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https://www.readbyqxmd.com/read/29342449/increased-use-of-adrenaline-in-the-management-of-childhood-anaphylaxis-over-the-last-decade
#1
Kristina Rueter, Brennan Ta, Natasha Bear, Michaela Lucas, Meredith L Borland, Susan L Prescott
BACKGROUND: We recently determined that allergy training programs have improved physician recognition and diagnosis of pediatric anaphylaxis in the last decade. OBJECTIVE: To investigate for changes in management, in particular the appropriate use of adrenaline for the treatment of anaphylaxis in a tertiary pediatric emergency department (PED). METHODS: We conducted a retrospective case note study including children aged 0 to 16 years coded and verified for anaphylaxis comparing cases in years 2003/2004 with 2012...
January 13, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29315782/exogenous-cushing-syndrome-due-to-misuse-of-potent-topical-steroid
#2
Fatma Özgüç Çömlek, Sevim Örüm, Salih Aydın, Filiz Tütüncüler
We report an infant with exogenous Cushing syndrome after being treated for 2 months with a potent topical corticosteroid via the mother's application of topical clobetasol for diaper rash without a prescription. We emphasize that potent topical steroids should be used with great caution, especially when used under occlusion (e.g., diaper area) and that parents should be warned about potential side effects of these medications, particularly when used in infants.
January 9, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29301471/the-association-between-metabolic-syndrome-and-its-components-with-systemic-lupus-erythematosus-a-comprehensive-systematic-review-and-meta-analysis-of-observational-studies
#3
J Hallajzadeh, M Khoramdad, N Izadi, N Karamzad, A Almasi-Hashiani, E Ayubi, M Qorbani, R Pakzad, M J M Sullman, S Safiri
Objectives Based upon inflammatory-related factors in chronic systemic lupus erythematosus (SLE), as well as the long-term prescription of corticosteroids, metabolic syndrome (MetS) prevalence is expected to be higher in SLE patients than among those without SLE. The aim of this study was to systematically analyze: (1) the worldwide prevalence of MetS in patients with SLE using different criteria, (2) the risk of MetS in patients with SLE compared with those without SLE, and (3) the risk of MetS component in patients with SLE compared with healthy controls...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29278942/objective-confirmation-of-asthma-diagnosis-improves-medication-adherence
#4
V Backer, L Stensen, A Sverrild, E Wedge, C Porsbjerg
OBJECTIVE: The impact of diagnostic work-up in asthma management on medication redemption and probably also drug adherence is largely unknown, but we hypothesized that a confirmed diagnosis of asthma in a hospital-based out-patient clinic increases the willingness to subsequent medication redemption in a real life setting. METHODS: In a retrospective register-based study, 300 medical records of patients referred with possible asthma during one year were examined, of whom 171 had asthma (57%)...
December 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29238240/the-effect-of-dpp-4-inhibitors-on-asthma-control-an-administrative-database-study-to-evaluate-a-potential-pathophysiological-relationship
#5
Gene Colice, David Price, Maria Gerhardsson de Verdier, Karma Rabon-Stith, Christopher Ambrose, Katherine Cappell, Debra E Irwin, Paul Juneau, Anna Vlahiotis
Rationale: DPP-4 may regulate immunological pathways implicated in asthma. Assessing whether DPP-4 inhibitor (DPP-4i) use might affect asthma control is clinically important because DPP-4i use in type 2 diabetes mellitus management (T2DM) is increasing. This study evaluated associations between DPP-4i use and asthma control. Methods: This was a retrospective, observational, matched cohort study using administrative claims in the MarketScan® Commercial Claims and Encounters (Commercial) and Medicare Supplemental and Coordination of Benefits (Medicare Supplemental) databases...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29228528/the-dilemma-of-irrational-antibiotic-and-corticosteroid-prescription-in-iran-how-much-it-can-affect-the-medicine-expenditures
#6
Parisa Mehdizadeh, Nooredin Dopeykar, Mohammad Meskarpour-Amiri, Hediyeh Zekri, Mahmoud Salesi
In recent years the high cost of medicines and the lack of it were one of the major problems in developing countries that despite numerous efforts to solve the root causes of this problem, the issue remains, unfortunately. Therefore, this study aimed to assess the impact of antibiotics and corticosteroids prescription on the medicines expenditures. This was descriptive-analytical study that conducted to assess the function of medical expenditures through prescription letters and analysis the factors affecting medicine expenditures...
