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https://www.readbyqxmd.com/read/28655057/evaluating-surgeon-specific-performance-for-endoscopic-sinus-surgery
#1
Luke Rudmik, Yuan Xu, Jeremiah A Alt, Adam Deconde, Timothy L Smith, Rodney J Schlosser, Hude Quan, Zachary M Soler
Importance: Several identified factors have raised questions concerning the quality of care for endoscopic sinus surgery (ESS), including the presence of large geographic variation in the rates and extent of surgery, poorly defined indications, and lack of ESS-specific quality metrics. Combined with the risk of major complications, ESS represents a high-value target for quality improvement. Objective: To evaluate differences in surgeon-specific performance for ESS using a risk-adjusted, 5-year ESS revision rate as a quality metric...
June 22, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28654928/risk-stratification-of-patients-with-crohn-s-disease-a-retrospective-analysis-of-clinical-decision-making-and-its-impact-on-long-term-outcome
#2
Mahmoud Mosli, Hanadi Sabbahi, Hind Alyousef, Mada Abdulhaq, Afnan Hadadi, Emad Aljahdali, Hani Jawa, Salem Bazarah, Yousif Qari
BACKGROUND AND AIMS: Complications such as need for bowel resections and hospitalization due to Crohn's disease (CD) occur when disease activity persists due to ineffective therapy. Certain "high-risk" features require an early introduction of anti-tumor necrosis factor-α therapy to prevent such complications. We aim to evaluate the prevalence of "high-risk" features among a cohort of patients with CD and examine the association between discordance of early therapy with baseline risk stratification and disease outcome...
June 28, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/28654710/nonpharmacologic-strategies-and-topical-agents-for-treating-atopic-dermatitis-an-update
#3
Linda F Stein Gold, Lawrence F Eichenfield
The signs and symptoms of atopic dermatitis can be safely and effectively controlled in most patients; in many cases, the disease can be improved to the point that signs and symptoms are absent or minimal. In addition, flares can be effectively controlled and, in some cases, prevented. New topical medications, improved strategies for the use of topical corticosteroids and topical calcineurin inhibitors, and judicious use of nonpharmacologic regimens-including bathing, bleach baths, and early use of emollients-have led to better disease management and improved quality of life for patients and their families...
March 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28654461/natural-history-pathogenesis-and-treatment-of-evans-syndrome-in-children
#4
Elpis Mantadakis, Evangelia Farmaki
Primary Evans syndrome (ES) is defined by the concurrent or sequential occurrence of immune thrombocytopenia and autoimmune hemolytic anemia in the absence of an underlying etiology. The syndrome is characterized by a chronic, relapsing, and potentially fatal course requiring long-term immunosuppressive therapy. Treatment of ES is hardly evidence-based. Corticosteroids are the mainstay of therapy. Rituximab has emerged as the most widely used second-line treatment, as it can safely achieve high response rates and postpone splenectomy...
June 26, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28654132/henoch-sch%C3%A3-nlein-purpura-a-literature-review
#5
Liv Eline Hetland, Kjærsti Sørensen Susrud, Kim Hein Lindahl, Anette Bygum
Henoch-Schönlein purpura is the most common childhood vasculitis, but may also affect adults. This article reviews the literature since 2011 on advances in diagnosis, clinical disease manifestations, pathophysiology and treatment of Henoch-Schönlein purpura. The clinical manifestations are thought to arise from IgA depositions in blood vessel walls in the affected organs, mostly skin, gastrointestinal tract, joints and kidneys. Corticosteroids may be effective in rapid resolution of renal manifestations and treating joint and abdominal pain, but they are not proven effective for treating organ manifestations and complications, such as glomerulonephritis, bowel infarction or intussusception...
