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Pneumonia and steroides

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https://www.readbyqxmd.com/read/29031617/steroid-sparing-effects-of-doxofylline
#1
Yanira Riffo-Vasquez, Radhakrishnan Venkatasamy, Clive P Page
Glucocorticosteroids are widely used in the treatment of asthma and chronic obstructive pulmonary disease (COPD). However, there are growing concerns about the side effect profile of this class of drug, particularly an increased risk of pneumonia. Over the last two decades there have been many attempts to find drugs to allow a reduction of glucocorticosteroids, including xanthines such as theophylline. Use of xanthines has been shown to lead to a reduction in the requirement for glucocorticosteroids, although xanthines also have a narrow therapeutic window limiting their wider use...
October 12, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29030378/worsening-guillain-barr%C3%A3-syndrome-harbinger-of-iris-in-hiv
#2
Neeharika L Mathukumalli, Niloufer Ali, Meena A Kanikannan, Sireesha Yareeda
We report an HIV patient aged 38 years with acute inflammatory demyelinating polyradiculoneuropathy subtype of Guillain-Barré syndrome (GBS) as the only manifestation of seroconversion and worsening of GBS being the harbinger of immune reconstitution inflammatory syndrome (IRIS). To date, only 5 cases of GBS during IRIS are reported. They manifested either during the third week or later after starting highly active antiretroviral therapy (HAART). Our patient witnessed worsening weakness by fifth day after starting HAART, even before the occurrence of Pneumocystis jirovecii pneumonia, cautioning one of the impending serious complications of IRIS and helped us initiate steroids at an early date...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29021484/anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-complicated-by-periaortitis-and-cranial-hypertrophic-pachymeningitis-a-report-of-an-autopsy-case
#3
Hajime Kaga, Atsushi Komatsuda, Masaya Saitoh, Mizuho Nara, Ayumi Omokawa, Masaru Togashi, Shin Okuyama, Hideki Wakui, Naoto Takahashi
Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a systemic inflammatory disorder categorized as small-vessel vasculitis. We herein report an elderly Japanese man with AAV (granulomatous with polyangiitis affecting the eyes, nose, lungs, and kidneys) who also showed periaortitis at the diagnosis and developed cranial hypertrophic pachymeningitis (HP) during steroid maintenance therapy. His consciousness disturbance caused by HP improved after steroid pulse therapy, but he died of aspiration pneumonia...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28971302/risk-factors-for-postoperative-complications-following-diverting-loop-ileostomy-takedown
#4
Anuradha R Bhama, Farwa Batool, Stacey D Collins, Jane Ferraro, Robert K Cleary
INTRODUCTION: Diverting loop ileostomies are frequently created to divert the fecal stream in an effort to protect downstream anastomoses. These are later reversed to restore intestinal continuity. The goal of this study is to evaluate risk factors for postoperative complications following diverting loop ileostomy takedown. MATERIALS AND METHODS: Patients who underwent diverting loop ileostomy takedown between January 1, 2010 and April 28, 2015 were identified in the Michigan Surgical Quality Collaborative registry...
October 2, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28969741/abruptio-placentae-with-type-ii-respiratory-failure-secondary-to-acute-interstitial-pneumonia-responsive-to-steroids
#5
Muhammad Umer Salim, Syed Muhammad Mustahsan, Anum Fatima
Acute Interstitial Pneumonia (AIP) is categorized as Idiopathic Interstitial Pneumonia (IIP), in which the cause is unknown. Ayoung female of 22 years presented in 34 weeks gestation with abruptio placentae (AP) and underwent Lower Segment Caesarian Section (LSCS) for AP. It progressed to type II respiratory failure secondary to AIPon 4th day post-surgery. It remained unresponsive when treated with noninvasive ventilation (NIV-BiPAP) along with antibiotics. Later, a trial treatment of pulse therapy of Methylprednisolone was executed on 7th day post-surgery which resulted in dramatic improvement in symptoms...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28956537/epidemiology-and-treatment-of-the-commonest-form-of-listeriosis-meningitis-and-bacteraemia
#6
Pasquale Pagliano, Ferhat Arslan, Tiziana Ascione
Listeria monocytogenes is a Gram-positive bacillus and facultative intracellular bacterium whose transmission occurs mainly through the consumption of contaminated food. Listeriosis has an incidence estimated at around three-six cases per million per year and the most common forms of the infection are neurolisteriosis, bacteraemia, and maternal-neonatal infection. Those affected by listeriosis are at the extremes age of the life or report specific risk factors, such as malignancies, causing a defect of cellular immunity...
