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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/27882879/treatment-of-chronic-spontaneous-urticaria-with-an-inadequate-response-to-h1-antihistamines-an-expert-opinion
#2
Christian Vestergaard, Elias Toubi, Marcus Maurer, Massimo Triggiani, Barbara Ballmer-Weber, Alexander Marsland, Marta Ferrer, André Knulst, Ana Giménez-Arnau
Chronic spontaneous urticaria (CSU) is characterized by the sudden, continuous or intermittent appearance of pruritic wheals (hives), angioedema, or both for six weeks or more, with no known specific trigger. The international EAACI/GA(2)LEN/EDF/WAO urticaria guideline advises standard-dose, second-generation H1-antihistamines as first-line therapy. However, H1-antihistamine treatment leads to absence of symptoms in fewer than 50% of patients. Updosing of second-generation H1-antihistamines (up to fourfold) as recommended by the EAACI/GA(2)LEN/EDF/WAO urticaria guideline as second-line therapy, can improve response, but many patients remain symptomatic...
November 23, 2016: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/27882559/lipiodol-does-not-affect-the-tissue-distribution-of-intravenous-doxorubicin-infusion-in-pigs
#3
Elsa Lilienberg, Ilse R Dubbelboer, Erik Sjögren, Hans Lennernäs
OBJECTIVES: In liver cancer treatment, lipiodol is used as a pharmaceutical excipient to improve delivery of the cytostatic drug doxorubicin (DOX). As DOX and its metabolite doxorubicinol (DOXol) cause serious off-target adverse effects, we investigated the effects of drug-free lipiodol or ciclosporin (CsA) on the tissue distribution (Kp ) of DOX and DOXol in relevant pig tissues. METHODS: Four treatment groups (TI-TIV) all received an intravenous DOX solution at 0 and 200 min...
November 23, 2016: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/27868221/what-s-new-in-atopic-eczema-an-analysis-of-systematic-reviews-published-in-2014-part-2-treatment-and-prevention
#4
REVIEW
A Lloyd-Lavery, N K Rogers, S J Hatfield, D Grindlay, R Barnett, K S Thomas
This review forms part of a series of annual updates that summarize the evidence base for atopic eczema (AE). It provides a summary of key findings from 12 systematic reviews (SRs) that were published or indexed during 2014, and focuses on the treatment and prevention of AE. For an update of SRs on the epidemiology, mechanisms of disease and methodological issues, see Part 1 of this update. Although phototherapy and various systemic medications (including ciclosporin, azathioprine and methotrexate) are commonly used to treat AE, many of these have not been robustly assessed in head-to-head randomized controlled trials...
November 21, 2016: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/27862987/einsatz-und-wirksamkeit-von-systemtherapien-bei-erwachsenen-mit-schwerer-neurodermitis-erste-ergebnisse-des-deutschen-neurodermitis-registers-treatgermany
#5
Jochen Schmitt, Susanne Abraham, Freya Trautmann, Victoria Stephan, Regina Fölster-Holst, Bernhard Homey, Thomas Bieber, Natalija Novak, Michael Sticherling, Matthias Augustin, Andreas Kleinheinz, Peter Elsner, Stephan Weidinger, Thomas Werfel
HINTERGRUND: Versorgungsregister dienen der Erfassung des Einsatzes und der Wirksamkeit von Therapien unter realen Versorgungsbedingungen und sind als Basis einer evidenzbasierten Gesundheitsversorgung unverzichtbar. METHODIK: Das deutsche Neurodermitis-Register TREATgermany wurde als weltweit erstes Register für Patienten mit schwerer Neurodermitis 2011 initiiert. Erwachsene mit schwerer Neurodermitis (aktuelle/frühere antientzündliche Systemtherapie und/oder objektiver SCORAD ≥ 40) werden über einen Zeitraum von 24 Monaten prospektiv beobachtet...
