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Khaled Ezzedine, Maxine Whitton, Mariona Pinart
Clinical Question: Which interventions are associated with highest efficacy and fewest adverse events for treating vitiligo? Bottom Line: Combination therapies, particularly those involving some form of light (ie, narrowband UV-B) were associated with more improved repigmentation than monotherapies. There was limited evidence to support the association of UV-A alone and UV-B alone with repigmentation for vitiligo. There was moderate evidence to support the association of UV-A and UV-B, when used in combination with psoralens, topical corticosteroids, vitamin D analogues, fluorouracil, azathioprine, and oral prednisolone with improved outcomes for vitiligo...
October 25, 2016: JAMA: the Journal of the American Medical Association
W Michael Dismuke, Mikael Klingeborn, W Daniel Stamer
Exosomes are emerging as important mediators of cell-matrix interactions by means of specific adhesion proteins. Changes in the tissue-specific exosomal protein expression may underlie pathological conditions whereby extracellular matrix turnover and homeostasis is disrupted. Ocular hypertension due to extracellular matrix accumulation in the trabecular meshwork is a hallmark of glucocorticoid-induced glaucoma. In the trabecular meshwork, exosomal fibronectin mediates cell matrix interactions at cellular structures called "invadosomes"...
2016: PloS One
Nathalie A Bogaards, Menno A de Rie
INTRODUCTION: Tumor necrosis factor (TNF)-α inhibitors are widely used for the treatment of inflammatory diseases. One of the side effects of TNF-inhibitors is the development of a psoriatiform eruption, also known as paradoxical psoriasis. In this case report, we describe a patient with this side effect after treatment with adalimumab and etanercept. CASE REPORT: A 45-year-old female was treated with adalimumab 40 mg once every 2 weeks for pustulosis palmoplantaris and psoriatic arthritis...
October 25, 2016: Dermatology and Therapy
Mario Cazzola, Maria Gabriella Matera
In asthma and chronic obstructive pulmonary disease (COPD), an important step in simplifying management and improving adherence with prescribed therapy is to reduce the dose frequency to the minimum necessary to maintain disease control. Fixed-dose combination (FDC) therapy might enhance compliance by decreasing the number of medications and/or the number of daily doses. Furthermore, they have the potential for enhancing, sensitizing, and prolonging the effects of monocomponents. Combination therapy with an inhaled corticosteroid (ICS) and a long-acting β-agonist (LABA) is considered an important approach for treating patients with asthma and patients with severe COPD who have frequent exacerbations...
October 26, 2016: Handbook of Experimental Pharmacology
L Amsallem, J Serane, D Zbili, B Marion, P Boyer
We report on the case of bilateral avascular osteonecrosis (AVN) of the lunate and triquetrum in a 45-year-old woman without any relevant medical history for which the cause could not be established. She was treated conservatively with splinting and analgesics. The patient was able to pursue her work and hobbies with subnormal range of motion at 1-year follow-up. AVN of the triquetrum is very rare, as it is a richly vascularized bone. The presence of AVN in multiple carpal bones has only been described in patients receiving high doses of corticosteroids...
October 2016: Hand Surgery and Rehabilitation
W P J van Oosterhout, J Haan, N D Kruyt
BACKGROUND: Melkersson-Rosenthal syndrome (MRS) is a relatively rare syndrome characterised by the clinical triad of persisting or recurrent facial oedema, recurrent peripheral facial palsy, and a fissured tongue. CASE DESCRIPTION: A 30-year-old male patient presented with a left peripheral facial palsy spreading to the right side of the face. The left-sided facial paralysis recurred twice after initial recovery. The patient had also suffered from oedema of the lip and face, which sometimes occurred simultaneously with the paralysis, and he had always had a fissured tongue...
2016: Nederlands Tijdschrift Voor Geneeskunde
Hongfeng Huang, Xi Yao, Jianyong Wu, Wenhan Peng, Jianghua Chen
AIMS: To investigate the area under the curve (AUC) of mycophenolic acid (MPA) in adult Chinese renal allograft recipients receiving concomitant enteric-coated mycophenolate sodium (EC-MPS) and cyclosporine (CsA) during the early post-transplant phase and to develop optimal model equations for estimation of the MPA area under the plasma concentration-time curve from 0 to 12 hours (AUC0-12h) using a limited-sampling strategy (LSS). METHODS: The present study enrolled 24 Chinese renal recipients treated with EC-MPS, CsA, and corticosteroid, from whom 24 serial blood samples were collected over 12 hours...
