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MedWorm: Corticosteroid Therapy provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in the Corticosteroid Therapy category.

Last Build Date: Tue, 29 Mar 2016 16:22:28 +0100


An unusual presentation of invasive aspergillosis - Diagnostic and management dilemmas

Tue, 29 Mar 2016 09:23:38 +0100

Background: Invasive Aspergillosis is a fungal infection occurring with increased incidence in patients who are receiving chemotherapy, immunosuppressive therapy or long term corticosteroid therapy. Among these, it more commonly afflicts patients with pre-existing respiratory compromise such as COPD or bronchial asthma. Typically it presents with fever, cough, dyspnoea, pleuritic chest pain and occasionally with haemoptysis. (Source: International Journal of Infectious Diseases)

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Mp87-19 the impact of steroid use on artificial urinary sphincter reoperation

Mon, 28 Mar 2016 19:24:02 +0100

The objective of this study was to determine if oral steriod use was associated with an increased risk of AUS related reoperation. (Source: The Journal of Urology)

Efficacy and Safety of Corticosteroids in Pneumonia Efficacy and Safety of Corticosteroids in Pneumonia

Mon, 28 Mar 2016 14:05:43 +0100

Although widely used, is there an actual benefit to using a short course of systemic corticosteroids in community-acquired pneumonia? Medscape Pulmonary Medicine (Source: Medscape Today Headlines)

Pathogenesis of Alcoholic Liver Disease

Sun, 27 Mar 2016 22:00:00 +0100

Alcoholic liver disease includes a broad clinical-histological spectrum from simple steatosis, cirrhosis, acute alcoholic hepatitis with or without cirrhosis to hepatocellular carcinoma as a complication of cirrhosis. The pathogenesis of alcoholic liver disease can be conceptually divided into (1) ethanol-mediated liver injury, (2) inflammatory immune response to injury, (3) intestinal permeability and microbiome changes. Corticosteroids may improve outcomes, but this is controversial and probably only impacts short-term survival. New pathophysiology-based therapies are under study, including antibiotics, caspase inhibition, interleukin-22, anakinra, FXR agonist and others. These studies provide hope for better future outcomes for this difficult disease. (Source: Clinics in Liver Disease)

Dural amyloidoma: An unusual presentation of CNS amyloidosis

Sun, 27 Mar 2016 22:00:00 +0100

A 46-year-old previously healthy woman presented with recurring left frontal and occipital headache. A brain MRI demonstrated diffuse dural thickening (figure 1, top). CSF analysis showed no abnormalities. A meningeal biopsy had pathology typical of an amyloid tumor (figure 2). Further investigations did not reveal evidence of plasma-cell tumor, multiple myeloma, systemic amyloidosis, underlying inflammatory disorder, or malignancy. Follow-up brain MRIs revealed regression of the pachymeningeal disease after treatment with corticosteroids and radiotherapy (figure 1, bottom). (Source: Neurology)

Dramatic improvement of anti-SS-A/Ro-associated interstitial lung disease after immunosuppressive treatment

Sun, 27 Mar 2016 22:00:00 +0100

This report may be useful in making therapeutic decisions in case of interstitial lung disease associated with anti-SS-A antibody. (Source: Rheumatology International)

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Sun, 27 Mar 2016 22:00:00 +0100

Disorders of the iliopsoas can be a significant source of groin pain in the athletic population. Commonly described pathologic conditions include iliopsoas bursitis, tendonitis, impingement, and snapping. The first-line treatment for iliopsoas disorders is typically conservative, including activity modification, physical therapy, nonsteroidal anti-inflammatory drugs, and corticosteroid injections. Surgical treatment can be considered if the patient fails conservative measures and typically involves arthroscopic lengthening the musculotendinous unit and treatment of concomitant intra-articular abnormality. Tendon release has been described: in the central compartment, in the peripheral compartment, and at the lesser trochanter, with similar outcomes observed between the techniques. (Source:...

Eosinophilic Esophagitis: An Evidence-Based Approach to Therapy.