November 10, 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27861314/effect-of-the-direct-oral-anticoagulants-rivaroxaban-and-apixaban-on-the-disposition-of-calcineurin-inhibitors-in-transplant-recipients
#6
Thomas Vanhove, Isabel Spriet, Pieter Annaert, Johan Maertens, Johan Van Cleemput, Robin Vos, Dirk Kuypers
BACKGROUND: Calcineurin inhibitors (CNIs) and direct oral anticoagulants (DOACs) share certain metabolic pathways, but whether DOACs influence CNI exposure has not been assessed. METHODS: A single-center retrospective analysis was performed including 39 organ recipients treated with the combination of a CNI and rivaroxaban (n = 29) or apixaban (n = 10). Dose-corrected CNI trough concentrations (C0/D) during 200 days before and after DOAC initiation were recorded (n = 261), together with covariates known to influence CNI disposition such as steroid dose and hematocrit...
November 17, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27820833/multiparametric-functional-mri-a-tool-to-uncover-subtle-changes-following-allogeneic-renal-transplantation
#7
Mike Notohamiprodjo, Aivars Kalnins, Martin Andrassy, Manuel Kolb, Benjamin Ehle, Susanna Mueller, Michael N Thomas, Jens Werner, Markus Guba, Konstantin Nikolaou, Joachim Andrassy
PURPOSE: To investigate multiparametric functional MRI to characterize acute rejection in a murine allogeneic renal transplant model and evaluate the effect of novel therapeutics. MATERIAL AND METHODS: We performed allogeneic and syngeneic orthotopic transplantations (Balb/c to C57Bl/6 and C57Bl/6 to C57Bl/6). Allogeneic Groups (n = 5) were either treated with the anti-CCL2-Spiegelmer (mNOX-E36) in monotherapy or in combination with low doses of Ciclosporin-A (10mg/kgBW/d) for 10 days...
2016: PloS One
https://www.readbyqxmd.com/read/27812112/systematic-review-and-meta-analysis-of-tacrolimus-versus-ciclosporin-as-primary-immunosuppression-after-liver-transplant
#8
Gorden Muduma, Rhodri Saunders, Isaac Odeyemi, Richard F Pollock
BACKGROUND AND AIMS: Several meta-analyses comparing ciclosporin with tacrolimus have been conducted since the 1994 publication of the tacrolimus registration trials, but most captured data from randomized controlled trials (RCTs) predating recent improvements in waiting list prioritization, induction protocols and concomitant medications. The present study comprised a systematic review and meta-analysis of ciclosporin and tacrolimus in liver transplant recipients using studies published since January 2000...
2016: PloS One
https://www.readbyqxmd.com/read/27801486/focal-segmental-glomerulosclerosis-in-children
#9
Manel Jellouli, Kamel Abidi, Mouna Askri, Meriem Ferjani, Ouns Naija, Yousra Hammi, Rym Goucha, Tahar Gargah
Background Focal segmental glomerulosclerosis (FSGS) represents 20% of nephrotic syndrome in children. The clinical course and prognosis is heterogeneous in children. The aim of this study was to analyze treatment and outcome of children with FSGS. Methods This retrospective study was conducted in the Department of Pediatrics in Charles Nicolle Hospital during a 15-year period (1996-2010). Results There were 30 children, 16 boys and 14 girls. The mean age was 7 ± 4 years. Nephrotic syndrome was observed in 26 patients, hematuria was noticed in 2 patients and renal insufficiency was detected in 2 patients at presentation...
May 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/27793869/example-of-the-drug-interaction-between-ciclosporin-and-orlistat-resulting-in-relapse-of-evan-s-syndrome
#10
Irina Earnshaw, Jecko Thachil
A man aged 35 years with a history of Evan's syndrome presented to the clinic with jaundice and shortness of breath, with further testing indicating a relapse of his previously well-controlled condition, for which he was taking ciclosporin. This followed shortly after he had started taking orlistat to prevent weight gain from a course of steroids, and once the orlistat was stopped, his platelets began to rise. The patient required 4 months of steroid treatment before his platelet levels finally stabilised and he could be put back on his regular medicine regime...