October 26, 2016: International Journal of Clinical Pharmacology and Therapeutics
Candace L Beilman, Nguyen Xuan Thanh, Victoria Ung, Christopher Ma, Karen Wong, Karen I Kroeker, Thomas Lee, Haili Wang, Arto Ohinmaa, Phil Jacobs, Brendan P Halloran, Richard N Fedorak
Background. Adalimumab is effective for the maintenance of remission in patients with moderate-to-severe ulcerative colitis (UC). Currently, biologic therapies are used in cases where patients fail conventional medical therapies. If biologic therapies are not available, patients often choose to remain in an unwell state rather than undergo colectomy. Objective. The aim of the study was to evaluate the cost-effectiveness of adalimumab in patients with UC where adalimumab was readily available compared to not available...
2016: Canadian Journal of Gastroenterology & Hepatology
Massimo Accorinti, Giovanni Spinucci, Maria Pia Pirraglia, Simone Bruschi, Francesca Romana Pesci, Ludovico Iannetti
Purpose. To study epidemiology, clinical findings and visual prognosis of patients with Fuchs' Heterochromic Iridocyclitis (FHI). Methods. A retrospective analysis was performed on 158 patients with FHI. Thirty-five patients were observed only once; the remaining 123 had a mean follow-up of 30.7 months (50 of them had a mean follow-up of 63.5 months) and in those we assessed complications, medical and surgical treatment, and long-term visual prognosis. Results. Average age at uveitis diagnosis was 27.2 years and 18...
2016: Journal of Ophthalmology
Kazutaka Fujita, Yuko Morishima, Yuka Aida, Yoshiya Tsunoda, Norihito Hida, Toshihiro Shiozawa, Kensuke Nakazawa, Ikuo Sekine, Nobuyuki Hizawa
No abstract text is available yet for this article.
October 22, 2016: Journal of Thoracic Oncology
Jan P Kamiński, Emily Miraflor, Karen Zaghiyan, Phillip Fleshner
Treatment of Crohn's disease (CD) relies on medical therapy with surgery reserved for medically refractory cases. This study measured pharmaceutical therapies that CD patients receive before surgery. Prospective data were collected on 558 patients undergoing surgery for medically refractory CD from November 1999 through June 2014. Patient demographics and preoperative medical therapies were tabulated, including types and number of doses of aminosalicylic acid, corticosteroids, immunomodulators, and biologic therapies...
October 2016: American Surgeon
Hashim Ali Khan, Muhammad Aamir Shahzad
PURPOSE: To report a case of atypical serpiginous choroiditis with previously unreported findings on optical coherence tomographic angiography. CASE REPORT: A 35-year-old otherwise healthy man had a 1-week history of vision loss in his right eye. The visual acuity in right eye was counting fingers at 1 meter. Fundoscopy showed a classic peripapillary serpiginous lesion and a solitary macular lesion. Fundus fluorescein angiography revealed early hypofluorescence of active lesions with gradual increase in fluorescence across the phase of angiogram...
October 25, 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Durga Anil K Kanigicherla, Patrick Hamilton, Krystyna Czapla, Paul Ec Brenchley
AIM: Primary membranous nephropathy (PMN) is associated with progression to end stage renal disease in some patients. Standard immunosuppressive therapy with cyclical cyclophosphamide and corticosteroids can be associated with significant adverse effects. We aimed to assess immunological and clinical response with intravenous pulse cyclophosphamide and oral steroids in patients with severe nephrotic syndrome - in a prospective observational cohort study at our centre. METHODS: 17 consecutive patients (9 New-incident and 8 relapses) with severe nephrotic syndrome received intravenous pulse cyclophosphamide and daily oral steroids after failure to achieve remission with supportive therapy alone...
October 24, 2016: Nephrology
Emna Farhat, Mourad Zouari, Ines Ben Abdelaziz, Cyrine Drissi, Rahma Beyrouti, Mohamed Ben Hammouda, Fayçal Hentati
BACKGROUND: Cerebellar ataxia represents a rare and severe complication of Sjӧgren syndrome (SS), especially with a progressive onset and cerebellar atrophy on imaging. CASE PRESENTATION: We report the case of a 30-year-old woman, with a past history of dry eyes and mouth, who presented a severe cerebellar ataxia worsening over 4 years associated with tremor of the limbs and the head. Brain MRI showed bilateral hyperintensities on T2 and FLAIR sequences, affecting periventricular white matter, with marked cerebellar atrophy...
