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Paradoxical worsening

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https://www.readbyqxmd.com/read/29766672/ribcage-deformity-and-the-altered-breathing-pattern-in-children-with-osteogenesis-imperfecta
#1
Antonella LoMauro, Paolo Fraschini, Simona Pochintesta, Marianna Romei, Maria G D'Angelo, Andrea Aliverti
AIM: Osteogenesis Imperfecta (OI) is a genetic disease characterized by bones fragility and progressive deformity. Life expectancy is reduced in the non-lethal most severe type III form before the age of 10 years. The main cause of death in OI is respiratory insufficiency resulting from impaired thoracic function worsened by ribcage deformity and scoliosis. METHODS: We used opto-electronic plethysmography to study chest geometry, the ventilatory, and the thoraco-abdominal pattern at rest in supine position in children younger than 10 years...
May 15, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29705819/paradoxical-pustular-psoriasis-induced-by-ustekinumab-in-a-patient-with-crohn-s-disease-associated-spondyloarthropathy
#2
REVIEW
Michael Benzaquen, Benoit Flachaire, Frank Rouby, Philippe Berbis, Sandrine Guis
Palmoplantar pustular psoriasis (PPP) is a clinical form of psoriasis, for which tumor necrosis factor alpha inhibitors (TNFi) or interleukins 12/23 inhibitor (ustekinumab) can be a therapeutic option. Paradoxical psoriatic reactions induced by TNFi are now well known. We present the exceptional case of a paradoxical PPP appeared under ustekinumab in a patient with Crohn's disease-associated spondyloarthropathy. A 58-year-old woman presented with recent peripheral inflammatory arthralgias appeared in the context of a Crohn's disease diagnosed in 2008...
April 28, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29601606/chronic-noise-exposure-exacerbates-insulin-resistance-and-promotes-the-manifestations-of-the-type-2-diabetes-in-a-high-fat-diet-mouse-model
#3
Lijie Liu, Yi Huang, Cong Fang, Hongyu Zhang, Jing Yang, Chuanying Xuan, Fanfan Wang, Haiying Lu, Shuangfeng Cao, Yongfang Wang, Shengwei Li, Jun Sha, Mingming Zha, Min Guo, Jian Wang
Epidemiological studies have revealed that noise exposure was associated with an increased risk of type 2 diabetes mellitus (T2DM). However, the exact nature of that association remains to be elucidated. The present study is designed to examine the effects of chronic noise exposure on the development of T2DM in combination with a high-fat-diet (HFD) in mice. Here we show that chronic noise exposure at 85 dB SPL (4 h /day, below the safety limit for occupational noise exposure) exaggerated multiple metabolic abnormalities induced by HFD in C57BL/6J male mice, including worsened glucose intolerance, insulin resistance, fasting hyperglycemia and dyslipidemia...
2018: PloS One
https://www.readbyqxmd.com/read/29590685/skin-ulceration-of-eyelids-in-atopic-dermatitis
#4
Kim David Plattner, Markus Tschopp, Margarita G Todorova
BACKGROUND: Superinfection of atopic dermatitis due to a disturbed skin barrier is well known. Still, affected eyelids with ulceration are rarely described. We present a case series of three patients in different stages of upper eyelid superinfection. HISTORY AND SIGNS: Three males aged 58, 37, and 52 years with clinical symptomatology of gradual expansion of eyelid ulcerations, crusts, and pus were evaluated. In all cases a standard ophthalmologic examination, including a detailed neuro-ophthalmological status, was performed...
March 28, 2018: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/29567873/-two-cases-of-difficult-to-treat-acute-epidural-hematoma-and-a-review-of-decompressive-craniectomy-with-hematoma-evacuation
#5
Takanari Okamoto, Kunihiko Umezawa, Syogo Ogita, Kunikazu Kurosaki, Tetsuro Takegami, Satoshi Kimura
INTRODUCTION: Decompressive craniectomy(DC)with craniotomy for acute epidural hematoma(AEDH)removal is controversial. Here, we summarized two difficult AEDH cases where DC was performed. CASE 1:A 26-year-old man sustained a head injury in a bicycle accident, with a Japan Coma Scale(JCS)score of 200, right pupil mydriasis, and a left decerebrate posture on admission. Computed tomography(CT)revealed right AEDH with a midline shift. Craniotomy was performed without DC. Postoperatively, his consciousness level and anisocoria improved(JCS score, 30)...
