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https://www.readbyqxmd.com/read/28644225/adjuvant-steroid-therapy-in-community-acquired-pneumonia
#1
Caroline Bell Sisson
Despite medical advances, pneumonia is a leading cause of death worldwide. Because inflammation is a key defense mechanism, adjuvant corticosteroid therapy has long been considered but never widely recommended to treat pneumonia. New research is exploring potential benefits of this therapy, including reduced time to clinical stability, reduced hospital stay, reduced rates of treatment failure, and prevention of complications.
July 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28641094/emerging-concepts-in-cytomegalovirus-infection-following-hematopoietic-stem-cell-transplantation
#2
REVIEW
Jose F Camargo, Krishna V Komanduri
Despite the refinements in molecular methods for the detection of cytomegalovirus (CMV) and the advent of highly effective preemptive strategies, CMV remains a leading cause of morbidity and mortality in hematopoietic cell transplant (HCT) recipients. CMV can cause tissue-invasive disease including pneumonia, hepatitis, colitis, retinitis, and encephalitis. Mortality in HCT recipients with CMV disease can be as high as 60%. CMV infection has been associated with increased risk of secondary bacterial and fungal infections, increased risk of graft-versus-host disease, and high rates of nonrelapse mortality following HCT...
June 14, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28639502/rituximab-as-first-line-treatment-for-acquired-thrombotic-thrombocytopenic-purpura
#3
Haifei Chen, Ailin Fu, Jing Wang, Tianqin Wu, Zhengyang Li, Jieqing Tang, Hongshi Shen, Jingjing Zhu, Jie Li, Qian Zhu, Longmei Qing
Objective To investigate the efficacy and safety of rituximab (RTX) as first-line treatment of acquired thrombotic thrombocytopenic purpura (aTTP). Methods Twenty-five patients with acute aTTP and/or severe a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) deficiency were admitted to our centre from April 2009 to March 2015. Fourteen patients received RTX plus standard therapy (plasma exchange and corticosteroids) at acute episodes. Haemoglobin, platelet count, schistocytes, lactate dehydrogenase levels, ADAMTS13 activity and its inhibitors, and the ratio of B lymphocytes in the peripheral blood, were monitored...
June 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28634021/mycoplasma-pneumoniae-and-health-outcomes-in-children-with-asthma
#4
Pamela R Wood, Jordan C Kampschmidt, Peter H Dube, Marianna P Cagle, Paola Chaparro, Norma S Ketchum, Thirumalai R Kannan, Harjinder Singh, Jay I Peters, Joel B Baseman, Edward G Brooks
BACKGROUND: Acute infections with Mycoplasma pneumoniae (Mp) have been associated with worsening asthma in children. Mp can be present in the respiratory tract for extended periods; it is unknown whether the long-term persistence of Mp in the respiratory tract affects long-term asthma control. OBJECTIVE: To determine the effect of Mp on asthma control. METHODS: We enrolled 31 pediatric subjects 3 to 10 years of age with persistent asthma who completed up to 8 visits over a 24-month period...
June 17, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#5
REVIEW
Marc Miravitlles, Antonio Anzueto, José R Jardim
The natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilization; reduced quality of life; and increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations (GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA)/LAMA combination, respectively, as preferred initial treatments...
