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https://www.readbyqxmd.com/read/28548868/inhaled-corticosteroid-prescribing-in-a-pediatric-emergency-department-sustained-success-and-prescription-filling-rates
#1
Sarah Nicole Adams, Mary Abel, Dustin Fowler, Jennifer Braden, Myla D Ebeling, Annie N Simpson, M Olivia Titus, Annie Lintzenich Andrews
OBJECTIVE: To determine if improvement in Inhaled Corticosteroid (ICS) prescribing in the pediatric emergency department (PED) can be sustained after transition from intense intervention to low-intervention phase, and to determine ICS fill rates. METHODS: A Quality Improvement (QI) project began in Aug 2012. Results through Feb 2014 were previously published. In Feb 2014 interventions were scaled back to determine the sustainability of QI success. Eligible patients included children aged 2-17 seen in the PED for asthma between Feb 2014 and Sept 2016...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28548632/diagnostic-and-prognostic-value-of-inflammatory-parameters-including-neopterin-in-the-setting-of-pneumonia-copd-and-acute-exacerbations
#2
Alex Pizzini, Fabian Lunger, Amra Sahanic, Nada Nemati, Dietmar Fuchs, Günter Weiss, Katharina Kurz, Rosa Bellmann-Weiler
Acute exacerbations and community-acquired pneumonia (CAP) are severe complications in patients with chronic obstructive pulmonary disease (COPD). In this study, we analyzed inflammatory parameters in serum including C-reactive protein (CRP), procalcitonin (PCT), and serum neopterin (NPT) to determine their potential to differentiate between patients with CAP+COPD and with acute exacerbations of COPD (AECOPD) without pneumonia. 102 (39 women and 63 men) patients were included in this retrospective study, of whom 48 presented with CAP without underlying COPD, 20 with CAP+COPD and 34 with AECOPD...
June 2017: COPD
https://www.readbyqxmd.com/read/28548078/associated-variables-of-myositis-in-systemic-lupus-erythematosus-a-cross-sectional-study
#3
Yan Liang, Rui-Xue Leng, Hai-Feng Pan, Dong-Qing Ye
BACKGROUND This study aimed to estimate the point prevalence of myositis and identify associated variables of myositis in systemic lupus erythematosus (SLE). MATERIAL AND METHODS Clinical date of patients hospitalized with lupus at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital were collected. Patients were defined as having myositis if they reported the presence of persistent invalidating muscular weakness combined with increased levels of creatine phosphokinase (CPK) and abnormal electromyography (EMG)...
May 26, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28548005/geographic-variation-in-diagnostic-ability-and-quality-of-care-metrics-a-case-study-of-ankylosing-spondylitis-and-low-back-pain
#4
Jason Shafrin, Jenny Griffith, Jin Joo Shim, Caroline Huber, Arijit Ganguli, Wade Aubry
Studies examining geographic variation in care for low back pain often focus on process and outcome measures conditional on patient diagnosis but generally do not take into account a physician's ability to diagnose the root cause of low back pain. In our case study, we used increased detection of ankylosing spondylitis-a relatively rare inflammatory back disease-as a proxy for diagnostic ability and measured the relationship between ankylosing spondylitis detection, potentially inappropriate low back pain care, and cost...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28546944/corticosteroid-associated-atypical-central-serous-chorioretinopathy-in-a-patient-with-multiple-sclerosis
#5
Mahmut Kaya, Derya Kaya, Egemen Idiman
No abstract text is available yet for this article.
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28546874/acute-paraparesis-and-sensory-loss-following-intravenous-corticosteroid-administration-in-a-case-of-longitudinally-extensive-transverse-myelitis-caused-by-spinal-dural-arteriovenous-fistula-case-report-and-review-of-literature
#6
Michael A DiSano, Russell Cerejo, MaryAnn Mays
INTRODUCTION: The underlying causes of longitudinally extensive transverse myelitis (LETM) are broad and include inflammatory processes, compression and spinal dural arteriovenous fistula (SDAVF). Presenting symptoms of SDAVF are nonspecific and often go misdiagnosed. Acute clinical deterioration from SDAVF has been described following exertion or valsalva. However, deterioration has been recently recognized following steroid administration and may contribute to increased morbidity. CASE PRESENTATION: We describe a 63-year-old woman with a 2-year history of intermittent lower extremity numbness and back pain, lumbar stenosis, who presented with subacute worsening of symptoms following a course of oral steroids for an upper respiratory infection...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28546764/optimal-management-of-primary-focal-segmental-glomerulosclerosis-in-adults
#7
REVIEW
Séverine Beaudreuil, Hans Kristian Lorenzo, Michele Elias, Erika Nnang Obada, Bernard Charpentier, Antoine Durrbach
Focal segmental glomerulosclerosis (FSGS) is a frequent glomerular kidney disease that is revealed by proteinuria or even nephrotic syndrome. A diagnosis can be established from a kidney biopsy that shows focal and segmental glomerulosclerosis. This histopathological lesion may be caused by a primary podocyte injury (idiopathic FSGS) but is also associated with other pathologies (secondary FSGS). The first-line treatment for idiopathic FSGS with nephrotic syndrome is a prolonged course of corticosteroids. However, steroid resistance or steroid dependence is frequent, and despite intensified immunosuppressive treatment, FSGS can lead to end-stage renal failure...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28546463/a-phase-ii-study-of-everolimus-plus-oral-prednisone-in-patients-with-metastatic-renal-cell-cancer
#8
Cristian Lolli, Valentina Gallà, Giuseppe Schepisi, Domenico Barone, Salvatore Luca Burgio, Antonio Maugeri, Bernadette Vertogen, Dino Amadori, Ugo De Giorgi
LESSONS LEARNED: The combination of everolimus and low-dose prednisone administered daily was hypothesized to prevent noninfectious pneumonitis (NIP) and mucositis, two common adverse events related to everolimus. Although mucositis was detected in only one case, all-grade NIP occurred in four of eight cases (50%), and this was considered enough to stop accrual of the study.These data suggest the need for careful monitoring of patients receiving everolimus who are treated with corticosteroids...