March 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29518092/paradoxical-worsening-of-emergomyces-africanus-infection-in-an-hiv-infected-male-on-itraconazole-and-antiretroviral-therapy
#6
Kenneth Crombie, Zandile Spengane, Michael Locketz, Sipho Dlamini, Rannakoe Lehloenya, Sean Wasserman, Tsidiso G Maphanga, Nelesh P Govender, Chris Kenyon, Ilan S Schwartz
No abstract text is available yet for this article.
March 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29516894/pneumoperitoneum-during-treatment-of-abdominal-tuberculosis-in-a-non-hiv-patient-natural-progression-or-paradoxical-worsening
#7
Shuwei Zheng, Humaira Shafi
Paradoxical reactions during tuberculosis (TB) treatment are well-described in the HIV seropositive population but less so in the HIV seronegative group. Abdominal TB rarely presents as spontaneous perforation; cases occurring during anti-TB therapy are even rarer. We describe the clinical progress of a case of an HIV-negative patient who developed acute peritonitis while on anti-TB treatment for peritoneal TB through a series of clinical, radiological and histological images. Visceral perforation can occur as a complication of TB treatment...
January 2018: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/29477993/first-case-of-acute-granulomatous-interstitial-nephritis-with-immune-reconstitution-inflammatory-syndrome-in-a-patient-with-hiv-coinfected-with-disseminated-mycobacterium-kansasii
#8
Vikas Kapoor, Azka Latif, Faiza Hassan Warraich, Aneela Majeed
Restoration of immune response by highly active antiretroviral therapy (HAART) effectively improved the overall prognosis of HIV infection. However, 25%-31.7% of patients experience paradoxical worsening of pre-existing infections or unmasking of subclinical infections after starting HAART therapy, which is termed as immune reconstitution inflammatory syndrome (IRIS). Acute granulomatous interstitial nephritis as a consequence of IRIS has never been reported with Mycobacteriumkansasii coinfection. Here, we describe an HIV/AIDS patient coinfected with disseminated M...
February 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29465433/emerging-targets-for-reprograming-the-immune-response-to-promote-repair-and-recovery-of-function-after-spinal-cord-injury
#9
Faith H Brennan, Phillip G Popovich
PURPOSE OF REVIEW: In adult mammals, a traumatic spinal cord injury (SCI) elicits a chronic unregulated neuroinflammatory response accompanied by seemingly paradoxical suppression of systemic immunity. These SCI-induced changes in immune function contribute to poor neurological outcomes and enhanced morbidity or mortality. Nonspecific anti-inflammatory or proinflammatory therapies are ineffective and can even worsen outcomes. Therefore, recent experimental SCI research has advanced the understanding of how neuroimmune cross-talk contributes to spinal cord and systemic pathology...
June 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29443366/paradoxical-anatomic-response-to-topical-carbonic-anhydrase-inhibitor-in-x-linked-retinoschisis
#10
Brandon Menke, Alex Walters, John F Payne
An 11-year-old boy presented for central vision blurring in each eye. Visual acuity was 20/80 and examination revealed spoke-wheel foveal schisis and peripheral elevated diaphanous inner retina in each eye. Spectral-domain optical coherence tomography showed inner-retinal, flat-topped cysts in each eye. Electrophysiologic testing was refused, but a clinical diagnosis of X-linked retinoschisis was made. Three months after topical dorzolamide (Trusopt; Santen Pharmaceutical, Osaka, Japan) was started, the macular cysts worsened significantly...