September 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28954408/history-and-outcome-of-febrile-neutropenia-outside-the-oncology-setting-a-retrospective-study-of-76-cases-related-to-non-chemotherapy-drugs
#7
Emmanuel Andrès, Rachel Mourot-Cottet, Frédéric Maloisel, Olivier Keller, Thomas Vogel, François Séverac, Martine Tebacher, Jacques-Eric Gottenberg, Jean-Christophe Weber, Georges Kaltenbach, Bernard Goichot, Jean Sibilia, Anne-Sophie Korganow, Raoul Herbrecht
BACKGROUND: Despite major advances in its prevention and treatment, febrile neutropenia remains a most concerning complication of cancer chemotherapy. Outside the oncology setting, however, only few data are currently available on febrile neutropenia related to non-chemotherapy drugs. We report here data on 76 patients with febrile neutropenia related to non-chemotherapy drugs, followed up in a referral center within a university hospital. PATIENTS AND METHODS: Data from 76 patients with idiosyncratic drug-induced febrile neutropenia were retrospectively reviewed...
September 26, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28932614/acute-low-dose-hydralazine-induced-lupus-pneumonitis
#8
Sarah K Holman, Donique Parris, Sarah Meyers, Jason Ramirez
A 35-year-old female was started on hydralazine 10 mg orally three times a day for treatment of postpartum hypertension. Three months later, after multiple unsuccessful courses of prednisone and antibiotics for presumed pneumonia and asthma exacerbations, her respiratory symptoms progressed in severity and she developed resting hypoxia. Previous diagnostic work-up included spirometry with a restrictive pattern, chest CT showing bilateral basilar consolidation, negative BAL, and nonspecific findings on lung biopsy of mild inflammatory cells...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28930847/guillain-barr%C3%A3-like-axonal-polyneuropathy-associated-with-toscana-virus-infection-a-case-report
#9
Eugenia Rota, Nicola Morelli, Paolo Immovilli, Paola De Mitri, Donata Guidetti
RATIONALE: Numerous cases of post-infectious Guillain-Barré syndrome (GBS) have been reported in the literature. Toscana virus (TOSV) is an arthropod-borne emerging pathogen in the Mediterranean area. PATIENT CONCERNS: A 40-year-old male patient was admitted to hospital for acute facial weakness, associated to numbness paraesthesias at lower and upper limbs. The neurological examination revealed facial diplegia and reduced tendon reflexes. The nerve conduction studies documented an acute motor and sensory axonal neuropathy (AMSAN); the lumbar puncture detected albuminocytologic dissociation...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28919347/invasive-mold-infections-of-the-central-nervous-system-in-patients-with-hematologic-cancer-or-stem-cell-transplantation-2000-2016-uncommon-with-improved-survival-but-still-deadly-often
#10
Minas P Economides, Leomar Y Ballester, Vinodh A Kumar, Ying Jiang, Jeffrey Tarrand, Victor Prieto, Harrys A Torres, Dimitrios P Kontoyiannis
BACKGROUND: Historically considered to have very poor outcome, there is paucity of recent data regarding invasive mold infections (IMIs) of the central nervous system (CNS) in patients with hematologic cancer (HC) or stem cell transplantation (SCT). METHODS: We reviewed the records of HC patients and/or SCT recipients who were diagnosed with CNS IMIs (EORTC/MSG criteria) at MD Anderson Cancer Center (1/1/2000-6/31/2016). Risk factors for survival at day (d) 42 post diagnosis were assessed...
