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Inhaled steroids

Alexandra Ahmet, Eric I Benchimol, Ellen B Goldbloom, Janice L Barkey
BACKGROUND: Adrenal suppression (AS), a glucocorticoid (GC) side effect associated with significant morbidity, is well described related to inhaled corticosteroid therapy for asthma. Swallowed topical glucocorticoid therapy is the main pharmacotherapy treatment for eosinophilic esophagitis (EoE) and therefore children with EoE are potentially at increased risk of AS. METHODS: In this prospective cohort study, we included children and youth <18 years diagnosed with EoE and treated with swallowed fluticasone or oral viscous budesonide for more than 1 month...
2016: Allergy, Asthma, and Clinical Immunology
Cecilia K Andersson, Alexandra Adams, Prasad Nagakumar, Cara Bossley, Atul Gupta, Daphne De Vries, Afiqah Adnan, Andrew Bush, Sejal Saglani, Clare M Lloyd
BACKGROUND: Neutrophils and IL-17A have been linked mechanistically in models of allergic airways disease and have been associated with asthma severity. However, their role in paediatric asthma is unknown. OBJECTIVES: To investigate the role of neutrophils and the IL-17A pathway in mediating paediatric severe therapy resistant asthma (STRA). METHODS: Children with STRA (n=51, age 12.6 (6 -16.3) years) and non-asthmatic controls (n=15, age 4...
October 13, 2016: Journal of Allergy and Clinical Immunology
Andrew Skeggs, Tricia McKeever, Lelia Duley, Eleanor Mitchell, Lucy Bradshaw, Kevin Mortimer, Samantha Walker, Steve Parrott, Andrew Wilson, Ian Pavord, Chris Brightling, Mike Thomas, David Price, Graham Devereux, Bernard Higgins, Tim Harrison, Rebecca Haydock
BACKGROUND: Asthma is one of the commonest chronic diseases in the UK. Acute exacerbations of asthma are unpredictable, disruptive and frightening. They cause considerable morbidity and account for a large component of the health service costs of asthma. The widespread use of an asthma self-management plan, designed to encourage disease monitoring and timely intervention, can reduce exacerbations and is, therefore, recommended for all patients with asthma. Unfortunately, the majority of patients are not provided with such a plan...
October 13, 2016: Trials
A Kugelman, M Peniakov, S Zangen, Y Shiff, A Riskin, A Iofe, I Shoris, D Bader, S Arnon
OBJECTIVE: The efficacy of inhaled steroids in spontaneously breathing infants with established bronchopulmonary dysplasia (BPD) is debatable. The inhaled steroid hydrofluoalkane-beclomethasone dipropionate (QVAR) is unique in its small particle size that results in higher lung deposition. Our objective was to determine if inhaled QVAR could decrease respiratory rehospitalizations of infants with established BPD. STUDY DESIGN: Double-blind, randomized placebo-controlled, multicenter pilot study...
October 13, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Frederik Buchvald, Lue Drasbaek Phillipsen, Thomas Hjuler, Kim G Nielsen
BACKGROUND AND AIMS: Exercise-induced inspiratory symptoms (EIIS) have multiple causes, one of which is exercise-induced laryngeal obstruction (EILO). There is limited knowledge regarding EIIS in children, both in primary care practices and in pediatric asthma clinics. The aim of this study was to describe the feasibility of a diagnostic methodology and its results in a cohort of children with EIIS referred to our tertiary pediatric pulmonary center. METHODS: This study analyzed consecutively collected data in children from East Denmark and Greater Copenhagen referred during a 3½ years period...
November 2016: Pediatric Pulmonology
Raphaële Nové-Josserand, Soazic Grard, Lila Auzou, Philippe Reix, Marlène Murris-Espin, François Brémont, Benyebka Mammar, Laurent Mely, Dominique Hubert, Isabelle Durieu, Pierre-Régis Burgel
Allergic bronchopulmonary aspergillosis (ABPA) affects up to 15% of patients with cystic fibrosis (CF). Corticosteroids are used as first-line therapy, but relapse and adverse effects commonly occur. Case reports have suggested the efficacy of the anti-IgE recombinant humanized monoclonal antibody omalizumab. A retrospective multicenter observational French study retrieved 32 CF patients (11 children and 21 adults) who have received omalizumab for more than 3 months in the context of ABPA. Clinical characteristics, concomitant medications (inhaled and oral corticosteroids, antifungal drugs), lung function, body mass index (BMI), and serum IgE were compared at the start and during the first year of omalizumab therapy...
