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https://www.readbyqxmd.com/read/27922741/how-do-dual-long-acting-bronchodilators-prevent-exacerbations-of-chronic-obstructive-pulmonary-disease
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27919560/posterior-ankle-impingement-syndrome-in-football-players-case-series-of-26-elite-athletes
#13
Savaş Kudaş, Gürhan Dönmez, Çetin Işık, Mesut Çelebi, Nurdan Çay, Murat Bozkurt
OBJECTIVE: To describe a clinical treatment algorithm for posterior ankle impingement (PAI) syndrome in professional football players. MATERIAL AND METHODS: A case series of 26 elite professional football players diagnosed and treated for posterior ankle impingement syndrome were included for the study. All of the athletes received conservative treatment with physical therapy modalities initially. If the first line medical treatment and rehabilitation was ineffective to alleviate the symptoms, ultrasound-guided corticosteroid injection was proposed and thereafter the patients underwent posterior ankle arthroscopy if the complaints are still unresolved...
December 3, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27919500/favorable-outcome-of-interferon-beta-associated-thrombotic-microangiopathy-following-treatment-with-corticosteroids-plasma-exchange-and-rituximab-a-case-report
#14
Lea M Gerischer, Eberhard Siebert, Oliver Janke, Gerhard Jan Jungehuelsing, Klemens Ruprecht
Thrombotic microangiopathy (TMA) is a rare but increasingly recognized complication of interferon-beta therapy, which can be associated with serious sequelae. We report on a 53-year-old woman with a longstanding history of relapsing-remitting multiple sclerosis, who developed TMA after 15 years of high-dose treatment with subcutaneous interferon-beta-1a. The patient presented with headaches, an epileptic seizure, confusion, and arterial hypertension. Laboratory findings included thrombocytopenia and hemolytic anemia...
November 2016: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/27919491/comparing-outcomes-from-clinical-studies-of-oral-disease-modifying-therapies-dimethyl-fumarate-fingolimod-and-teriflunomide-in-relapsing-ms-assessing-absolute-differences-using-a-number-needed-to-treat-analysis
#15
Mark S Freedman, Xavier Montalban, Aaron E Miller, Catherine Dive-Pouletty, Steven Hass, Karthinathan Thangavelu, Thomas P Leist
Dimethyl fumarate (DMF), fingolimod, and teriflunomide are oral disease-modifying therapies (DMTs) indicated for the treatment of relapsing-remitting multiple sclerosis. Despite well-established limitations of cross-trial comparisons, DMTs are still frequently compared in terms of relative reductions in specific endpoints, most commonly annualized relapse rate. Consideration of absolute risk reduction and number needed to treat (NNT) provides an alternative approach to assess the magnitude of treatment effect and can provide valuable additional information on therapeutic gain...
November 2016: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/27919456/risk-factors-and-prognosis-of-postpericardiotomy-syndrome-in-patients-undergoing-valve-surgery
#16
Dirk van Osch, Jan M Dieleman, Jeroen J Bunge, Diederik van Dijk, Pieter A Doevendans, Willem J Suyker, Hendrik M Nathoe
OBJECTIVE: The study aim was to investigate the long-term prognosis and risk factors of postpericardiotomy syndrome (PPS). METHODS: We performed a single-center cohort study in 822 patients undergoing nonemergent valve surgery. Risk factors of PPS were evaluated using multivariable logistic regression analysis. We also compared the incidence of reoperation for tamponade at 1 year between patients with and without PPS. Main secondary outcomes were hospital stay and mortality...
November 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27919193/treatment-of-giant-cell-arteritis-a-literature-review
#17
Bénédicte Watelet, Maxime Samson, Hubert de Boysson, Boris Bienvenu
Giant cells arteritis (GCA) is the most common vasculitis in people over 50 years. Despite the frequency of this disease, there is currently no international consensus on its therapeutic modalities. The aim of this study was to conduct a review of the international literature on the treatment of GCA, whatever the clinical pattern. Oral corticosteroids remain the cornerstone treatment, possibly preceded by intravenous bolus in complicated forms. In cases of glucocorticoid dependence or glucocorticoid-related side effects, a glucocorticoid-sparing agent may be necessary...
December 6, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27918884/acute-invasive-fungal-rhinosinusitis-presentation-of-19-cases-review-of-the-literature-and-a-new-classification-system
#18
Onur Ergun, Emel Tahir, Oguz Kuscu, Burce Ozgen, Taner Yilmaz
PURPOSE: The aim of this study was to determine the correlation between acute invasive fungal rhinosinusitis (AIFRS) and underlying diseases, micro-organisms, presenting symptoms, extent of disease, radiologic findings, and outcomes and propose a new classification system. MATERIALS AND METHODS: The data of 19 AIFRS cases were analyzed retrospectively. Magnetic resonance imaging and computed tomography were performed in all patients preoperatively. All patients underwent at least 1 surgical debridement...
November 15, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27918754/interventions-to-improve-rates-of-successful-extubation-in-preterm-infants-a-systematic-review-and-meta-analysis
#19
Kristin N Ferguson, Calum T Roberts, Brett J Manley, Peter G Davis
Importance: Clinicians aim to extubate preterm infants as early as possible, to minimize the risks of mechanical ventilation. Extubation is often unsuccessful owing to lung disease or inadequate respiratory drive. Objective: To conduct a systematic review and meta-analysis of interventions to improve rates of successful extubation in preterm infants. Data Sources: Searches were undertaken in PubMed and The Cochrane Library. Study Selection: The review was conducted using the methods of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
December 5, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27918377/utility-of-emergency-department-observation-units-for-neurologically-intact-children-with-head-ct-abnormalities-secondary-to-acute-closed-head-injury
#20
Roxanna Lefort, Jill V Hunter, Andrea T Cruz, A Chantal Caviness, Thomas G Luerssen, Aderonke Adekunle-Ojo
OBJECTIVE: The aim of the study was to evaluate the utility of the emergency department observation unit (EDOU) for neurologically intact children with closed head injuries (CHIs) and computed tomography (CT) abnormalities. METHODS: A retrospective cohort study of children aged 0 to 18 years with acute CHI, abnormal head CT, and a Glasgow Coma Scales score of 14 or higher admitted to the EDOU of a tertiary care children's hospital from 2007 to 2010. Children with multisystem trauma, nonaccidental trauma, and previous neurosurgical or coagulopathic conditions were excluded...
December 1, 2016: Pediatric Emergency Care
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