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https://www.readbyqxmd.com/read/27910127/treatment-of-severe-chronic-hand-eczema-results-from-a-uk-wide-survey
#1
I L Smith, S Brown, J Nixon, F C Cowdell, S Ersser, C Fernandez, M Goodfield, C M Green, P Hampton, J T Lear, C H Smith, L Sunderland, S Tubeuf, M Wittmann
Treatment of severe hand eczema (HE) that is resistant to topical potent corticosteroid treatment is challenging. In 2013, we surveyed 194 UK dermatologists to obtain information about their usual treatment pathways to inform the choice of the comparator in a trial of alitretinoin in severe HE (ALPHA trial); the results indicated that the treatment approaches favoured by UK dermatologists differ. Psoralen combined with ultraviolet A (PUVA) and alitretinoin were identified as the most frequent first-line treatment options for hyperkeratotic HE, whereas oral corticosteroids were identified as the most frequent first-line treatment for vesicular HE, followed by PUVA and alitretinoin...
December 2, 2016: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/27900326/case-of-severe-alcoholic-hepatitis-treated-with-granulocytapheresis
#2
Yukari Watanabe, Kenya Kamimura, Tomohiro Iwasaki, Hiroyuki Abe, Shunsaku Takahashi, Ken-Ichi Mizuno, Manabu Takeuchi, Atsushi Eino, Ichiei Narita, Shuji Terai
Severe alcoholic hepatitis (AH) has a high mortality, and it is associated with encephalopathy, acute renal failure, sepsis, gastrointestinal bleeding, and endotoxemia. The 28-d mortality remains poor (34%-40%), because no effective treatment has been established. Recently, corticosteroids (CS) have been considered effective for significantly improving the prognosis of those with AH, as it prevents the production of pro-inflammatory cytokines. However, CS are not always appropriate as an initial therapeutic option, such as in cases with an infection or resistance to CS...
November 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27897120/dropless-cataract-surgery-an-overview
#3
Richard L Lindstrom, M Stewart Galloway, Andrzej Grzybowski, Jeffrey T Liegner
Risk reduction and the attainment of good outcomes in contemporary cataract surgery depend in part on patient compliance with a postoperative regimen of topical eye drops. Topical drops are expensive and challenging to instill properly for patients. The consequences of noncompliance or poor compliance can be significant for the patient (in the case of a complication) and for society (in the case of development of antibiotic resistance). For all of these reasons, new approaches that reduce the need for topical therapy are beginning to emerge, including intracameral injection, sustained or slow-release drug delivery mechanisms, and the recently introduced "Dropless cataract surgery," which involves intravitreal injection of single-use, compounded combination of antibiotics and corticosteroids...
November 29, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27895446/a-case-of-fatal-sepsis-due-to-multidrug-resistant-corynebacterium-striatum
#4
M Chatzopoulou, T Koufakis, I Voulgaridi, I Gabranis, M Tsiakalou
BACKGROUND: Although non-diphtheria corynebacteria have traditionally been regarded as avirulent members of human bacterial flora, their pathogenic potential is increasingly recognized in our time. Reasons for this include the prolonged survival of severely ill and immunocompromised patients, the development of more invasive diagnostic and therapeutic procedures and the sub-optimal use of antibiotics that disrupts normal microbial balance and favors superinfections. CASE REPORT: We present a rare case of sepsis due to multidrug-resistant Corynebacterium striatum in a 76-year-old host...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27890958/nonhealing-genital-ulcer-in-aids-a-diagnostic-dilemma
#5
Yogesh S Marfatia, Devi Sathianadha Menon, Sheethal Jose, Brijesh Kumar Patel
HIV/AIDS-related immune alteration poses many diagnostic and therapeutic challenges. HIV-positive 44-year-old male, on second-line antiretroviral therapy (ART) presented with asymptomatic non healing, well-defined, erythematous ulcer over penis since 8 months with serosanguinous discharge. Inguinal lymph nodes were not palpable. Tzanck smear was negative. Biopsy was not done as the patient was not willing for the same. Acyclovir was given considering herpes infection to which there was no response, and hence azithromycin and metronidazole were given, without improvement...