June 20, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28626631/chronic-eosinophilic-pneumonia-adjunctive-therapy-with-inhaled-steroids
#6
Christopher Chan, David DeLapp, Perry Nystrom
Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare form of diffuse parenchymal lung disease first identified by Carrington et al. in 1969. It is characterized by the presence of constitutional and respiratory symptoms with associated peripheral opacities on imaging and elevated serum and/or bronchoalveolar eosinophilia. Although data is limited regarding etiology or prevalence, it is known that ICEP has a 2:1 female: male predominance and typically affects non-smokers. Diagnosis rests on the clinical constellation of respiratory symptoms of at least 2-4 weeks duration, the presence of diffuse pulmonary alveolar consolidation, classically described as the "photographic negative of pulmonary edema", the presence of eosinophils ≥40% on bronchoalveolar lavage or ≥1000/mm(3) eosinophils on peripheral blood and the exclusion of other known causes of eosinophilic lung diseases such as drugs, toxins, fungi, parasites, and collagen-vascular disorders...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28619722/corticosteroid-therapy-during-acute-bronchiolitis-in-patients-who-later-develop-asthma
#7
Steven L Shein, Alexandre T Rotta, Richard Speicher, Katherine N Slain, Benjamin Gaston
BACKGROUND AND OBJECTIVE: Meta-analyses show that corticosteroids are not effective in patients with bronchiolitis. However, risk factors for asthma such as eczema or familial atopy prompt some practitioners to prescribe corticosteroids for bronchiolitis. We assessed if corticosteroid prescription is associated with shorter hospitalization for bronchiolitis among patients who later develop asthma. METHODS: The Pediatric Health Information System database was interrogated for patients with bronchiolitis aged <2 years hospitalized between 2006 and 2015...
June 15, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28617814/risk-of-pneumonia-in-obstructive-lung-disease-a-real-life-study-comparing-extra-fine-and-fine-particle-inhaled-corticosteroids
#8
Samatha Sonnappa, Richard Martin, Elliot Israel, Dirkje Postma, Wim van Aalderen, Annie Burden, Omar S Usmani, David B Price
BACKGROUND: Regular use of inhaled corticosteroids (ICS) in patients with obstructive lung diseases has been associated with a higher risk of pneumonia, particularly in COPD. The risk of pneumonia has not been previously evaluated in relation to ICS particle size and dose used. METHODS: Historical cohort, UK database study of 23,013 patients with obstructive lung disease aged 12-80 years prescribed extra-fine or fine-particle ICS. The endpoints assessed during the outcome year were diagnosis of pneumonia, acute exacerbations and acute respiratory events in relation to ICS dose...
2017: PloS One
https://www.readbyqxmd.com/read/28617807/treatment-with-macrolides-and-glucocorticosteroids-in-severe-community-acquired-pneumonia-a-post-hoc-exploratory-analysis-of-a-randomized-controlled-trial
#9
Adrian Ceccato, Catia Cilloniz, Otavio T Ranzani, Rosario Menendez, Carles Agusti, Albert Gabarrus, Miquel Ferrer, Oriol Sibila, Michael S Niederman, Antoni Torres
BACKGROUND: Systemic corticosteroids have anti-inflammatory effects, whereas macrolides also have immunomodulatory activity in addition to their primary antimicrobial actions. We aimed to evaluate the potential interaction effect between corticosteroids and macrolides on the systemic inflammatory response in patients with severe community-acquired pneumonia to determine if combining these two immunomodulating agents was harmful, or possibly beneficial. METHODS: We performed a post-hoc exploratory analysis of a randomized clinical trial conducted in three tertiary hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28614979/docetaxel-induced-cardiac-respiratory-arrest-in-a-patient-with-chronic-atrial-fibrillation
#10
Mostaqul Huq, Tracie M Balvanz, Scott Mambourg
Docetaxel has been approved by the Food and Drug Administration for the treatment of many cancer types, including breast cancer, head and neck cancer, lung cancer, and prostate cancer. Many severe to life-threatening side effects (Grades 3-5) of docetaxel have been reported in clinical trials, case reports, and Food and Drug Administration Adverse Events Reporting System. These include anaphylactic reactions, febrile neutropenia, fluid retention, acute respiratory distress, pleural effusion, pneumonia, and peripheral neuropathy...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28593791/eosinophil-rich-tissue-infiltrates-in-chronic-myelomonocytic-leukemia-patients
#11
Nathalie Droin, Nolwenn Lucas, Vincent Parinet, Dorothée Selimoglu-Buet, Marc Humbert, Véronique Saada, Olivier Lambotte, Eric Solary, Nicolas Noël
Chronic myelomonocytic leukemia (CMML) is a clonal hematopoietic disorder that associates dysplastic and proliferative features. Tissue inflammatory disorders occur in a fraction of CMML patients during the course of their disease. Here, we describe the occurrence of eosinophil-rich tissue inflammation, including eosinophilic pneumonia, chondritis, and cystitis, in CMML patients. Whole exome sequencing of leukemic cells did not identify a recurrent genetic abnormality among these three patients who were clinically improved by local or oral corticosteroids...