May 25, 2017: Oncologist
https://www.readbyqxmd.com/read/28546381/adjunct-therapies-for-refractory-status-asthmaticus-in-children
#9
Kyle J Rehder
Asthma exacerbation is a common reason for children to present to the emergency department. If primary therapies fail to halt the progression of an asthma flare, status asthmaticus often leads to hospital, and potentially ICU, admission. Following the initial administration of inhaled β agonists and systemic corticosteroids, a wide array of adjunct medical therapies may be used to treat status asthmaticus. Unfortunately, the data supporting the use of these adjunct therapies are often unclear, conflicting, or absent...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546103/neurological-manifestations-of-beh%C3%A3-et-s-disease-case-report-and-literature-review
#10
Alba López Bravo, Carlos Parra Soto, Elena Bellosta Diago, Álvaro Cecilio Irazola, Sonia Santos-Lasaosa
Neurological involvement in Behçet's disease is rare, especially at the onset. It can present in the form of parenchymal changes or as damage to the vascular structures in its nonparenchymal form. The coexistence of both kinds of manifestations in the same patient is exceptional. We report the case of a 32-year-old patient with a history of deep venous thrombosis, who was being treated for holocranial headache, apathy, and oral and genital ulcers. Brain magnetic resonance imaging showed hyperintense lesions in the basal ganglia and white matter, and the vascular study evidenced venous thrombosis of the left transverse sinus...
May 22, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28545978/benralizumab-for-patients-with-mild-to-moderate-persistent-asthma-bise-a-randomised-double-blind-placebo-controlled-phase-3-trial
#11
Gary T Ferguson, J Mark FitzGerald, Eugene R Bleecker, Michel Laviolette, David Bernstein, Craig LaForce, Lyndon Mansfield, Peter Barker, Yanping Wu, Maria Jison, Mitchell Goldman
BACKGROUND: Benralizumab is a humanised, anti-interleukin 5 receptor α monoclonal antibody that directly and rapidly depletes eosinophils, reduces asthma exacerbations, and improves lung function for patients with severe eosinophilic asthma. The objective of this trial was to assess the safety and efficacy of benralizumab for patients with mild to moderate, persistent asthma. METHODS: In this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients aged 18-75 years, weighing at least 40 kg, and with a postbronchodilator reversibility in forced expiratory volume in 1 s (FEV1) of at least 12% at screening, from 52 clinical research centres in six countries...
May 22, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28545834/the-relationship-of-the-subtypes-of-preterm-birth-with-retinopathy-of-prematurity
#12
Anne M Lynch, Brandie D Wagner, Jennifer K Hodges, Tamara S Thevarajah, Emily A Mccourt, Ashlee M Cerda, Naresh Mandava, Ronald S Gibbs, Alan G Palestine
BACKGROUND: Retinopathy of prematurity (ROP) is an adverse outcome of preterm birth (PTB) and is a leading cause of childhood blindness. The relationship between the subtypes of PTB with ROP is understudied. OBJECTIVE: To investigate if there is a difference in the incidence of type 1 or type 2 ROP in infants with PTB resulting from spontaneous preterm labor (SPTL), a medical indication (MIPTB), or preterm-premature rupture of the membranes (PPROM). STUDY DESIGN: A retrospective cohort study of 827 infants screened for ROP who delivered at a single tertiary care center in Colorado...
May 22, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28545804/knemometry-assessment-of-short-term-growth-in-children-with-asthma-receiving-fluticasone-furoate-for-2-weeks-a-randomized-placebo-controlled-crossover-trial
#13
Ole D Wolthers, Sally Stone, Philippe Bareille, Susan Tomkins, Sanjeev Khindri
PURPOSE: A dry powder inhaler formulation of the inhaled corticosteroid fluticasone furoate (FF) is being evaluated for use in children. An important potential risk associated with the use of inhaled corticosteroids in children is growth suppression. Therefore, the aim of this study was to assess the short-term lower leg growth in children with asthma treated for 2 weeks with inhaled FF versus placebo from the ELLIPTA inhaler. METHODS: Prepubertal children with persistent asthma (n = 60; aged 5 to <12 years) were recruited into a randomized, double-blind, placebo-controlled, 2-way crossover, noninferiority study...