October 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29221297/current-status-of-asthma-care-in-south-korea-nationwide-the-health-insurance-review-and-assessment-service-database
#7
Joon Young Choi, Hyoung Kyu Yoon, Jae Ha Lee, Kwang Ha Yoo, Bo Yeon Kim, Hye Won Bae, Young Kyoon Kim, Chin Kook Rhee
Background: Quality control is important for patients with asthma because of its prevalence and because the social burden is substantial. This study analyzed the Health Insurance Review and Assessment Service (HIRA) database to assess asthma quality control in South Korea. Methods: We investigated the HIRA nationwide database for reimbursed insurance claims from all medical institutions in South Korea from July 2013 to June 2014. The number of patients with asthma were evaluated and the medical institutions were categorized by type of medical institution...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29208079/asthma-control-lung-function-symptoms-and-corticosteroid-sparing-after-omalizumab-initiation-in-patients-with-allergic-asthma
#8
(no author information available yet)
BACKGROUND: Omalizumab is approved in patients with moderate-to-severe allergic asthma with symptoms uncontrolled, despite the mainstay therapy. OBJECTIVE: Electronic medical records (EMR) were used to increase the knowledge of omalizumab effectiveness in areal-world setting. METHODS: Patients with uncontrolled moderate-to-severe allergic asthma, ages greater than or equal to 12 years old, initiated on omalizumab (index date), with greater than or equal to 12 months of pre- and postindex data, were identified in an EMR data base...
December 5, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29170340/43%C3%A2-management-of-acute-low-back-pain-in-the-ed-a-systematic-review
#9
Jane Ashbrook, Nikos Rodgdakis, Peter Goodwin, Gill Yeowell, Michael Callaghan
STUDY OBJECTIVE: There is no consensus on the management of low back pain in the ED and evidence suggests that these patients are likely to receive unwarranted imaging and inappropriate opioid prescription.The purpose of this study is to review the available literature pertaining to the clinical management of acute low back pain in the ED. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines were observed during this review...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29168213/economic-assessment-of-actual-prescription-of-drugs-for-treatment-of-atopic-dermatitis-differences-between-dermatology-and-pediatrics-in-large-scale-receipt-data
#10
Yoko Komura, Takamichi Kogure, Kazuo Kawahara, Hiroo Yokozeki
Using large-scale receipt data, we analyzed the differences in the prescription of drugs and their costs between dermatology and pediatrics in the treatment of atopic dermatitis (AD) in children. Between August 2010 and July 2011, 50 706 patients were diagnosed as having AD, and the data of 21 075 (15 257 dermatology, 5818 pediatric) patients aged 0-14 years were included in this study. The use of classes I (strongest), II (very strong), and III (strong) topical corticosteroids and tacrolimus was significantly higher in dermatology than in pediatrics (class I, 2...
November 23, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/29164650/market-share-and-costs-of-biologic-therapies-for-inflammatory-bowel-disease-in-the-usa
#11
H Yu, D MacIsaac, J J Wong, Z M Sellers, A A Wren, R Bensen, C Kin, K T Park
BACKGROUND: Real-world data quantifying the costs of increasing use of biologics in inflammatory bowel disease (IBD) are unknown. AIM: To determine the outpatient IBD drug utilization trends, relative market share, and costs in the USA during a 9-year period. METHODS: The Truven MarketScan(®) Database was analysed for patients with Crohn's disease (CD) and ulcerative colitis (UC) during 2007-2015. National drug codes were used to identify prescription drugs; Healthcare Common Procedure Coding System J-codes were used to capture biologic out-patient infusions...
November 22, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29145237/the-impact-of-the-government-health-funding-on-prescribing-behaviors-in-community-health-institutions-in-china
#12
Gang Sun, Zuxun Lu, Yong Gan, Xiaoxin Dong, Yongbin Li, Yunxia Wang, Liqing Li
Government health funding (GHF) is a cosmopolitan problem. It is especially conspicuous in China, where drug sales become a main source of medical institutions' incomes due to limited GHF. This is well known as China's "drug maintain medical institutions (DMMIs)" system which results directly in very high use of antibiotics, injections, and corticosteroids. However, few statistical data existed in China on the association between the GHF and the prevalence of inappropriate drug prescribing, despite widespread acknowledgment of its existence...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29131874/association-between-inhaled-corticosteroid-use-and-bone-fracture-in-children-with-asthma
#13
Natasha Gray, Andrew Howard, Jingqin Zhu, Laura Y Feldman, Teresa To
Importance: Daily use of inhaled corticosteroids is a widely recommended treatment for mild persistent asthma in children. There is concern that, similar to systemic corticosteroids, inhaled corticosteroids may have adverse effects on bone health. Objective: To determine whether there is an increased risk of bone fracture associated with inhaled corticosteroid use in children with asthma. Design, Setting, and Participants: In this population-based nested case-control study, we used health administrative databases to identify a cohort of children aged 2 to 18 years with a physician diagnosis of asthma between April 1, 2003, and March 31, 2014, who were eligible for public drug coverage through the Ontario Drug Benefit Program (Ontario, Canada)...