June 8, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28592332/the-negative-effect-of-initial-high-dose-methylprednisolone-and-tapering-regimen-for-acute-respiratory-distress-syndrome-a-retrospective-propensity-matched-cohort-study
#12
Makoto Takaki, Kazuya Ichikado, Kodai Kawamura, Yasuhiro Gushima, Moritaka Suga
BACKGROUND: The efficacy of corticosteroid use in acute respiratory distress syndrome (ARDS) remains controversial. Generally, short-term high-dose corticosteroid therapy is considered to be ineffective in ARDS. On the other hand, low-dose, long-term use of corticosteroids has been reported to be effective since they provide continued inhibition of the systemic inflammatory response syndrome (SIRS) that accompanies ARDS. Thus far, no reports have been published on the efficacy of initiating treatment with a high-dose corticosteroid regimen with tapering...
June 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28583135/outcomes-and-prognostic-factors-of-non-hiv-patients-with-pneumocystis-jirovecii-pneumonia-and-pulmonary-cmv-co-infection-a-retrospective-cohort-study
#13
Qing Yu, Peng Jia, Li Su, Hong Zhao, Chengli Que
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) and pulmonary cytomegalovirus (CMV) infection are common opportunistic infections among immunocompromised patients. However, few studies have evaluated their co-infection, especially among non-HIV patients. Therefore, we aimed to evaluate the outcomes and prognostic factors among non-HIV patients with PJP according to their CMV infection status. METHODS: This retrospective study evaluated non-HIV patients who were diagnosed with PJP between January 2009 and January2016...
June 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28560041/severe-acute-asthma-caused-by-chlamydophila-pneumoniae-infection
#14
Yoshinari Endo, Toshihiro Shirai, Mika Saigusa, Eisuke Mochizuki
Asthma exacerbation is associated with respiratory infections, including those by viruses and atypical bacteria. We herein report a case of severe acute asthma in an adult caused by Chlamydophila pneumoniae (C. pneumoniae) infection. A 39-year-old woman without a history of asthma reported to the emergency department with progressive worsening of cough, shortness of breath, and wheezing with low oxygen saturation. A computed tomography (CT) scan revealed patchy ground-glass opacity and bronchial wall thickening...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28554260/efficacy-of-direct-hemoperfusion-using-polymyxin-b-immobilized-fiber-column-pmx-dhp-in-rapidly-progressive-interstitial-pneumonias-results-of-a-historical-control-study-and-a-review-of-previous-studies
#15
Hidenori Ichiyasu, Yuko Horio, Aiko Masunaga, Yohei Migiyama, Yasumiko Sakamoto, Takayuki Jodai, Hideharu Ideguchi, Hiroko Okabayashi, Shohei Hamada, Chieko Yoshida, Susumu Hirosako, Shinichiro Okamoto, Hirotsugu Kohrogi
BACKGROUND: Direct hemoperfusion using polymyxin B-immobilized fiber column (PMX-DHP) therapy has been approved for sepsis-associated acute respiratory distress syndrome, but its efficacy for other rapidly progressive interstitial pneumonias (RPIPs) is unclear. The purpose of this study was to examine the efficacy of PMX-DHP therapy for acute respiratory failure in patients with RPIPs, when compared with a historical control receiving conventional treatment without PMX-DHP. METHODS: This study comprised 77 patients with RPIPs in our institute between January 2002 and December 2015...