June 27, 2017: Acta Dermato-venereologica
https://www.readbyqxmd.com/read/28653747/pharmacological-treatment-of-orofacial-pain-health-technology-assessment-including-a-systematic-review-with-network-meta-analysis
#6
REVIEW
B Häggman-Henrikson, P Alstergren, T Davidson, Ed Högestätt, P Östlund, S Tranaeus, S Vitols, T List
This health technology assessment evaluated the efficacy of pharmacological treatment in patients with orofacial pain. Randomised controlled trials were included if they reported pharmacological treatment in patients ≥18 years with chronic (≥3 months) orofacial pain. Patients were divided into subgroups: TMD-muscle [Temporomandibular disorders (TMD) mainly associated with myalgia]; TMD-joint (TMD mainly associated with temporomandibular joint pain); and Burning mouth syndrome (BMS). The primary outcome was pain intensity reduction after pharmacological treatment...
June 27, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28653264/survival-analysis-of-patients-with-systemic-lupus-erythematosus-in-a-tertiary-hospital-in-southern-brazil
#7
Jordana Vaz Hendler, Lucian de Souza, Daniele Corrêa de Freitas Zernow, Juliano Guimarães, Thiago Bertotto, Carla Forgiarini Saldanha, João Carlos Tavares Brenol, Odirlei André Monticielo
Systemic lupus erythematosus (SLE) treatments progress over the years. However, the mortality remains higher than in the general population. Few studies have examined SLE patients' survival in Brazil. This study aims to identify the main characteristics and risk factors to predict mortality and recognize the main causes of death in Brazilian patients with SLE. We retrospectively assessed clinical, demographic, and serological characteristics from 600 patients followed since 2001 in SLE outpatient clinic from Hospital de Clínicas de Porto Alegre...
June 26, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28652962/cryptogenic-organising-pneumonia-presenting-with-spontaneous-pneumothorax-and-the-value-of-procalcitonin-a-case-report
#8
Chong Kang, Yusuf Vali, Muhammad Naeem, Raja Reddy
Cryptogenic Organising Pneumonia (COP) is a relatively rare condition and can be difficult to differentiate from Community acquired pneumonia (CAP). We report two cases which demonstrate the importance of considering this differential diagnosis in patients with spontaneous pneumothorax who have raised inflammatory markers or lung infiltrates. Our report highlights the value of serum procalcitonin as a biomarker in differentiating between community acquired pneumonia and cryptogenic organising pneumonia especially in the context of a high serum C-reactive protein...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28652903/complete-clearance-of-resistant-granuloma-faciale-with-pulsed-dye-laser-after-pre-treatment-with-mometasone-and-tacrolimus
#9
Daniel Micallef, Michael J Boffa
Introduction: Granuloma faciale is an uncommon inflammatory dermatosis which usually affects the face and is often resistant to treatment. Case Report: A 39-year-old English lady with Fitzpatrick skin phototype II presented with typical lesions of granuloma faciale, confirmed on biopsy, on her cheeks and nose. Treatment with ScleroPlus pulsed dye laser (Candela Corporation, Wayland, Mass) produced no visible improvement. The patient re-presented 5 years later with the same lesions, now more prominent. No improvement was noted with topical mometasone, however addition of topical tacrolimus caused significant flattening...
2017: Journal of Lasers in Medical Sciences
https://www.readbyqxmd.com/read/28652823/optic-perineuritis-a-retrospective-case-series
#10
Olle Bergman, Tommy Andersson, Madeleine Zetterberg
Optic perineuritis (OPN) is a rare inflammatory disorder involving the optic nerve sheath characterized by visual loss. OPN may be isolated and idiopathic or part of an underlying disorder. This case series aimed to help clinicians investigate and manage this disorder. Presentation, clinical findings, and treatment of OPN are discussed. After review of medical records at the ophthalmology clinic at Sahlgrenska University hospital in Gothenburg, Sweden, seven OPN patients (three men and four women) were identified and included in the present case series...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28652697/efficacy-and-safety-of-a-3-month-loteprednol-etabonate-0-5-gel-taper-for-routine-prophylaxis-after-photorefractive-keratectomy-compared-to-a-3-month-prednisolone-acetate-1-and-fluorometholone-0-1-taper
#11
Mark D Mifflin, Brent S Betts, P Adam Frederick, Jason M Feuerman, Carlton R Fenzl, Majid Moshirfar, Brian Zaugg
PURPOSE: To compare the outcome of photorefractive keratectomy (PRK) and complications in patients treated with either loteprednol etabonate 0.5% gel or prednisolone acetate 1% suspension and fluorometholone (fml) 0.1% suspension. SETTING: John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA. DESIGN: Prospective, randomized, partially masked trial. METHODS: PRK was performed on 261 eyes of 132 participants...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28652675/eosinophilic-myocarditis-and-hypereosinophilic-syndrome
#12
Hanane Boussir, Amine Ghalem, Nabila Ismaili, Noha El Ouafi
Hypereosinophilic syndrome (HES) is a heterogeneous group of hematological disorders characterized by a chronic, unexplained hypereosinophilia with tissue damage. Cardiac involvement occurs in ∼20% of patients with HES and represents a major turning point. Cardiac injuries related to eosinophilia are divided into three chronological phases: eosinophilic infiltration, thrombosis, and fibrosis. We report a case of a 33-year-old woman diagnosed with HES, with pulmonary and gastrointestinal involvement and eosinophilic myocarditis in cardiogenic shock...