July 2016: Indian Journal of Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/27886803/relapsing-polychondritis-a-2016-update-on-clinical-features-diagnostic-tools-treatment-and-biological-drug-use
#6
REVIEW
Alexis Mathian, Makoto Miyara, Fleur Cohen-Aubart, Julien Haroche, Miguel Hie, Micheline Pha, Philippe Grenier, Zahir Amoura
Relapsing polychondritis (RP) is a very rare autoimmune disease characterised by a relapsing inflammation of the cartilaginous tissues (joints, ears, nose, intervertebral discs, larynx, trachea and cartilaginous bronchi), which may progress to long-lasting atrophy and/or deformity of the cartilages. Non-cartilaginous tissues may also be affected, such as the eyes, heart, aorta, inner ear and skin. RP has a long and unpredictable course. Because no randomised therapeutic trials are available, the treatment of RP remains mainly empirical...
April 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27886616/serial-fdg-pet-scans-help-to-identify-steroid-resistance-in-cardiac-sarcoidosis
#7
Abhijeet B Shelke, Hrushikesh U Aurangabadkar, Jason S Bradfield, Zakir Ali, K Shiv Kumar, Calambur Narasimhan
BACKGROUND: Cardiac sarcoidosis (CS) is increasingly being recognized. Immunosuppression with corticosteroids is the mainstay of therapy. But the optimal dose of steroids and how to assess response to therapy is not known. Prognosis is poor if these patients are untreated or undertreated. Fluorine-18-flurodeoxyglucose positron emission computed tomography ((18)FDG-PET CT) is a sensitive tool in diagnosing CS. It correlates closely with the level of granulomatous inflammation and can be used to monitor response to therapy...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27884795/forced-oscillation-technique-as-a-predictor-of-fev1-improvement-in-asthma
#8
Taisuke Akamatsu, Toshihiro Shirai, Yukiko Shimoda, Takahito Suzuki, Ichiro Hayashi, Rie Noguchi, Eisuke Mochizuki, Shogo Sakurai, Mika Saigusa, Akito Yamamoto, Yuichiro Shishido, Takefumi Akita, Satoru Morita, Kazuhiro Asada
The usefulness of the forced oscillation technique (FOT) for predicting the treatment outcomes in untreated asthmatic patients is unknown. We investigated whether FOT could predict an improvement in FEV1 following treatment. FOT, spirometry, and fractional exhaled nitric oxide were performed in 31 outpatients before and after undergoing a minimum of two months combination therapy of inhaled corticosteroids and long-acting β2-agonists. The patients were classified as responders or nonresponders to treatment based on the presence or absence of a 10% improvement in the FEV1...
November 21, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27884537/-nephrotic-syndrome-complicated-by-chylous-ascites-in-a-girl-of-2%C3%A2-years-and-8%C3%A2-months-old
#9
J R Mabiala Babela, L C Ollandzobo Ikobo, R Loumingou, E R Nika, A Mouko
We report on a case of nephrotic syndrome with focal and segmental hyalinosis complicated by chylous ascites in a girl of 2 years and 8 months old. This pure nephrotic syndrome in its early stage was initially treated with intensive steroid treatment at 2mg/kg/day orally for 2 months, followed by a bolus of methylprednisolone. The persistence of proteinuria meant corticosteroid resistance. Renal biopsy then revealed focal and segmental hyalinosis. A recurrence of the edema-ascites syndrome was associated with macroscopic hematuria...
November 21, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27878318/-corticosteroids-in-the-management-of-advanced-prostate-cancer
#10
H Kübler
Corticosteroids have been widely used for decades in cancer therapy, predominantly due to their anti-inflammatory activity. In the treatment of metastatic castration-resistant prostate cancer (mCRPC), corticosteroids play an important role both in the management of tumor-related symptoms, especially bone metastasis-related pain, and as concomitant treatment to counteract side effects associated with approved active prostatic anticancer agents such as docetaxel, cabazitaxel, and abiraterone acetate. In association with abiraterone acetate, low-dose corticosteroids (prednisone or prednisolone) reduce the mineralocorticoid side effects of abiraterone...