Sun, 27 Mar 2016 09:51:02 +0100

Authors: González-Cervera J, Lucendo AJ Abstract In recent years, several randomized controlled trials and meta-analyses have evaluated the efficacy of the various therapeutic options available for treating patients with eosinophilic esophagitis, including dietary modifications, proton pump inhibitors, topical corticosteroids, and endoscopic esophageal dilation. Proton pump inhibitors are currently considered the first-line treatment for eosinophilic esophagitis, achieving histological remission and improvement of symptoms in 50.5% and 60.8% of patients, respectively. The efficacy of topical corticosteroids in eosinophilic esophagitis has been assessed in several trials. Meta-analyses summarizing results indicate that budesonide and fluticasone propionate are significantly superio...

Current and Future Techniques in Wound Healing Modulation after Glaucoma Filtering Surgeries.

Sat, 26 Mar 2016 17:54:02 +0100

Authors: Masoumpour MB, Nowroozzadeh MH, Razeghinejad MR Abstract Filtering surgeries are frequently used for controlling intraocular pressure in glaucoma patients. The long-term success of operation is intimately influenced by the process of wound healing at the site of surgery. Indeed, if has not been anticipated and managed accordingly, filtering surgery in high-risk patients could end up in bleb failure. Several strategies have been developed so far to overcome excessive scarring after filtering surgery. The principal step involves meticulous tissue handling and modification of surgical technique, which can minimize the severity of wound healing response at the first place. However, this is usually insufficient, especially in those with high-risk criteria. Thus, several adjuvan...

Continuous Positive Airway Pressure to Prevent Neonatal Lung Injury: How Did We Get Here, and How Do We Improve?

Fri, 25 Mar 2016 23:00:00 +0100

Supporting the respiratory status of the newly born, critically ill premature neonate is a long held focus of the practicing neonatologist. One could argue that neonatology evolved out of the search for the pathophysiology of respiratory distress syndrome (RDS); and that it was defined by interventions aimed at preventing and treating RDS, namely antenatal corticosteroids (ACS) and surfactant treatment. There are now multiple interventions to assist the premature infant during this transition including ACS, surfactant, monitored administration of supplemental oxygen, and sophisticated mechanical ventilators. (Source: The Journal of Pediatrics)

[Hyperglycemia assessment in the post-anesthesia care unit].

Fri, 25 Mar 2016 20:50:01 +0100

CONCLUSION: The prevalence of hyperglycemia was high in the PACU, and factors such as age, BMI, corticosteroids, blood pressure, and duration of surgery are strongly related to this complication. PMID: 27005828 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Anestesiologia)

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An Open Randomized Trial Comparing the Effects of Oral NSAIDs Versus Steroid Intra-Articular Infiltration in Congestive Osteoarthritis of the Knee.

Fri, 25 Mar 2016 10:27:02 +0100

CONCLUSION: Corticosteroid injections have a short efficacy compared to NSAIDs. Prescribing NSAIDs should consider the cons-indications, comorbidities and their deleterious digestive, renal, and cardiovascular effect. PMID: 27006727 [PubMed - as supplied by publisher] (Source: Open Rheumatology Journal)

Emerging drugs for graft-versus-host disease.

Fri, 25 Mar 2016 09:53:02 +0100

Authors: Kekre N, Antin JH Abstract INTRODUCTION: Graft-versus-host disease (GVHD) leads to significant morbidity and mortality after allogeneic stem cell transplantation. While corticosteroids alone are adequate in some cases, they are often insufficient, leading to poor quality of life associated with the symptoms of disease, or mortality from infection and GVHD. Moreover, corticosteroids have significant side effects and often do not lead to durable responses. New therapies are needed to improve the development and progression of acute and chronic GVHD. Areas covered: We discuss the spectrum of emerging drugs for GVHD prevention and therapy. Cellular therapies will be briefly discussed. The available pre-clinical and clinical data regarding monoclonal antibodies, interleukin-2, ...

Occurrence of and Risk Factors for Ocular Hypertension and Secondary Glaucoma in Juvenile Idiopathic Arthritis-associated Uveitis.

Fri, 25 Mar 2016 06:34:02 +0100

CONCLUSIONS: OHT and SG were common in patients with JIA-associated uveitis. Use of immunosuppressive drugs may decrease the risk of developing OHT. PMID: 27003850 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

Adalimumab for Ocular Inflammation.