July 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28548632/diagnostic-and-prognostic-value-of-inflammatory-parameters-including-neopterin-in-the-setting-of-pneumonia-copd-and-acute-exacerbations
#16
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/28512413/two-cases-of-nivolumab-re-administration-after-pneumonitis-as-immune-related-adverse-events
#17
Keisuke Imafuku, Koji Yoshino, Kei Yamaguchi, Satoshi Tsuboi, Kuniaki Ohara, Hiroo Hata
Nivolumab is a recently approved medication for the treatment of unresectable malignant melanoma. Many immune-related adverse events (irAEs) associated with nivolumab have been reported, such as pneumonitis, hepatitis, dermatitis, and thyroiditis. Prednisolone can effectively treat irAEs. However, it is unclear how or if nivolumab should be administered to patients after they have experienced an irAE. Herein, we show 2 patients who underwent pneumonitis as irAE. Case 1 demonstrated a cryptogenic organizing pneumonia pattern in the CT scan and case 2 had a diffuse alveolar damage (DAD) pattern...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28502934/a-cryptogenic-case-of-fulminant-fibrosing-organizing-pneumonia
#18
Takehiko Kobayashi, Masanori Kitaichi, Kazunobu Tachibana, Yutaro Kishimoto, Yasushi Inoue, Tomoko Kagawa, Toshiya Maekura, Chikatoshi Sugimoto, Toru Arai, Masanori Akira, Yoshikazu Inoue
Cryptogenic organizing pneumonia (COP) generally responds well to corticosteroids with a favorable outcome. Rare cases of organizing pneumonia are rapidly progressive. Yousem et al. studied pathologic predictors of idiopathic bronchiolitis obliterans organizing pneumonia/COP with an unfavorable prognosis. Beardsley and Rassl proposed the name fibrosing organizing pneumonia (FOP). A 74-year-old female non-smoker presented with a 2-week history of dry cough followed by dyspnea and a fever. The clinical course was fulminant, but we successfully performed bronchoscopy...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28497921/macrolide-resistance-and-its-impacts-on-m-pneumoniae-pneumonia-in-children-comparison-of-two-recent-epidemics-in-korea
#19
Jong Hyun Kim, Jee Yong Kim, Chang Hoon Yoo, Won Hee Seo, Young Yoo, Dae Jin Song, Ji Tae Choung
PURPOSE: The aim of this study was to investigate the change in macrolide resistance rate in pediatric Mycoplasma pneumoniae pneumonia and to evaluate the influence of macrolide-resistant M. pneumoniae (MRMP) on the clinical course of disease, by comparing 2 recent, consecutive epidemics in Korea. METHODS: A total of 250 patients with M. pneumoniae pneumonia admitted to a single tertiary hospital were enrolled in this study. Detection of MRMP was based on specific point mutations in domain V of the 23S rRNA gene...
July 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28482840/blood-and-sputum-eosinophils-in-copd-relationship-with-bacterial-load
#20
Umme Kolsum, Gavin C Donaldson, Richa Singh, Bethan L Barker, Vandana Gupta, Leena George, Adam J Webb, Sarah Thurston, Anthony J Brookes, Timothy D McHugh, Jadwiga A Wedzicha, Christopher E Brightling, Dave Singh
BACKGROUND: Sputum and blood eosinophil counts predict corticosteroid effects in COPD patients. Bacterial infection causes increased airway neutrophilic inflammation. The relationship of eosinophil counts with airway bacterial load in COPD patients is uncertain. We tested the hypothesis that bacterial load and eosinophil counts are inversely related. METHODS: COPD patients were seen at stable state and exacerbation onset. Sputum was processed for quantitative polymerase chain reaction detection of the potentially pathogenic microorganisms (PPM) H...
May 8, 2017: Respiratory Research
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