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corticosteroids usage tuberculosis

Somanath Padhi, Kandasamy Ravichandran, Jayaprakash Sahoo, Renu G'Boy Varghese, Aneesh Basheer
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is an uncommon, potentially fatal, hyperinflammatory syndrome that may rarely complicate the clinical course of disseminated Mycobacterium tuberculosis (MTB). The clinical course of tuberculosis-associated HLH (TB-HLH) has been reported to be unpredictable. MATERIALS AND METHODS: Here we describe the clinicopathological features, laboratory parameters, management, and outcome data of a patient who satisfied the 2004 diagnostic criteria for HLH secondary to disseminated MTB; we also do a systematic review of the international literature on TB-HLH...
November 2015: Lung India: Official Organ of Indian Chest Society
Joseph Tkacz, Brenna L Brady, Roxanne Meyer, Jennifer H Lofland, Charles Ruetsch, Nayantara Coelho-Prabhu
BACKGROUND: Inflammatory bowel disease (IBD) is a chronic relapsing disease characterized by activation of the mucosal immune system and inflammation of the gastrointestinal tract. Management of IBD places a significant burden on the health care system because of the complexity of treatment, variability in patient outcomes, and chronic nature of the disease.  OBJECTIVE: To investigate the American Gastroenterological Association (AGA) and Crohn's and Colitis Foundation of America's (CCFA) quality measurement sets in a sample of IBD patients...
November 2015: Journal of Managed Care & Specialty Pharmacy
Maunank Shah, Caitlin Reed
PURPOSE OF REVIEW: Diagnosis and management of tuberculosis (TB) remains challenging and complex because of the heterogeneity of disease presentations. Despite effective treatment, TB disease can lead to significant short-and long-term health consequences. We review potential acute and chronic complications of TB disease and current management approaches. RECENT FINDINGS: Acute and subacute complications of TB disease are attributable to structural damage or vascular compromise caused by Mycobacterium tuberculosis, as well as metabolic abnormalities and host inflammatory responses...
October 2014: Current Opinion in Infectious Diseases
Yu-Sheng Chang, Chia-Jen Liu, Shou-Ming Ou, Yu-Wen Hu, Tzeng-Ji Chen, Hui-Ting Lee, Chi-Ching Chang, Chung-Tei Chou
Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease and may complicate with interstitial lung disease. The risk of Mycobacterium tuberculosis (TB) infection in patients with pSS has not been determined. This nationwide population-based study aimed to explore the incidence and risk factors of TB infection in patients with pSS. We identified 4,822 pSS patients from the Taiwan National Health Insurance database and compared the incidence rates of TB infection in these patients with 48,220 randomly selected age-, sex-, and comorbidity-matched subjects without pSS...
March 2014: Clinical Rheumatology
Sei Won Lee, Dal Rae Kim, Tae Jung Kim, Jin Ho Paik, Jin-Haeng Chung, Sanghoon Jheon, Jin Won Huh, Jae-Ho Lee, Choon-Taek Lee
BACKGROUND: An association between innate immunity including Toll-like receptors (TLRs) and COPD is reported recently; TLR4 deficiency in lung can cause emphysema in animals, which is not evident in humans. We analyzed the association of TLR4 expression, airflow limitation and emphysema in smokers. METHODS: We enrolled patients of ≥40years old with smoking histories of ≥10 pack-years and who had undergone lung resection. We measured TLR4 expression in lung lysates...
2012: Respiratory Research
Ravindra Kumar Garg, Vimal Paliwal, Hardeep Singh Malhotra
Tuberculous meningitis is primarily a disease of the meninges of brain and spinal cord along with adjacent brain parenchyma. The characteristic pathological changes are meningeal inflammation, basal exudates, vasculitis and hydrocephalus. Tuberculous meningitis has a strong predilection for basal parts of the brain. Exudates, if dominantly present in the interpeduncular, suprasellar and Sylvian cisterns, result in optochiasmatic arachnoiditis and tuberculoma. Optochiasmatic arachnoiditis and tuberculoma are devastating forms of tuberculous meningitis and often associated with profound vision loss...
September 2011: Expert Review of Anti-infective Therapy
Maria W Greenwald, William J Shergy, Jeffrey L Kaine, Marianne T Sweetser, Kye Gilder, Matthew D Linnik
OBJECTIVE: To assess the safety of rituximab in combination with a tumor necrosis factor (TNF) inhibitor and methotrexate (MTX) in patients with rheumatoid arthritis (RA). METHODS: Adult patients with active RA (≥ 5 swollen and ≥ 5 tender joints) receiving a stable dose of MTX (10-25 mg/week) and stable dose of TNF inhibitor (etanercept or adalimumab) for ≥ 12 weeks were randomized 2:1 to receive one course of rituximab or placebo, given intravenously at a dose of 2 × 500 mg...
March 2011: Arthritis and Rheumatism
Attapon Cheepsattayakorn, Ruangrong Cheepsattayakorn
There is substantial evidence from studies on racial variation in susceptibility to tuberculosis (TB) that human genetic variation is an important determinant of the outcome of infection with Mycobacterium tuberculosis (M tb). In only a minority of cases is there an obvious identifiable risk factor such as human immunodeficiency virus (HIV) infection, advanced age, diabetes, corticosteroid usage or alcohol abuse. In the remainder, a complex interaction of genetic and environmental factors causes the development of clinical TB...
January 2009: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
S L Swartz, R G Dluhy
The widespread use of corticosteroids in clinical practice emphasises the need for a thorough understanding of their metabolic effects. In general, the actions of corticosteroids on carbohydrate, protein, and lipid metabolism result in increased hepatic capacity for gluconeogenesis and enhanced catabolic actions upon muscle, skin, lymphoid, adipose and connective tissues. Because of the morbidity associated with steroid therapy, the clinician must carefully consider in each case the gains that can reasonably be expected from corticosteroid therapy versus the inevitable undesirable side effects of prolonged therapy...
September 1978: Drugs
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