September 14, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28904944/antibacterial-and-antibiotic-modifying-activity-of-methanol-extracts-from-six-cameroonian-food-plants-against-multidrug-resistant-enteric-bacteria
#11
Joachim K Dzotam, Victor Kuete
The present work was designed to investigate the antibacterial activities of methanol extracts from six Cameroonian edible plants and their synergistic effects with some commonly used antibiotics against multidrug-resistant (MDR) Gram-negative bacteria expressing active efflux pumps. The extracts were subjected to qualitative phytochemical screening and the microdilution broth method was used for antibacterial assays. The results of phytochemical tests indicate that all tested crude extracts contained polyphenols, flavonoids, triterpenes, and steroids...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28891032/the-need-for-unique-risk-adjustment-for-surgical-site-infections-at-a-high-volume-tertiary-care-center-with-inherent-high-risk-colorectal-procedures
#12
E Gorgun, C Benlice, J Hammel, T Hull, L Stocchi
BACKGROUND: The aim of the present study was to create a unique risk adjustment model for surgical site infection (SSI) in patients who underwent colorectal surgery (CRS) at the Cleveland Clinic (CC) with inherent high risk factors by using a nationwide database. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients who underwent CRS between 2005 and 2010. Initially, CC cases were identified from all NSQIP data according to case identifier and separated from the other NSQIP centers...
September 11, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28881516/-effectiveness-and-safety-of-rituximab-for-children-with-autoimmune-diseases-of-the-nervous-system
#13
Z Fu, X H Bao, Y Wu, J Zhou, Y H Zhang, Y Zhang, T Y Ji, Y Chen
Objective: To assess the effectiveness and safety of rituximab in Chinese children with autoimmune diseases of the nervous system. Method: An ambispective cohort study enrolled patients with refractory and(or) relapse autoimmune diseases of nervous system from June 2010 to June 2016 in Peking University First Hospital.These patients failed to respond to steroids and(or)intravenous immunoglobulin (IVIG) were treated with rituximab and seen for follow-up visits once every 3 months.The effectiveness was assessed by modified Rankin scale (mRs) and the annualized relapse rate...
September 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28870847/bundle-of-care-for-blunt-chest-trauma-patients-improves-analgesia-but-increases-rates-of-intensive-care-unit-admission-a-retrospective-case-control-study
#14
Cédric Carrie, Laurent Stecken, Elsa Cayrol, Vincent Cottenceau, Laurent Petit, Philippe Revel, Matthieu Biais, François Sztark
INTRODUCTION: This single-centre retrospective case-control study aimed to assess the effectiveness of a multidisciplinary clinical pathway for blunt chest trauma patients admitted in emergency department (ED). PATIENTS AND METHODS: All consecutive blunt chest trauma patients with more than 3 rib fractures and no indication of mechanical ventilation were compared to a retrospective cohort over two 24-month periods, before and after the introduction of the bundle of care...
September 21, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28869233/meropenem-a-possible-new-culprit-in-eosinophilic-lung-diseases
#15
Nathalie Abi Hatem, Sabrina Campbell, Edmundo Rubio, Anthony Lukas Loschner
Eosinophilic lung diseases are a diverse group of pulmonary disorders with an extensive list of differential diagnoses. Multiple drugs particularly antibiotics can cause pulmonary eosinophilia with variable pulmonary manifestations. Cutaneous drug reactions are common. Diagnosis is usually made on clinical history and blood eosinophilia with an accumulation of eosinophils in alveolar spaces on histologic analysis. Imaging findings are nonspecific. Stopping the offending agent is often enough while a short course of corticosteroids can hasten recovery...