November 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29116901/use-of-ics-in-copd-from-blockbuster-medicine-to-precision-medicine
#14
Marco Contoli, Angelo G Corsico, Pierachille Santus, Fabiano Di Marco, Fulvio Braido, Paola Rogliani, Luigi Calzetta, Nicola Scichilone
Chronic obstructive pulmonary disease (COPD) is a major cause of mortality worldwide, whose burden is expected to increase in the next decades, because of numerous risk factors, including the aging of the population. COPD is both preventable and treatable by an effective management including risk factor reduction, prevention, assessment, and treatment of acute exacerbations and co-morbidities. The available agents approved for COPD treatment are long-acting or ultra-long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) bronchodilators, as well as inhaled corticosteroids (ICS) in combination with LABAs...
November 8, 2017: COPD
https://www.readbyqxmd.com/read/29105270/inappropriate-inhaled-corticosteroid-prescribing-in-chronic-obstructive-pulmonary-disease-patients
#15
Amelia Harrison, Brigitte Borg, Bruce Thompson, Mark Hew, Eli Dabscheck
The Australian National Chronic Obstructive Pulmonary Disease (COPD) guidelines recommend that inhaled corticosteroids (ICS) be reserved for patients with a post-bronchodilator forced expiratory volume in 1 s (FEV1 ) less than 50% predicted and those who experience ≥2 exacerbations in 12 months. In total, 707 COPD patients were identified from the lung function test database at our tertiary hospital; 52.4% of patients with a post-bronchodilator FEV1 ≥50% were prescribed an ICS. Significant discordance exists between guideline recommendations and inhaler prescription...
November 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29081653/drug-utilization-and-therapy-provision-patterns-by-prescriber-types-among-patients-with-systemic-lupus-erythematosus-in-korea
#16
Sooyoung Shin
BACKGROUND: Systemic lupus erythematosus (SLE) poses a growing challenge for healthcare systems, affecting an increasing number of people in Korea. This study aimed to investigate the prescribing patterns of SLE therapies and to compare common drug regimens prescribed by provider types. METHODS: Sampled national health insurance claims data in 2015 were used to select eligible SLE patients. Frequency analyses were carried out regarding patient characteristics related to relevant SLE prescriptions...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29067959/corticosteroid-induced-osteonecrosis-of-the-femoral-head-detection-diagnosis-and-treatment-in-earlier-stages
#17
REVIEW
Li-Hua Liu, Qing-Yu Zhang, Wei Sun, Zi-Rong Li, Fu-Qiang Gao
OBJECTIVE: This review aimed to provide a current recommendation to multidisciplinary physicians for early detection, diagnosis, and treatment of corticosteroid-induced osteonecrosis of the femoral head (ONFH) based on a comprehensive analysis of the clinical literature. DATA SOURCES: For the purpose of collecting potentially eligible articles, we searched for articles in the PubMed, Cochrane Library, Embase, and CNKI databases up to February 2017, using the following key words: "corticosteroid", "osteonecrosis of the femoral head", "risk factors", "diagnosis", "prognosis", and "treatment"...
November 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29063436/non-prescription-treatment-options
#18
Sandy François, Kayla Felix, Leah Cardwell, Taylor Edwards, Zakiya Rice
The pathogenesis of atopic dermatitis (AD) is complex and multifactorial. However, recent advancements in the genetics and pathophysiology of AD suggest that epidermal barrier dysfunction is paramount in the development and progression of the condition (Boguniewicz and Leung, Immunol Rev 242(1):233-246, 2011). In addition to standard therapy for AD, there are a plethora of non-prescription treatment modalities which may be employed. Over-the-counter treatments for atopic dermatitis can come in the form of topical corticosteroids, moisturizers/emollients, and oral anti-histamines...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29063435/prescription-treatment-options
#19
Brad Ackerson, Ryan Thorpe, Matilda W Nicholas
Atopic dermatitis frequently requires the use of over-the-counter and prescription medications for effective management. Emollients and topical corticosteroids are effective for most patients and are the most commonly utilized agents by experienced dermatologists. Antihistamines, antibiotics, and calcineurin inhibitors may also prove helpful in the correct clinical scenarios. Severe atopic dermatitis, however, can be difficult to manage and not infrequently require substantial immunomodulatory medications. Targeted molecular therapies, such as dupilumab, are promising, emerging atopic dermatitis therapies...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29061489/corticosteroid-therapy-exacerbates-the-reduction-of-melatonin-in-multiple-sclerosis
#20
Shima Dokoohaki, Majid Ghareghani, Amir Ghanbari, Naser Farhadi, Kazem Zibara, Heibatollah Sadeghi
OBJECTIVES: Corticosteroid therapy is employed in multiple sclerosis (MS), a neurological abnormality characterized by an inflammatory process. Melatonin, a potent sleep-promoting and circadian phase regulatory hormone, is produced mainly in the pineal gland whose inhibition leads to sleep disturbances. METHODS: In this study, methylprednisolone (MP) corticosteroid treatment was used in an acute experimental autoimmune encephalomyelitis (EAE) rat model (intraperitoneal, 30 mg/kg) and in MS patients (intravenous, 1000 mg/day), followed by assessing melatonin serum levels...
October 20, 2017: Steroids
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