July 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28651591/the-cost-of-systemic-corticosteroid-induced-morbidity-in-severe-asthma-a-health-economic-analysis
#13
L E Barry, J Sweeney, C O'Neill, D Price, L G Heaney
BACKGROUND: Treatment of severe asthma may include high dose systemic-steroid therapy which is associated with substantial additional morbidity. This study estimates the additional healthcare costs associated with steroid-induced morbidity by comparing three patients groups: those with severe asthma, moderate asthma and no asthma. METHODS: Patients with severe asthma (n = 808, GINA step 5 treatment) were matched by age and gender with patients with mild/moderate asthma (n = 3,975, GINA step 2 and 3 treatment) and a non-asthma control cohort (with a diagnosis of rhinitis; n = 2,412) from the Optimum Patient Care Research Database (OPCRD), a nationally representative primary care database...
June 26, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28651515/statistical-analysis-plan-for-the-adjunctive-corticosteroid-treatment-in-critically-ill-patients-with-septic-shock-adrenal-trial
#14
Laurent Billot, Balasubramanian Venkatesh, John Myburgh, Simon Finfer, Jeremy Cohen, Steve Webb, Colin McArthur, Christopher Joyce, Rinaldo Bellomo, Andrew Rhodes, Anders Perner, Yaseen Arabi, Dorrilyn Rajbhandari, Parisa Glass, Kelly Thompson, Maryam Correa, Meg Harward
BACKGROUND: The Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock (ADRENAL) trial, a 3800-patient, multicentre, randomised controlled trial, will be the largest study to date of corticosteroid therapy in patients with septic shock. OBJECTIVE: To describe a statistical analysis plan (SAP) and make it public before completion of patient recruitment and data collection. The SAP will be adhered to for the final data analysis of this trial, to avoid analysis bias arising from knowledge of study findings...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651262/relationship-of-radiographic-osteoarthritis-severity-with%C3%A2-treatment-outcomes-after-imaging-guided-knee%C3%A2-injections-a-prospective-outcomes-study
#15
Ivan Miletic, Christoph Agten, Reto Sutter, Christian Pfirrmann, Cynthia Peterson
Introduction To be able to predict which patients are more likely to have a positive treatment outcome, the purpose of this study is 1: To compare outcomes after intra-articular corticosteroid knee injections with the Kellgren and Lawrence (KL) 5 and 3 grading systems for knee osteoarthritis, the Osteoarthritis Research Society International (OARSI) grading system and actual joint space measurements; and 2: To compare the reliability of these grading systems. Materials and Methods Knee radiographs of 117 patients who received intra-articular corticosteroid injections were independently evaluated by two radiologists blinded to the outcome...