February 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/29438557/is-drug-induced-hepatitis-related-to-the-severity-of-tuberculous-meningitis
#11
Mritunjai Kumar, Jayantee Kalita, Abhilasha Tripathi, Usha K Misra
Background: Drug-induced hepatitis (DIH) occurs more commonly in tuberculous meningitis (TBM) than non-CNS tuberculosis. We evaluate DIH in TBM and its relationship with disease severity and surrogate markers of stress. Methods: Sixty-seven patients with TBM were included prospectively. The diagnosis of DIH was based on five times elevation of alanine amino transferase (ALT) in asymptomatic and three times in symptomatic patients, serum bilirubin 1.5 mg/dL or more occurring after 3 days of antitubercular drugs without any other cause of liver dysfunction; and improvement in liver function upon drug withdrawal...
November 1, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29425802/health-changes-in-low-income-men-transitioning-from-a-state-funded-prostate-cancer-program-to-comprehensive-insurance
#12
Jamal A Nabhani, Ruby Kuang, Hui Liu, Lorna Kwan, Mark S Litwin
PURPOSE: We evaluated the effect of transitioning from a prostate cancer specific treatment program to comprehensive insurance under the ACA (Patient Protection and Affordable Care Act) on the physical, mental and prostate cancer related health of poor, previously uninsured men. MATERIALS AND METHODS: We assessed general and prostate cancer specific health related quality of life using the RAND SF-12v2™ (12-Item Short Form Survey, version 2) and the UCLA PCI (Prostate Cancer Index) at 3 time points in 24 men who transitioned to comprehensive insurance as the insured group relative to 39 who remained in the prostate cancer program as the control group...
February 6, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29425553/invasive-treatment-of-nstemi-patients-in-german-chest-pain-units-evidence-for-a-treatment-paradox
#13
Frank P Schmidt, Claus Schmitt, Matthias Hochadel, Evangelos Giannitsis, Harald Darius, Lars S Maier, Claus Schmitt, Gerd Heusch, Thomas Voigtländer, Harald Mudra, Tommaso Gori, Jochen Senges, Thomas Münzel
BACKGROUND: Patients with non ST-segment elevation myocardial infarction (NSTEMI) represent the largest fraction of patients with acute coronary syndrome in German Chest Pain units. Recent evidence on early vs. selective percutaneous coronary intervention (PCI) is ambiguous with respect to effects on mortality, myocardial infarction (MI) and recurrent angina. With the present study we sought to investigate the prognostic impact of PCI and its timing in German Chest Pain Unit (CPU) NSTEMI patients...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29419749/deficiency-of-invariant-natural-killer-t-cells-does-not-protect-against-obesity-but-exacerbates-atherosclerosis-in-ldlr-mice
#14
Savitha Subramanian, Leela Goodspeed, Shari Wang, Yilei Ding, Kevin D O'Brien, Godfrey S Getz, Alan Chait, Catherine A Reardon
Obesity is a chronic inflammatory state characterized by altered levels of adipose tissue immune cell populations. Natural killer T (NKT) cells are CD1d restricted lymphocyte subsets that recognize lipid antigens whose level decreases in obese adipose tissue. However, studies in mice with deficiency or increased levels of NKT cells have yielded contradictory results, so the exact role of these cells in obesity and adipose tissue inflammation is not yet established. We previously showed that Ldlr-/- mice with excess invariant NKT (iNKT) cells demonstrate significant weight gain, adiposity, metabolic abnormalities, and atherosclerosis...
February 8, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29379704/paradoxical-respiratory-failure-due-to-cryptococcal-pneumonia-after-amphotericin-b-treatment-for-hiv-associated-cryptococcal-meningitis
#15
James E Scriven, Francois Cj Botha, Charlotte Schutz, David G Lalloo, Helen Wainwright, Graeme Meintjes
We present a 27-year-old lady with HIV-1 infection who died due to rapidly worsening respiratory failure one day after commencing amphotericin B deoxycholate therapy for cryptococcal meningitis. Chest x-ray appearances were consistent with pneumocystis pneumonia but post mortem examination showed evidence of severe necrotizing cryptococcal pneumonia. Cryptococcal pneumonia is an underrecognized condition and should be considered in the differential of patients with HIV-1 infection and low CD4 count who develop respiratory symptoms...