November 22, 2016: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/27861348/central-nervous-system-nocardiosis-in-queensland-a-report-of-20-cases-and-review-of-the-literature
#11
Nastaran Rafiei, Anna Maria Peri, Elda Righi, Patrick Harris, David L Paterson
Nocardia infection of the central nervous system (CNS) is an uncommon but clinically important disease, often occurring in immunocompromised individuals and carrying a high mortality rate. We present 20 cases of microbiologically proven CNS nocardiosis diagnosed in Queensland from 1997 to 2015 and review the literature from 1997 to 2016.Over 50% of cases occurred in immunocompromised individuals, with corticosteroid use posing a particularly significant risk factor. Nine (45%) patients were immunocompetent and 3 had no comorbidities at time of diagnosis...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27860166/treatment-of-antiviral-resistant-recurrent-erythema-multiforme-with-dapsone
#12
Allen S W Oak, Lucia Seminario-Vidal, Naveed Sami
Recurrent erythema multiforme (REM) is a chronic disease characterized by frequent episodes of target cutaneous lesions in an acral distribution. Conventional treatment includes systemic corticosteroids and antiviral therapy. The aim of this study was to evaluate dapsone as a potential steroid sparing-agent for the treatment of REM after a failed trial of at least one antiviral therapy (acyclovir, famciclovir, or valacyclovir). A retrospective chart review was conducted on thirteen patients with a diagnosis of REM who underwent treatment with dapsone after failing at least one antiviral therapy...
November 18, 2016: Dermatologic Therapy
https://www.readbyqxmd.com/read/27853364/curcumin-modulates-the-effect-of-histone-modification-on-the-expression-of-chemokines-by-type-ii-alveolar-epithelial-cells-in-a-rat-copd-model
#13
Lixing Gan, Chengye Li, Jian Wang, Xuejun Guo
BACKGROUND: Studies have suggested that histone modification has a positive impact on various aspects associated with the progression of COPD. Histone deacetylase 2 (HDAC2) suppresses proinflammatory gene expression through deacetylation of core histones. OBJECTIVE: To investigate the effect of histone modification on the expression of chemokines in type II alveolar epithelial cells (AEC II) in a rat COPD model and regulation of HDAC2 expression by curcumin in comparison with corticosteroid...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27852250/impaired-anti-inflammatory-action-of-glucocorticoid-in-neutrophil-from-patients-with-steroid-resistant-asthma
#14
Meijia Wang, Pengfei Gao, Xiaojie Wu, Yuetao Chen, Yikuan Feng, Qun Yang, Yongjian Xu, Jianping Zhao, Jungang Xie
BACKGROUND: Steroid resistant (SR) asthma is characterized by persistent airway inflammation that fails to resolve despite treatment with high doses of corticosteroids. Furthermore, SR patient airways show increased numbers neutrophils, which are less responsive to glucocorticoid. The present study seeks to determine whether dexamethasone (DEX) has different effect on neutrophils from steroid sensitive (SS) asthmatics compared to SR asthmatics. METHODS: Adults with asthma (n = 38) were classified as SR or SS based on changes in lung FEV1% following a one-month inhaled corticosteroid (ICS) treatment...
November 16, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27848200/vancomycin-induced-thrombocytopenia-a-narrative-review
#15
REVIEW
Mehdi Mohammadi, Zahra Jahangard-Rafsanjani, Amir Sarayani, Molouk Hadjibabaei, Maryam Taghizadeh-Ghehi
Thrombocytopenia has been reported as an adverse reaction of numerous drugs. Vancomycin is often overlooked as a culprit but has been associated with several cases of thrombocytopenia that were not well described in the literature. A literature search was conducted to find reports of thrombocytopenia induced by vancomycin. Biomedical databases including 'PubMed', 'Scopus', and 'Web of Science' were searched using terms 'vancomycin', 'platelet', 'pancytopenia', 'thrombocytopenia', and 'bleeding'. English language articles published before July 2015 were included...
November 15, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/27835947/successful-treatment-of-severe-pneumocystis-pneumonia-in-an-immunosuppressed-patient-using-caspofungin-combined-with-clindamycin-a-case-report-and-literature-review
#16
Hongjuan Li, Haoming Huang, Hangyong He
BACKGROUND: Pneumocystis jirovecii is responsible for Pneumocystis pneumonia (PCP), which occurs almost exclusively in immunocompromised individuals. Trimethoprim-sulfamethoxazole (TMP-SMZ) is regarded as the first-line treatment and prophylaxis for P. jirovecii infection, but the frequency of adverse reactions and newly emerged antibiotic resistance limit its use. CASE PRESENTATION: Ulcerations and hemorrhages involving the tongue were noted secondary to TMP-SMZ desensitization against PCP in a 46-year-old male who had previously been diagnosed with IgA nephropathy and sustained prolonged corticosteroid therapy...