Fri, 25 Mar 2016 06:34:02 +0100

CONCLUSIONS: Adalimumab was moderately effective in controlling inflammation in a group of highly pre-treated cases of ocular inflammatory disease. PMID: 27003323 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)

Infections complicating severe alcoholic hepatitis: Enterococcus species represent the most frequently identified pathogen.

Fri, 25 Mar 2016 06:03:02 +0100

Discussion Infections frequently complicate severe alcoholic hepatitis and affect survival. The high rate of Enterococcus infections suggests that commonly used antibiotics, such as cephalosporins and quinolones, may represent an ineffective choice of empiric antibiotic treatment for complicated AH. PMID: 27000534 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Gastroenterology)

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Management of septic shock and severe infections in migrants and returning travelers requiring critical care

Fri, 25 Mar 2016 02:23:13 +0100

Abstract During the past decade, global human movement created a virtually “borderless world”. Consequently, the developed world is facing “forgotten” and now imported infectious diseases. Many infections are observed upon travel and migration, and the clinical spectrum is diverse, ranging from asymptomatic infection to severe septic shock. The severity of infection depends on the etiology and timeliness of diagnosis. While assessing the etiology of severe infection in travelers and migrants, it is important to acquire a detailed clinical history; geography, dates of travel, places visited, type of transportation, lay-overs and intermediate stops, potential exposure to exotic diseases, and activities that were undertaken during travelling and prophylaxis and vaccines eith...

Adrenal Imaging: Magnetic Resonance Imaging and Computed Tomography.

Thu, 24 Mar 2016 23:44:02 +0100

Authors: McCarthy CJ, McDermott S, Blake MA Abstract The adrenal glands are located superior to the kidneys and play an important role in the endocrine system. Each adrenal gland contains an outer cortex, responsible mainly for the secretion of androgens and corticosteroids, and an inner medulla, which secretes epinephrine and norepinephrine. Here, we review the anatomy of the adrenal glands and explain the current imaging modalities that are most useful for the assessment of the various conditions - both benign and malignant - that can affect these glands. As adrenal lesions are often identified incidentally on cross-sectional imaging performed for other reasons, the management of such adrenal 'incidentalomas' is also discussed. In many cases, adrenal lesions have distinctive imag...

IJERPH, Vol. 13, Pages 360: Influence of Occupational and Environmental Exposure to Low Concentrations of Polychlorobiphenyls and a Smoking Habit on the Urinary Excretion of Corticosteroid Hormones

Thu, 24 Mar 2016 23:00:00 +0100

The effects of occupational exposure to low concentrations of polychlorobiphenyls (PCBs) on the urinary excretion of corticosteroid hormones were evaluated, taking into account the influence of cigarette smoking. The study included 26 males working as electrical maintenance staff in a steel factory, previously exposed to a mixture of PCBs (exposed workers), and 30 male workers with no occupational exposure to PCBs (controls). Serum PCBs (33 congeners), urinary 17-hydroxycorticosteroids, 17-ketosteroids (KS) and pregnanes, and their respective glucuronidated and sulfonated compounds, were determined for each subject. PCBs were significantly higher in the exposed workers than controls, and were correlated with age. Both the urinary concentrations of the total 17-KS and pregnanes, and those o...

Blood eosinophils and treatment response in hospitalized exacerbations of chronic obstructive pulmonary disease: A case-control study

Thu, 24 Mar 2016 23:00:00 +0100

Conclusions In severe acute exacerbations of COPD requiring hospitalization, blood eosinophilia identifies a subgroup of subjects characterized by a prompt response to treatment with shorter hospital stay. (Source: Pulmonary Pharmacology and Therapeutics)

Topical sulfasalazine for unresponsive oral lichen planus

Thu, 24 Mar 2016 15:15:54 +0100

Conclusion: Topical sulfasalazine should be considered when OLP does not respond to corticosteroid therapy. Furthermore, high concentrations of IL-1β and IL-8 in the saliva are useful indicators for the application of topical sulfasalazine in OLP patients refractory to steroid treatment. (Source: Quintessence International)

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Protein tyrosine phosphatase PTP-RR regulates corticosteroid sensitivity

Thu, 24 Mar 2016 00:00:00 +0100

We have recently reported that protein phosphate 2A (PP2A) inactivation resulted in increased phosphorylation of the mitogen-activated protein kinase (MAPK) c-Jun N-terminal kinase 1 (JNK1) and glucocorticoid ... (Source: Respiratory Research)