March 2018: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/29367364/unusual-case-of-hemidiaphragmatic-paralysis-secondary-to-cervical-herpes-zoster
#16
Muhammad Adnan Saleem, Zeeshan Mustafa, Noman Qayyum, Muhammad Badar Ganaie
Hemidiaphragmatic paralysis is usually caused by surgery, malignancy or trauma and rarely by viral infections. Herpes zoster (shingles) results in varied neurological complications, but peripheral motor involvement or diaphragmatic paralysis is rare. We report the case of an 87-year-old male who presented with worsening breathlessness soon after an episode of shingles, affecting his right neck and upper chest. He had no alarm symptoms, history of trauma or malignancy. Skin lesions resolved after a few weeks, but his breathing did not improve...
January 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29352071/worsening-renal-function-in-acute-heart-failure-patients-undergoing-aggressive-diuresis-is-not-associated-with-tubular-injury
#17
Tariq Ahmad, Keyanna Jackson, Veena S Rao, W H Wilson Tang, Meredith A Brisco-Bacik, Horng H Chen, G Michael Felker, Adrian F Hernandez, Christopher M O'Connor, Venkata S Sabbisetti, Joseph V Bonventre, F Perry Wilson, Steven G Coca, Jeffrey M Testani
Background -Worsening renal function (WRF) in the setting of aggressive diuresis for acute heart failure (AHF) treatment may reflect renal tubular injury or simply indicate a hemodynamic or functional change in glomerular filtration. Well-validated tubular injury biomarkers-NAG, NGAL, and KIM-1- are now available that can quantify the degree of renal tubularinjury. The ROSE-AHF trial provides an experimental platform for the study of mechanisms of WRF during aggressive diuresis for AHF, as the ROSE-AHF protocol dictated high dose loop diuretic therapy in all patients...
January 19, 2018: Circulation
https://www.readbyqxmd.com/read/29284686/role-of-common-hypnotics-on-the-phenotypic-causes-of-obstructive-sleep-apnoea-paradoxical-effects-of-zolpidem
#18
Jayne C Carberry, Lauren P Fisher, Ronald R Grunstein, Simon C Gandevia, David K McKenzie, Jane E Butler, Danny J Eckert
Hypnotics are contraindicated in obstructive sleep apnoea (OSA) because of concerns of pharyngeal muscle relaxation and delayed arousal worsening hypoxaemia. However, human data are lacking. This study aimed to determine the effects of three common hypnotics on the respiratory arousal threshold, genioglossus muscle responsiveness and upper airway collapsibility during sleep.21 individuals with and without OSA (18-65 years) completed 84 detailed sleep studies after receiving temazepam (10 mg), zolpidem (10 mg), zopiclone (7...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29190170/the-role-of-dexamethasone-implant-in-the-management-of-tubercular-uveitis
#19
Aniruddha Agarwal, Sabia Handa, Kanika Aggarwal, Mansi Sharma, Ramandeep Singh, Aman Sharma, Rupesh Agrawal, Kusum Sharma, Vishali Gupta
PURPOSE: To study the safety and efficacy of intravitreal injection of dexamethasone implant in the management of posterior segment involvement in tubercular uveitis (TBU). METHODS: In this study, retrospective analysis of safety and efficacy of intravitreal injection of dexamethasone implant for various indications such as cystoid macular edema (CME), vitritis, or paradoxical worsening in TB-related intermediate uveitis, retinal vasculitis, and multifocal serpiginoid choroiditis (MSC) was performed...
November 30, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29185542/pimavanserin-a-novel-therapeutic-option-for-parkinson-disease-psychosis
#20
REVIEW
Trevor Hawkins, Brian D Berman
Purpose of review: In April 2016, the Food and Drug Administration (FDA) approved a first-in-class atypical antipsychotic medication called pimavanserin for the treatment of Parkinson disease psychosis (PDP). We aim to inform readers about its indications, effectiveness, and safety profile. Recent findings: Pimavanserin acts as an inverse agonist at serotonin 5-HT2A receptors and has negligible effects on other receptors, thereby avoiding the D2 receptor antagonism that can potentially worsen motor symptoms...
April 2017: Neurology. Clinical Practice
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