November 11, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27826062/characteristics-aetiology-antimicrobial-resistance-and-outcomes-of-bacteraemic-cholangitis-in-patients-with-solid-tumours-a-prospective-cohort-study
#17
C Royo-Cebrecos, C Gudiol, J García, F Tubau, J Laporte, C Ardanuy, M Antonio, M Marin, J B Gornals, J Carratalà
OBJECTIVES: To asses the clinical features, aetiology, antimicrobial resistance and outcomes of bacteraemic cholangitis in patients with solid tumours (ST). METHODS: All consecutive episodes of bacteraemia in hospitalized patients were prospectively analysed (2006-2015). RESULTS: Of 1852 episodes of bacteraemia, 750 involved patients with ST. Among them, 173 episodes (23%) were due to cholangitis. The most frequent neoplasms were hepato-biliary-pancreatic tumours (68...
November 5, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27825347/non-neuronal-cholinergic-system-contributes-to-corticosteroid-resistance-in-chronic-obstructive-pulmonary-disease-patients
#18
Javier Milara, Angela Cervera, Alfredo de Diego, Celia Sanz, Gustavo Juan, Amadeu Gavaldà, Montserrat Miralpeix, Esteban Morcillo, Julio Cortijo
BACKGROUND: Inhaled corticosteroid (ICS) with long-acting beta-2 agonists is a well-documented combination therapy for chronic obstructive pulmonary disease (COPD) based on its additive anti-inflammatory properties. By contrast, the recommendation of ICS in combination with long-acting muscarinic antagonist (LAMA) is not evidence-based. In this study, neutrophils obtained from COPD patients were used to compare the anti-inflammatory effects of aclidinium bromide (a long-acting muscarinic antagonist) with corticosteroids and their potential additive effect...
November 8, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27825009/effect-of-anakinra-on-recurrent-pericarditis-among-patients-with-colchicine-resistance-and-corticosteroid-dependence-the-airtrip-randomized-clinical-trial
#19
Antonio Brucato, Massimo Imazio, Marco Gattorno, George Lazaros, Silvia Maestroni, Mara Carraro, Martina Finetti, Davide Cumetti, Alessandra Carobbio, Nicolino Ruperto, Renzo Marcolongo, Monia Lorini, Alessandro Rimini, Anna Valenti, Gian Luca Erre, Maria Pia Sormani, Riccardo Belli, Fiorenzo Gaita, Alberto Martini
Importance: Anakinra, an interleukin 1β recombinant receptor antagonist, may have potential to treat colchicine-resistant and corticosteroid-dependent recurrent pericarditis. Objective: To determine the efficacy of anakinra for colchicine-resistant and corticosteroid-dependent recurrent pericarditis. Design, Setting, and Participants: The Anakinra-Treatment of Recurrent Idiopathic Pericarditis (AIRTRIP) double-blind, placebo-controlled, randomized withdrawal trial (open label with anakinra followed by a double-blind withdrawal step with anakinra or placebo until recurrent pericarditis occurred) conducted among 21 consecutive patients enrolled at 3 Italian referral centers between June and November 2014 (end of follow-up, October 2015)...
November 8, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27808261/community-acquired-bacterial-meningitis
#20
Diederik van de Beek, Matthijs Brouwer, Rodrigo Hasbun, Uwe Koedel, Cynthia G Whitney, Eelco Wijdicks
Meningitis is an inflammation of the meninges and subarachnoid space that can also involve the brain cortex and parenchyma. It can be acquired spontaneously in the community - community-acquired bacterial meningitis - or in the hospital as a complication of invasive procedures or head trauma (nosocomial bacterial meningitis). Despite advances in treatment and vaccinations, community-acquired bacterial meningitis remains one of the most important infectious diseases worldwide. Streptococcus pneumoniae and Neisseria meningitidis are the most common causative bacteria and are associated with high mortality and morbidity; vaccines targeting these organisms, which have designs similar to the successful vaccine that targets Haemophilus influenzae type b meningitis, are now being used in many routine vaccination programmes...
November 3, 2016: Nature Reviews. Disease Primers
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