Pneumocystis jiroveci pneumonia in patients treated with systemic immunosuppressive agents for dermatologic conditions: a systematic review with recommendations for prophylaxis

Wed, 23 Mar 2016 23:00:00 +0100

This study was conducted to determine when dermatology patients treated with immunosuppressive medications should be offered P. jiroveci pneumonia prophylaxis. We searched the literature from January 1, 1993, to December 31, 2013, using terms relating to P. jiroveci pneumonia and dermatologic diagnoses to analyze the clinical characteristics of previously affected patients. Guidelines for P. jiroveci pneumonia prophylaxis from other medical fields were also analyzed. Of 17 dermatology patients reported to have contracted P. jiroveci pneumonia, eight (47.1%) died of the pneumonia. Risk factors included lack of prophylaxis, systemic corticosteroid therapy, lymphopenia, hypoalbuminemia, low serum CD4 counts, comorbid pulmonary or renal disease, malignancy, and prior organ transplantation. The...

Complete neurogenic blepharoptosis after minor facial trauma: a case report

Wed, 23 Mar 2016 23:00:00 +0100

We describe our experience of a patient who recovered 7 weeks after treatment with corticosteroids, and review other cases. (Source: British Journal of Oral and Maxillofacial Surgery)

Long‐Term Safety and Efficacy of Epratuzumab in the Treatment of Moderate‐to‐ Severe Systemic Lupus Erythematosus: Results From an Open‐Label Extension Study

Wed, 23 Mar 2016 23:00:00 +0100

ConclusionOpen‐label epratuzumab treatment was well tolerated for up to 3.2 years, and associated with sustained improvements in disease activity and HRQOL, while steroids were reduced. (Source: Arthritis Care and Research)

Standard of treatment and outcomes of adults with lupus nephritis in Africa: a systematic review.

Wed, 23 Mar 2016 23:00:00 +0100

CONCLUSION: This analysis highlights diagnostic challenges in LN in Africa and shows that a CYC/glucocorticoid-based regimen remains the standard of treatment for adult patients. The contributions of this therapy to reported outcomes of LN in Africa require further exploration. PMID: 27013662 [PubMed - as supplied by publisher] (Source: Lupus)

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Pirfenidone‐induced severe phototoxic reaction in a patient with idiopathic lung fibrosis

Wed, 23 Mar 2016 20:22:52 +0100

ConclusionTo our knowledge, this is the first reported case of a severe phototoxic reaction during treatment with pirfenidone. Our aim by presenting this case is to increase the awareness of clinicians for severe phototoxic effects of oral pirfenidone. (Source: Journal of the European Academy of Dermatology and Venereology)

Intensive Care Management of Children Intubated for Croup: a retrospective analysis

Wed, 23 Mar 2016 18:44:09 +0100

Croup remains the commonest reason for acute upper airway obstruction in children, yet there are scarce contemporary data of airway management in those requiring intubation. We performed a retrospective analysis of the intensive care management of children intubated for croup in two quaternary Paediatric Intensive Care Units: Royal Children’s Hospital Melbourne, Australia and Alberta Children’s Hospital Calgary, Canada. Patients intubated for less than three days were compared with those intubated for greater than three days. Patients less than 10 kg body weight were compared to those greater than 10 kg. Demographic, clinical and microbiological data were recorded. Seventy-seven cases of croup requiring intubation were identified. The median duration of intubation was 60 hours. Parainf...

Early and late effects of prenatal corticosteroid treatment on the microRNA profiles of lung tissue in rats.

Wed, 23 Mar 2016 14:45:02 +0100

Authors: Yu HR, Li SC, Tseng WN, Tain YL, Chen CC, Sheen JM, Tiao MM, Kuo HC, Huang CC, Hsieh KS, Huang LT Abstract Glucocorticoids have been administered to mothers at risk of premature delivery to induce maturation of preterm fetal lungs and prevent the development of respiratory distress syndrome. Micro (mi)RNAs serve various crucial functions in cell proliferation, differentiation and organ development; however, few studies have demonstrated an association between miRNAs and lung development. The aim of the present study was to investigate alterations in the miRNA profiles of rat lung tissue following prenatal glucocorticoid therapy for fetal lung development. The differences in miRNA expression profiles were compared between postnatal days 7 (D7) and 120 (D120) rat lung tissue...