May 22, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28545491/treatment-of-acute-sciatica-with-transforaminal-epidural-corticosteroids-and-local-anesthetic-design-of-a-randomized-controlled-trial
#14
Bastiaan C Ter Meulen, Esther T Maas, Amrita Vyas, Marinus van der Vegt, Koo de Priester, Michiel R de Boer, Maurits W van Tulder, Henry C Weinstein, Raymond W J G Ostelo
BACKGROUND: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. METHODS: We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica...
May 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28545408/importance-of-correctly-interpreting-magnetic-resonance-imaging-to-diagnose-posterior-reversible-encephalopathy-syndrome-associated-with-hellp-syndrome-a-case-report
#15
Syuichi Tetsuka, Hiroaki Nonaka
BACKGROUND: Severe haemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome in pregnancy are possible underlying trigger factors for posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging (MRI) shows diffuse signal abnormalities involving the subcortical white matter in the parieto-occipital lobes. Although the diagnosis of RPES was clearly established by the distinctive reversibility of clinical and radiological abnormalities, it is difficult to distinguish from differential diagnosis...
May 25, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28544595/severe-cytokine-release-syndrome-in-a-patient-receiving-pd-1-directed-therapy
#16
Seth J Rotz, Daniel Leino, Sara Szabo, Jennifer L Mangino, Brian K Turpin, Joseph G Pressey
Cytokine release syndrome (CRS) is a phenomenon of immune hyperactivation described in the setting of cellular and bispecific T-cell engaging immunotherapy. Checkpoint blockade using anti-programmed cell death 1 (anti-PD-1) inhibitors is an approach to antitumor immune system stimulation. A 29-year-old female with alveolar soft part sarcoma developed severe CRS after treatment with anti-PD-1 therapy. CRS was characterized by high fevers, encephalopathy, hypotension, hypoxia, hepatic dysfunction, and evidence of coagulopathy, and resolved after infusion of the interleukin-6 inhibitor tocilizumab and corticosteroids...
May 24, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28544041/marked-variability-observed-in-inpatient-management-of-bronchiolitis-in-three-finnish-hospitals
#17
Varpu Elenius, Eija Bergroth, Petri Koponen, Sami Remes, Pedro A Piedra, Janice A Espinola, Matti Korppi, Carlos A Camargo, Tuomas Jartti
AIM: Infants hospitalised for bronchiolitis undergo examinations and treatments not supported by current research evidence and we investigated practice variations with regard to Finnish children under the age of two. METHODS: This prospective, multi-centre cohort study was conducted in paediatric units in three university hospitals in Finland from 2008-2010. Hospital medical records were reviewed to collect data on clinical course, testing and treatment. Data were analysed separately for children meeting our strict definition of bronchiolitis, aged under 12 months without a history of wheezing, and a loose definition, aged 12-23 months or with a history of wheezing...
May 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28543931/severe-asthma-in-children
#18
REVIEW
Andrew Bush, Louise Fleming, Sejal Saglani
Most children with asthma have their disease easily controlled if low-dose inhaled corticosteroids (ICSs) are regularly and correctly administered. If a child presents with asthma which is apparently resistant to therapy with high-dose ICS and other controllers, then they have problematic severe asthma. However, in light of the UK National Review of Asthma Deaths, definitions of severe asthma based solely on the levels of prescribed treatment are too narrow. A detailed assessment of all such children should be performed...
May 25, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28543851/guttate-psoriasis-triggered-by-perianal-streptococcal-infection
#19
F M Garritsen, D E Kraag, M de Graaf
The association of guttate psoriasis (GP) with streptococcal pharyngitis is well accepted. However, less is known about the association with perianal streptococcal infection. We report a case of a 19-month-old boy with GP after a preceding perianal streptococcal dermatitis, with no clinical signs of a streptococcal pharyngitis. Treatment with phenethicillin was given together with mometasone ointment. After 4 weeks, the perianal redness was reduced and the psoriasis had improved significantly. A review of the literature revealed nine previous case reports, comprising a total of 15 patients...
May 22, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28543730/treatment-of-disseminated-superficial-actinic-porokeratosis-with-oral-alitretinoin
#20
B J Park, E H Oh, J E Kim, J Y Ko, Y S Ro
Disseminated superficial actinic porokeratosis (DSAP), the most common type of porokeratosis, usually presents as large numbers of lesions on sun-exposed skin. Although several treatment options including corticosteroids, keratolytics, 5-fluorouracil, imiquimod, vitamin D3 analogues, cryotherapy, curettage, laser therapy and dermabrasion may be considered, there is no evidence-based standard treatment.(1-2) Patient 1 was a 26-year-old female who presented with a 2-year history of progressive scaly macules on both upper and lower extremities...
May 22, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
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