October 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27754526/-current-status-and-regulation-of-bioanalytical-laboratories-engaged-in-quantifying-immunosuppressants-for-transplant-patients-in-argentina
#11
Paula Schaiquevich, Paula Taich, Natalia Riva, Francisco Leone, Nora Paternoster, Gabriel Mato, Paulo Cáceres Guido
Objective Determine the status of analytical laboratories that quantify immunosuppressants in transplant patients who are under therapeutic drug monitoring (TDM) for these drugs in Argentina in order to identify potential perfectible areas for action. Methods A survey of the clinical and analytical TDM centers in Argentina was conducted between September 2013 and November 2014 under the direction of the Garrahan Hospital Clinical Pharmacokinetics Unit and the National Unified Central Institute for Ablation and Implant Coordination...
March 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/27748705/the-impact-of-total-gastrectomy-on-pharmacokinetics-in-kidney-transplant-immunosuppressive-drug-regimes-a-case-study
#12
Lucy Chen, Lisa Liberatore, Tom Chin, Scott Walker, Helen Fanous, Michelle M Nash, Lindita Rapi, Jennie Huckle, Jeffrey S Zaltzman, G V Ramesh Prasad
BACKGROUND: Ensuring reliable gastrointestinal drug absorption of orally-administered immunosuppressive medications posttransplant is critical to ensuring graft survival. METHODS: A 66 year old man of East Asian origin with a previous total gastrectomy was evaluated for living donor kidney transplantation. Pretransplant pharmacokinetic testing was performed to determine the most appropriate posttransplant medication strategy. The Gastrointestinal Quality of Life Index and Gastrointestinal Rating Scale questionnaires were administered to gauge immunosuppressive medication-related side effects in the absence of a stomach...
September 29, 2016: Transplantation
https://www.readbyqxmd.com/read/27747960/clinical-and-microscopic-features-of-generalized-discoid-lupus-erythematosus-in-dogs-10-cases
#13
Frane Banovic, Keith E Linder, Maarja Uri, Michael A Rossi, Thierry Olivry
BACKGROUND: Generalized discoid lupus erythematosus (GDLE) is a newly recognized canine variant of chronic cutaneous lupus erythematosus (CLE) that is not well characterized. HYPOTHESIS/OBJECTIVES: We report herein the signalment, clinical signs, treatment outcome, histopathology and immunological findings of 10 dogs with GDLE. METHODS: Inclusion criteria were: (i) a >3 month history of generalized skin lesions indicating a chronic or recurrent nature; (ii) skin lesions resembling those of human GDLE; (iii) histopathology of CLE (lymphocyte-rich interface dermatitis)...
December 2016: Veterinary Dermatology
https://www.readbyqxmd.com/read/27680225/a-case-of-intravenous-immunoglobulin-dependent-chronic-inflammatory-demyelinating-polyneuropathy-of-pure-motor-form-responsive-to-mycophenolate-mofetil-therapy
#14
Motomi Arai
This report concerns a case of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with frequent treatment-dependent relapses. A 75-year-old male presented with a 2-month history of progressive weakness of the limbs with no sensory symptoms. Neurological examination revealed normal cranial nerves, MRC grade 4 power in the proximal and distal muscles of the limbs, and generalized areflexia. However, the sensory examination results, serum immunoelectrophoresis, anti-HIV antibody, and vitamins B1 and B12 levels were normal...
October 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27644142/alopecia-universalis-in-a-dog-with-testicular-neoplasia
#15
Catherine A Outerbridge, Stephen D White, Verena K Affolter
OBJECTIVE: To describe a case of testicular neoplasia and alopecia universalis in a dog, and successful treatment of the latter with ciclosporin. ANIMAL: Twelve-year-old intact male wirehaired fox terrier. METHODS: Castration, skin biopsy for histopathology, lymphocyte immunophenotyping and clonality analysis of the canine T-cell receptor gamma locus (TCRγ) rearrangement. RESULTS: The dog presented with symmetrical generalized alopecia...