October 7, 2016: Pediatric Pulmonology
Lara Ravanetti, Annemiek Dijkhuis, Yanaika S Sabogal Pineros, Suzanne M Bal, Barbara S Dierdorp, Tamara Dekker, Adrian Logiantara, Ian M Adcock, Navin L Rao, Louis Boon, Gino Villetti, Peter J Sterk, Fabrizio Facchinetti, René Lutter
BACKGROUND: Acute worsening of asthma symptoms (exacerbation) is predominantly triggered by respiratory viruses, with influenza causing the most severe exacerbations. The lack of an adequate animal model hampers mechanistic insight and the development of new therapeutics. AIM: We developed and characterized a robust, consistent and reproducible mouse model of severe exacerbation of chronic allergic asthma. METHODS: Chronic allergic airway inflammation was induced following a house dust mite (HDM)-sensitization protocol...
October 3, 2016: Allergy
Tjard R Schermer, Bas Robberts, Alan J Crockett, Bart P Thoonen, Annelies Lucas, Joke Grootens, Ivo J Smeele, Cindy Thamrin, Helen K Reddel
Clinical guidelines indicate that a chronic obstructive pulmonary disease (COPD) diagnosis is made from a single spirometry test. However, long-term stability of diagnosis based on forced expiratory volume in 1 s over forced vital capacity (FEV1/FVC) ratio has not been reported. In primary care subjects at risk for COPD, we investigated shifts in diagnostic category (obstructed/non-obstructed). The data were from symptomatic 40+ years (ex-)smokers referred for diagnostic spirometry, with three spirometry tests, each 12±2 months apart...
September 29, 2016: NPJ Primary Care Respiratory Medicine
Nobuyuki Horita, Takeshi Kaneko
Corticosteroids are key medications to treat pulmonary diseases. A variety of medications, doses, administration route, and duration of corticosteroids were chosen for each of pulmonary diseases. Although corticosteroids are potent medications, they often cause serious adverse effects such as osteoporosis, diabetes, and immunosuppression. Thus, physicians have to properly assess the risk of adverse effects to prevent them. In this review, we discuss the risk of osteoporosis by corticosteroids that are prescribed for pulmonary diseases...
2016: Clinical Calcium
Alondra Frías, Alex Ortiz, Miriam Soto, Francisco Muñoz, Carolina Chacón
We report a 41-year-old man with HIV and a chronic obstructive pulmonary disease, treated for seven months with Fluticasone/Salmeterol and antiretroviral therapy (Lamivudine, Tenofovir, Atazanavir and Ritonavir). While using these medications, the patients developed a Cushing syndrome in a period of five months. After performing laboratory and imaging tests, it was concluded that the most probable cause of the syndrome was the interaction of inhaled steroids with Ritonavir. After discontinuing these medications the syndrome reverted in a period of 8 months...
July 2016: Revista Médica de Chile
Capan Konca, Mehmet Tekin, Mehmet Turgut
BACKGROUND: Some studies in the literature support the use of either inhaled or systemic steroids for the treatment of chemical pneumonitis; however, no data have been published on the combined use of inhaled and intravenous (IV) steroids. OBJECTIVES: This brief report describes the effective use of inhaled plus systemic steroids in managing six critical pediatric patients. PATIENTS AND METHODS: Medical records of patients were analyzed retrospectively...
July 2016: Iranian Red Crescent Medical Journal
James L Kreindler, Michael L Watkins, Sally Lettis, Ruth Tal-Singer, Nicholas Locantore
INTRODUCTION: Sputum and blood eosinophil counts have attracted attention as potential biomarkers in chronic obstructive pulmonary disease (COPD). One question regarding the use of blood eosinophils as a biomarker in COPD is whether their levels are affected by the use of inhaled corticosteroids (ICS), which are commonly prescribed for COPD. METHODS: We performed a retrospective analysis of peripheral blood leucocytes from a previously completed clinical trial that examined effects of ICS in steroid-naïve patients with COPD...
2016: BMJ Open Respiratory Research
Alexei Gonzalez-Estrada, Stephen A Geraci
Allergic diseases are common in women of childbearing age. Both asthma and atopic conditions may worsen, improve or remain the same during pregnancy. Primary care physicians commonly encounter women receiving multiple medications for pre-existing atopic conditions, who then become pregnant and require medication changes to avoid potential fetal injury or congenital malformations. Each medication should be evaluated; intranasal and inhaled steroids are relatively safe to continue during pregnancy (budesonide is the drug of choice), second-generation antihistamines of choice are cetirizine and loratadine, leukotriene receptor antagonists are safe, sparing use of oral decongestants during the first trimester and omalizumab may be used for both uncontrolled asthma and for antihistamine-resistant urticaria...