2016: Cerebellum & Ataxias
Takeru Asano, Ken-Ichi Matsuoka, Satoshi Iyama, Kazuteru Ohashi, Yoshihiro Inamoto, Chikako Ohwada, Makoto Murata, Atsushi Satake, Chikamasa Yoshida, Koichi Nakase, Yasuo Mori, Mitsune Yamamoto
Chronic graft versus host disease (cGVHD) remains a major problem for long survivors after allogeneic hematopoietic stem cell transplantation (HSCT). Currently, corticosteroid therapy is effective for cGVHD as the first line therapy. However, prolonged therapy with corticosteroids causes various severe adverse events. To develop the new therapeutic strategy of cGVHD, we have launched a multicenter phase I/IIa clinical trial of low dose subcutaneous interleukin-2 (IL-2) for treatment of steroid refractory cGVHD, which is constituted of 2 sequential phases (induction phase and maitanance phase)...
October 2016: Acta Medica Okayama
Anne M Fitzpatrick, Daniel J Jackson, David T Mauger, Susan J Boehmer, Wanda Phipatanakul, William J Sheehan, James N Moy, Ian M Paul, Leonard B Bacharier, Michael D Cabana, Ronina Covar, Fernando Holguin, Robert F Lemanske, Fernando D Martinez, Jacqueline A Pongracic, Avraham Beigelman, Sachin N Baxi, Mindy Benson, Kathryn Blake, James F Chmiel, Cori L Daines, Michael O Daines, Jonathan M Gaffin, Deborah Ann Gentile, W Adam Gower, Elliot Israel, Harsha Vardhan Kumar, Jason E Lang, Stephen C Lazarus, John J Lima, Ngoc Ly, Jyothi Marbin, Wayne Morgan, Ross E Myers, J Tod Olin, Stephen P Peters, Hengameh H Raissy, Rachel G Robison, Kristie Ross, Christine A Sorkness, Shannon M Thyne, Stanley J Szefler
BACKGROUND: Phenotypic presentations in young children with asthma are varied and may contribute to differential responses to asthma controller medications. METHODS: The Individualized Therapy for Asthma in Toddlers (INFANT) study was a multicenter, randomized, double-blind, double-dummy, clinical trial in children age 12-59 months (n=300) with asthma necessitating treatment with daily controller (Step 2) therapy. Participants completed a 2-8 week run-in period followed by three crossover periods with daily inhaled corticosteroid (ICS), daily leukotriene receptor antagonist (LTRA), and as-needed ICS treatment co-administered with albuterol...
October 21, 2016: Journal of Allergy and Clinical Immunology
Henri Traboulsi, Tamer El Natout, Ghassan Skaff, Abdul-Latif Hamdan
INTRODUCTION: Injection laryngoplasty using hyaluronic acid is a safe procedure commonly performed on patients with glottic insufficiency. STUDY DESIGN: This is a descriptive study of a case of adverse reaction to hyaluronic acid in a patient who underwent injection laryngoplasty for the treatment of unilateral vocal cord paralysis. DISCUSSION: The patient was treated with antibiotics and corticosteroids and had a full recovery. The authors recommend close observation following injection laryngoplasty using hyaluronic acid and diligent investigation of persistent postoperative laryngopharyngeal symptoms...
October 21, 2016: Journal of Voice: Official Journal of the Voice Foundation
T Schmitz
OBJECTIVE: To evaluate short- and long-term benefits and risks associated with antenatal administration of a single course of corticosteroids and the related strategies: multiple and rescue courses. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Antenatal administration of a single course of corticosteroids before 34 weeks of gestation is associated in the neonatal period with a significant reduction of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC) and death (LE1), and in possibly childhood with a reduction of cerebral palsy and increased psychomotor development index and intact survival (LE3)...
October 21, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Richard Ac Hughes, Ruth Brassington, Angela A Gunn, Pieter A van Doorn
BACKGROUND: Guillain-Barré syndrome (GBS) is an acute paralysing disease caused by inflammation of the peripheral nerves, which corticosteroids would be expected to benefit. OBJECTIVES: To examine the ability of corticosteroids to hasten recovery and reduce the long-term morbidity from GBS. SEARCH METHODS: On 12 January 2016, we searched the Cochrane Neuromuscular Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase...
October 24, 2016: Cochrane Database of Systematic Reviews
Cristóbal Couto, Ariel Schlaen, Mercedes Frick, Marina Khoury, Matilde Lopez, Erika Hurtado, Debra Goldstein
PURPOSE: To evaluate the clinical outcome and safety of adalimumab in patients with Vogt-Koyanagi-Harada (VKH) disease. METHODS: VKH patients treated with adalimumab seen at the University of Buenos Aires were reviewed. Main outcome measures were visual acuity, anterior segment inflammation, optic nerve inflammation (ONI), steroid sparing effect, number of immunosuppressives, and relapses. RESULTS: In total, 14 VKH patients, mean age 23.07 ± 8 years; median of adalimumab treatment 10 months, were analyzed...
October 24, 2016: Ocular Immunology and Inflammation
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