December 2016: Veterinary Dermatology
https://www.readbyqxmd.com/read/27620209/in-vitro-influence-of-mycophenolate-mofetil-mmf-and-ciclosporin-a-csa-on-cytokine-induced-killer-cik-cell-immunotherapy
#16
Melanie Bremm, Sabine Huenecke, Olga Zimmermann, Verena Pfirrmann, Andrea Quaiser, Halvard Bonig, Jan Soerensen, Thomas Klingebiel, Eva Rettinger, Peter Bader, Claudia Cappel
BACKGROUND: Cytokine-induced-killer (CIK) cells are a promising immunotherapeutic approach for impending relapse following hematopoietic stem cell transplantation (HSCT). However, there is a high risk for treatment failure associated with severe graft versus host disease (GvHD) necessitating pharmaceutical intervention post-transplant. Whether immunosuppression with mycophenolate mofetil (MMF) or Ciclosporin A (CsA) influences the cytotoxic effect of CIK cell immunotherapy is still an open issue...
2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27614385/-history-of-kidney-transplantation-surgery
#17
M O Timsit, F Kleinclauss, R Thuret
OBJECTIVES: To perform a state of the art about the history of kidney transplantation. MATERIAL AND METHODS: An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords (MESH): kidney transplantation, history, vascular anastomosis. RESULTS: From the first vascular ligations to the discovery of ciclosporin, the history of organ transplantation was made of surgical bets and medical discoveries, such as blood group, HLA-system, immunity, etc...
September 7, 2016: Progrès en Urologie
https://www.readbyqxmd.com/read/27595142/infliximab-versus-ciclosporin-for-steroid-resistant-acute-severe-ulcerative-colitis-construct-a-mixed-methods-open-label-pragmatic-randomised-trial
#18
John G Williams, M Fasih Alam, Laith Alrubaiy, Ian Arnott, Clare Clement, David Cohen, John N Gordon, A Barney Hawthorne, Mike Hilton, Hayley A Hutchings, Aida U Jawhari, Mirella Longo, John Mansfield, Jayne M Morgan, Frances Rapport, Anne C Seagrove, Shaji Sebastian, Ian Shaw, Simon P L Travis, Alan Watkins
BACKGROUND: Infliximab and ciclosporin are of similar efficacy in treating acute severe ulcerative colitis, but there has been no comparative evaluation of their relative clinical effectiveness and cost-effectiveness. METHODS: In this mixed methods, open-label, pragmatic randomised trial, we recruited consenting patients aged 18 years or older at 52 district general and teaching hospitals in England, Scotland, and Wales who had been admitted, unscheduled, with severe ulcerative colitis and failed to respond to intravenous hydrocortisone within about 5 days...
September 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27591328/con-the-use-of-calcineurin-inhibitors-in-the-treatment-of-lupus-nephritis
#19
Maria Fernandez Nieto, David R Jayne
Lupus nephritis (LN) therapy has limited efficacy due to its toxicity, and LN patients suffer high risks of renal and cardiovascular morbidity and mortality. Calcineurin inhibitors (CNIs) have been used for over >30 years in LN treatment and are an established alternative therapy for Class V nephritis, but uncertainty remains about their role in proliferative disease or in the maintenance of remission. More recently, the combination of CNIs with mycophenolate mofetil (MMF) and glucocorticoid combination therapy, 'multitarget' therapy and the use of tacrolimus as opposed to ciclosporin has received attention...
October 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27580687/acute-severe-ulcerative-colitis-from-pathophysiology-to-clinical-management
#20
Pieter Hindryckx, Vipul Jairath, Geert D'Haens
Ulcerative colitis is a common chronic inflammatory disease of the colon and rectum, resulting from a dysregulated immune response towards intraluminal antigens in a genetically predisposed host. The disease has a varying extent and severity. Approximately 20% of patients with ulcerative colitis experience a severe flare during the course of their disease, requiring hospitalization. Acute severe ulcerative colitis (ASUC) is potentially a life-threatening condition that requires early recognition, hospitalization, correction of body fluids and electrolytes, and nutritional support if needed...
November 2016: Nature Reviews. Gastroenterology & Hepatology
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