September 2016: American Journal of the Medical Sciences
G J Wesseling
Hyperinflation is an important element in chronic obstructive pulmonary disease (COPD), contributing significantly to dyspnoea and exercise intolerance. Bronchodilators have some, albeit slight, effect on hyperinflation. Lung volume reduction surgery has been advocated in a highly select group of patients with heterogeneous, predominantly upper lobe, emphysema but morbidity and mortality associated with this intervention have hampered its widespread use in respiratory medicine. Bronchoscopic lung volume reduction has recently been introduced...
2016: Nederlands Tijdschrift Voor Geneeskunde
Praveen Chandrasekharan, Rafal Kozielski, Vasantha H S Kumar, Munmun Rawat, Veena Manja, Changxing Ma, Satyan Lakshminrusimha
Inhaled nitric oxide (iNO) is being increasingly used in preterm infants < 34 weeks with hypoxemic respiratory failure (HRF) and/or pulmonary hypertension (PH). Objective To evaluate the risk factors, survival characteristics, and lung histopathology in preterm infants with PH/HRF. Methods Retrospective chart review was conducted to determine characteristics of 93 preterm infants treated with iNO in the first 28 days and compared with 930 matched controls. Factors associated with survival with preterm HRF and smooth muscle actin from nine autopsies were evaluated...
September 14, 2016: American Journal of Perinatology
Eri Hagiwara, Yasuhiro Gon, Kentaro Hayashi, Mai Takahashi, Yuko Iida, Hisato Hiranuma, Yoshiko Nakagawa, Tsukasa Hataoka, Kenji Mizumura, Shuichiro Maruoka, Tetsuo Shimizu, Noriaki Takahashi, Shu Hashimoto
The case subject was a 58-year-old woman who presented to our hospital with a chief complaint of respiratory discomfort. Wheezing could be heard in both lungs; treatment was initiated with inhaled steroids for suspected bronchial asthma. However, 1 week later, the respiratory discomfort had not improved and the wheezing sound had progressed to the neck area. Upper airway obstruction was suspected; therefore, chest computed tomography (CT) was performed, revealing tracheal stenosis caused by a tumor in the upper airway...
August 2016: Journal of Thoracic Disease
Jun-Jun Yeh, Yu-Chiao Wang, Chia-Hung Kao
PURPOSE: We conducted a cohort study to clarify this relationship between asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and pulmonary embolism (PE). METHODS: From the National Health Insurance Research Database of Taiwan, we identified patients who had a diagnosis of asthma and a diagnosis of COPD (defined as ACOS) and concurrent treatment between January 1999 and December 2009 (ACOS cohort: n = 14,150; non-ACOS cohort: n = 55,876)...
2016: PloS One
V Rajendran, Iqbal, Vinod Kumar
A case study of 35-year-old woman with persistent breathlessness and wheezing that had been unsuccessfully treated with inhaled beta 2-agonists and steroids for about two years. Patient developed dry cough and haemoptysis, so investigated further. Spirometry demonstrated a restrictive pattern. Chest CT demonstrated well defined hyperdense lesion in right middle lobe. Biopsy taken from the mass during bronchoscopy demonstrated the picture of atypical bronchial carcinoid. In this case, due to the lack of awareness, diagnosis of carcinoid was delayed by two years...
November 2015: Journal of the Association of Physicians of India
(no author information available yet)
Screening for posterior subcapsular cataracts in young people treated with inhaled glucocorticoids is not warranted, research from Canada suggests.
October 13, 1993: Nursing Standard
Michael Mosteller, Louise Hosking, Kay Murphy, Judong Shen, Kijoung Song, Matthew Nelson, Soumitra Ghosh
BACKGROUND: Inhaled corticosteroids (ICSs) are considered the most effective anti-inflammatory therapy for asthma control and management; however, there is substantial treatment response variability. OBJECTIVE: We sought to identify genetic markers of ICS response by conducting the largest pharmacogenetic investigation to date in 2672 ICS-treated patients with asthma. METHODS: Genotyping and imputation was performed in fluticasone furoate (FF) or fluticasone propionate-treated patients with asthma from 3 phase IIB and 4 phase IIIA randomized, double-blind, placebo-controlled, parallel group, multicenter studies...
July 5, 2016: Journal of Allergy and Clinical Immunology
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