September 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28861334/severe-pneumocystis-jiroveci-pneumonia-in-a-patient-on-temozolomide-therapy-a-case-report-and-review-of-literature
#16
Babar Ahmad Khan, Sania Khan, Benjamin White, Ambika Eranki
A 66 year old man was diagnosed with CNS diffuse large B-cell lymphoma, and underwent treatment with Temozolomide, Dexamethasone, Rituximab, and radiation therapy, and prolonged steroid taper with Dexamethasone. Approximately one month after this, he presented with severe acute hypoxemic respiratory failure, and was admitted to the Medical Intensive Care Unit. Imaging showed diffuse ground glass opacities. Patient underwent diagnostic bronchoalveolar lavage which was positive for Pneumocystis jiroveci. He did not respond well to appropriate therapy and was transitioned to comfort care per his family's wishes, and expired...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28855459/background-characteristics-and-clinical-features-of-elderly-patients-with-hyperglycemic-hyperosmolar-syndrome
#17
Takuya Yamaoka, Yoshiaki Tamura, Remi Kodera, Yuki Tsuboi, Ken Sato, Yuko Chiba, Seijiro Mori, Hideki Ito, Atsushi Araki
AIM: Few reports have described the characteristics of hyperglycemic hyperosmolar syndrome (HHS) in the elderly. We investigated the background characteristics and clinical features of 14 elderly patients with HHS. METHODS: HHS was diagnosed based on a blood glucose level of >600 mg/dL and an effective plasma osmolality [2 (Na) + glu/18] of >320 mOsm/kg. For 14 cases of HHS, we investigated the medical and social backgrounds of the patients, their clinical findings, and the outcomes...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/28838146/prolonged-shedding-of-human-coronavirus-in-hematopoietic-cell-transplant-recipients-risk-factors-and-viral-genome-evolution
#18
Chikara Ogimi, Alexander L Greninger, Alpana A Waghmare, Jane M Kuypers, Ryan C Shean, Hu Xie, Wendy M Leisenring, Terry L Stevens-Ayers, Keith R Jerome, Janet A Englund, Michael Boeckh
Background: Recent data suggest that human coronavirus (HCoV) pneumonia is associated with significant mortality in hematopoietic cell transplant (HCT) recipients. Investigation of risk factors for prolonged shedding and intrahost genome evolution may provide critical information for development of novel therapeutics. Methods: We retrospectively reviewed HCT recipients with HCoV detected in nasal samples by polymerase chain reaction (PCR). HCoV strains were identified using strain-specific PCR...
July 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28831119/altered-lipid-metabolism-in-recovered-sars-patients-twelve-years-after-infection
#19
Qi Wu, Lina Zhou, Xin Sun, Zhongfang Yan, Chunxiu Hu, Junping Wu, Long Xu, Xue Li, Huiling Liu, Peiyuan Yin, Kuan Li, Jieyu Zhao, Yanli Li, Xiaolin Wang, Yu Li, Qiuyang Zhang, Guowang Xu, Huaiyong Chen
Severe acute respiratory syndrome-coronavirus (SARS-CoV) and SARS-like coronavirus are a potential threat to global health. However, reviews of the long-term effects of clinical treatments in SARS patients are lacking. Here a total of 25 recovered SARS patients were recruited 12 years after infection. Clinical questionnaire responses and examination findings indicated that the patients had experienced various diseases, including lung susceptibility to infections, tumors, cardiovascular disorders, and abnormal glucose metabolism...
August 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28814258/management-of-complicated-pneumonia-in-childhood-a-review-of-recent-literature
#20
John B Darby, Amrita Singh, Ricardo Quinonez
BACKGROUND: Despite declining rates of community acquired pneumonia (CAP) in children, complicated pneumonia has been on the rise in the last two decades. The management of complicated pneumonia is challenging and continues to be an area of investigation. Despite recently published guidelines, many gaps exist and recent studies attempt to answer challenging questions. OBJECTIVE: To review recently published literature to inform the clinician on the most up to date management of complicated pneumonia in children...
August 16, 2017: Reviews on Recent Clinical Trials
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