June 26, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28650927/dexamethasone-prevents-lipopolysaccharide-induced-epithelial-barrier-dysfunction-in-rat-ileum
#16
Aline Barbosa Ribeiro, Humberto Giusti, Ana Paula Trevelin Souza, Celso Rodrigues Franci, Rafael Simone Saia
Inflammatory mediators have been postulated as elementary inducing factors to the disruption of the intestinal tight junctions (TJ) and consequently, gut permeability and bacterial translocation. Corticosteroids are considered the mainstay in the treatment of septic shock; however the impact of this therapy on the intestinal epithelial barrier dysfunction during septic shock remains unknown. Our aims were to demonstrate the role of low dexamethasone (DEX) doses in modulation of the inflammatory response, as well as the expression and the arrangement of TJ proteins in endotoxemic rats...
June 23, 2017: Shock
https://www.readbyqxmd.com/read/28650749/comparative-effectiveness-of-radial-extracorporeal-shockwave-therapy-and-ultrasound-guided-local-corticosteroid-injection-treatment-for-plantar-fasciitis
#17
Sehriban Hocaoglu, Umit Erkan Vurdem, Mehtap Aykac Cebicci, Serap Tomruk Sutbeyaz, Zuhal Guldeste, Serap Gurek Yunsuroglu
BACKGROUND: We compared the long-term clinical and ultrasonographic effects of radial extracorporeal shockwave therapy (rESWT) versus ultrasound-guided corticosteroid injection treatment in patients with plantar fasciitis unresponsive to conservative therapy. METHODS: Seventy-two patients with unilateral plantar fasciitis were randomized to receive either rESWT (three times once per week) (n = 36) or corticosteroid treatment (a single 1-mL dose of betamethasone sodium plus 0...
May 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28650745/longer-duration-antimicrobial-therapy-does-not-prevent-treatment-failure-in-high-risk-patients-with-complicated-intra-abdominal-infections
#18
Taryn E Hassinger, Christopher A Guidry, Ori D Rotstein, Therese M Duane, Heather L Evans, Charles H Cook, Patrick J O'neill, John E Mazuski, Reza Askari, Lena M Napolitano, Nicholas Namias, Preston R Miller, E Patchen Dellinger, Raul Coimbra, Christine S Cocanour, Kaysie L Banton, Joseph Cuschieri, Kimberley Popovsky, Robert G Sawyer
BACKGROUND: Recent studies have suggested the length of treatment of intra-abdominal infections (IAIs) can be shortened without detrimental effects on patient outcomes. However, data from high-risk patient populations are lacking. We hypothesized that patients at high risk for treatment failure will benefit from a longer course of antimicrobial therapy. METHODS: Patients enrolled in the Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial were evaluated retrospectively to identify risk factors associated with treatment failure, which was defined as the composite outcome of recurrent IAI, surgical site infection, or death...
June 26, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28650720/nonclinical-development-of-env905-difluprednate-ophthalmic-implant-for-the-treatment-of-inflammation-and-pain-associated-with-ocular-surgery
#19
Rozemarijn S Verhoeven, Andres Garcia, RiLee Robeson, Brian C Gilger, David Culp, Craig Struble, Lee Hamm, Tomas Navratil, Benjamin Yerxa
PURPOSE: Topical corticosteroids are widely used in the treatment of inflammation and pain after ocular surgery, but they possess several shortcomings, including frequent dosing and low patient adherence. We evaluated the efficacy and pharmacokinetics of ENV905 (difluprednate or DFBA) Ophthalmic Implant, a single-dose drug delivery system, compared with 0.05% Durezol. METHODS: PRINT(®) technology was used to fabricate ENV905 implants for either intracameral (IC) or subconjunctival (SCJ) delivery of extended-release DFBA...
June 26, 2017: Journal of Ocular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28649293/small-airways-disease-and-severe-asthma
#20
REVIEW
Tara F Carr, Roula Altisheh, Myron Zitt
The small airways of the lungs are commonly affected in pediatric and adult asthma. Small airways disease has been related to asthma control, severity, and risk of exacerbation. Diagnosis of small airways disease can be best made through evaluation of surgical lung specimens. Noninvasive techniques including spirometry, plethysmography, nitrogen washout, impulse oscillometry, and cross-sectional imaging have been utilized to assess and infer the extent of small airways disease in asthma and can be used longitudinally to assess response to treatment...
2017: World Allergy Organization Journal
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