-plasma-versus-corticosteroid-injections-for-carpal-tunnel-syndrome
#13
Hakan Uzun, Ozan Bitik, Öznur Uzun, Umut Sinan Ersoy, Erdem Aktaş
BACKGROUND: Platelet-rich plasma therapy has the potential to promote peripheral nerve regeneration through the autologous supply of growth factors. Therefore, this study aimed to compare the effects of platelet-rich plasma injections with the effects of corticosteroid injections in the treatment of carpal tunnel syndrome. METHODS: In total, 40 patients with mild carpal tunnel syndrome were equally divided into two groups. Nerve conduction studies were carried out, and the Boston Carpal Tunnel Questionnaire was administered to both groups before treatment...
December 6, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27921007/long-term-response-to-nivolumab-and-acute-renal-failure-in-a-patient-with-metastatic-papillary-renal-cell-carcinoma-and-a-pd-l1-tumor-expression-increased-with-sunitinib-therapy-a-case-report
#14
Juan Ruiz-Bañobre, Urbano Anido, Ihab Abdulkader, José Antúnez-López, Rafael López-López, Jorge García-González
INTRODUCTION: Papillary renal cell carcinoma (PRCC), which represents around 20% of renal cell carcinomas, is a heterogeneous disease that includes different tumor types with several clinical and molecular phenotypes. Nivolumab, a fully human IgG4 programed cell death protein 1 immune checkpoint inhibitor antibody, has shown not only an overall survival advantage when compared to everolimus but also a relatively good side-effect profile among patients with previously treated advanced or metastatic renal cell carcinoma...
2016: Frontiers in Oncology
https://www.readbyqxmd.com/read/27920712/hypertrophic-pachymeningitis-as-an-early-manifestation-of-relapsing-polychondritis-case-report-and-review-of-the-literature
#15
Satoru Ushiyama, Tomomi Kinoshita, Yasuhiro Shimojima, Nobuhiko Ohashi, Dai Kishida, Daigo Miyazaki, Katsuya Nakamura, Yoshiki Sekijima, Shu-Ichi Ikeda
Neurological involvement in relapsing polychondritis (RP) is relatively rare. We describe the case of an 80-year-old man who presented with hypertrophic pachymeningitis (HP) together with arthritis as the first manifestation of RP. Auricular chondritis, which subsequently determined the diagnosis of RP, occurred a few weeks after the detection of HP. The neurological symptoms, as well as arthritis, were promptly improved by treatment with corticosteroids. It is generally difficult to diagnose RP in the absence of typical cartilaginous involvement; however, the present case suggests that HP may occur as an early clinical manifestation of RP...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/27920706/ipilimumab-induced-enteritis-without-colitis-a-new-challenge
#16
Marcus Messmer, Sunita Upreti, Yaman Tarabishy, Nikhilesh Mazumder, Reezwana Chowdhury, Mark Yarchoan, Matthias Holdhoff
INTRODUCTION: Ipilimumab is an immune checkpoint inhibitor targeting cytotoxic T-lymphocyte associated antigen 4 (CTLA4), approved to treat metastatic melanoma. It was the first therapy shown to prolong survival in a large, randomized clinical trial. However, immune-related adverse events are common and can be severe. Enterocolitis is a common adverse event with ipilimumab, but enteritis without colitis has not been previously described. CASE REPORT: An 83-year-old man presented to our hospital with grade 3 diarrhea for 5 days...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920641/severe-de-novo-hepatitis-b-recovered-from-late-onset-liver-insufficiency-with-prolonged-ascites-and-hypoalbuminemia-due-to-hepatitis-b-virus-genotype-bj-with-precore-mutation
#17
Akira Sato, Toshiya Ishii, Fumiaki Sano, Takayuki Yamada, Hideaki Takahashi, Nobuyuki Matsumoto
De novo hepatitis B is associated with a high risk of hepatic failure often resulting in fatal fulminant hepatitis even when nucleotide analogues are administered. A 77-year-old female developed de novo hepatitis B after R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) treatment for diffuse large B-cell lymphoma. Hepatitis B virus (HBV) isolated from the patient was of genotype Bj, with a precore mutation (G1896A) exhibiting an extremely high viral load at the onset of hepatitis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27920512/the-burden-of-chronic-obstructive-pulmonary-disease-associated-with-maintenance-monotherapy-in-the-uk
#18
Susan C Edwards, Sian E Fairbrother, Anna Scowcroft, Gavin Chiu, Andrew Ternouth, Brian J Lipworth
BACKGROUND: This study characterized a cohort of chronic obstructive pulmonary disease (COPD) patients on maintenance bronchodilator monotherapy for ≥6 months to establish their disease burden, measured by health care utilization. METHODS: Data were extracted from the UK Clinical Practice Research Datalink and linked to Hospital Episode Statistics. The monotherapy period spanned the first prescription of a long-acting β2-adrenergic agonist or a long-acting muscarinic antagonist until the end of the study (December 31, 2013) or until step up to dual/triple therapy, for example, addition of another long-acting bronchodilator, an inhaled corticosteroid, or both...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27920342/experimentally-induced-preterm-birth-in-sheep-following-a-clinical-course-of-antenatal-betamethasone-effects-on-growth-and-long-term-survival
#19
Vivian B Nguyen, Robert De Matteo, Richard Harding, Aneta Stefanidis, Graeme R Polglase, M Jane Black
Preterm births account for approximately 10% of births worldwide, with the majority (∼80%) being moderate preterm. Our aim was to determine the effects of moderate preterm birth on survival and long-term growth of male and female offspring using an ovine model of preterm birth that was preceded by a clinically relevant dose of corticosteroids. Ewes were induced to deliver preterm or at term; those assigned to deliver preterm were administered antenatal betamethasone (11.4 mg, 2 doses, 24 hours apart). The growth (body weight and body dimensions) of offspring was monitored to adulthood (62 weeks) when the animals were humanely killed for organ collection...
December 5, 2016: Reproductive Sciences
https://www.readbyqxmd.com/read/27919664/photodynamic-therapy-with-green-light-for-the-treatment-of-vulvar-lichen-sclerosus-preliminary-results
#20
B J Osiecka, K Jurczyszyn, P Nockowski, M Murawski, P Ziółkowski
INTRODUCTION: The standard treatment for lichen sclerosus (LS) is symptomatic and is primarily based on the chronic use of corticosteroids, sometimes resulting in unsatisfactory effects. Therefore, other non-pharmacological methods are being sought, which are less aggravating for the patient. LS can be treated topically by using photodynamic therapy (PDT) based on 5-aminolevulinic acid (5-ALA). Unfortunately, therapy with the red light is often connected with severe local pain during the illumination...
December 2, 2016: Photodiagnosis and Photodynamic Therapy
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