Comparison of low-dose intravenous cyclophosphamide with oral mycophenolate mofetil in the treatment of lupus nephritis

Wed, 23 Mar 2016 13:15:29 +0100

This study randomized patients with LN (class III, IV, or V) to receive induction with low-dose CYC or oral MMF with the exclusion of patients with crescentic LN, a serum creatinine over 265 μmol/l, and neurological or pulmonary lupus were excluded. Maintenance therapy with azathioprine and low-dose corticosteroid was started at end of induction therapy. The complete remission rate was 50% in CYC and 54% in MMF group, adverse effect profile was similar except for more gastrointestinal symptoms in the  MMF group. : Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis Efficacy of Remission-Induction Regimens for ANCA-Associated Vasculitis Prolonged disease-free remission following rituximab and low-dose cyclophosphamide therapy for renal ANCA-associated v...

Treatment of Seborrhoeic Dermatitis in Asia: A Consensus Guide

Wed, 23 Mar 2016 01:23:24 +0100

Seborrhoeic dermatitis (SD) is common in Asia. Its prevalence is estimated to be 1-5% in adults. However, larger population-based studies into the epidemiology of SD in Asia are lacking, and the aetiology of SD may differ widely from Western countries and in different parts of Asia. In addition, clinically significant differences between Asian and Caucasian skin have been reported. There is a need to define standardized clinical diagnostic criteria and/or a grading system to help determine appropriate treatments for SD within Asia. With this in mind, experts from India, South Korea, Taiwan, Malaysia, Vietnam, Singapore, Thailand, the Philippines, Indonesia, and Italy convened to define the landscape of SD in Asia at a meeting held in Singapore. The consensus group developed a comprehensive...

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Post-steroid neuropsychiatric manifestations are significantly more frequent in SLE compared with other systemic autoimmune diseases and predict better prognosis compared with de novo neuropsychiatric SLE

Tue, 22 Mar 2016 23:00:00 +0100

In conclusion, PSNP frequently occurred in patients with SLE and treated successfully with immunosuppressive therapy, indicating that NPSLE is likely to harbor patients with PSNP-SLE. (Source: Autoimmunity Reviews)

High daily doses of trimethoprim/sulfamethoxazole are an independent risk factor for adverse reactions in patients with pneumocystis pneumonia and AIDS

Tue, 22 Mar 2016 23:00:00 +0100

Conclusion We found a high incidence of ADRs among patients with PJP and AIDS treated with TMP/SMX, and most involved the skin and liver. A daily dose of ≥ 16 mg/kg of TMP/SMX and age 34 years were independent risk factors for ADRs. (Source: Journal of the Chinese Medical Association)

Behçet’s Disease and Nervous System Involvement

Tue, 22 Mar 2016 23:00:00 +0100

Opinion statement Management of neuro-Behçet’s disease can be divided into two stages: treatment of acute attacks and prevention of relapses. Treatment of acute attacks is accomplished by high-dose intravenous corticosteroids followed by maintenance treatment with oral steroids for 6–12 months depending on the type and severity of the neurological involvement. Relapses can be prevented by using immunosuppressants. Oral immunosuppressants such as azathioprine and mycophenolate are the most widely utilized agents for this purpose. Patients who are refractory or who cannot tolerate these medications can be managed by cyclophosphamide, interferon alpha, or anti-TNF-α monoclonal antibodies such as infliximab, etanercept, and adalimumab. Recent reports showed that newer agents s...

Clinical experience with repository corticotropin injection in patients with multiple sclerosis experiencing mood changes with intravenous methylprednisolone: a case series

Tue, 22 Mar 2016 23:00:00 +0100

We describe six cases of patients with relapsing-remitting MS who had previously experienced detrimental mood changes with MP treatment. Some of these patients had previous histories of mood disorders or other neuropsychiatric symptoms prior to MS diagnosis. All six patients were subsequently treated with repository corticotropin injection for MS exacerbations and each demonstrated improvements in MS symptoms. This clinical experience suggests that repository corticotropin injection should be considered as an alternative for patients who do not tolerate corticosteroids or have difficulties associated with intravenous medication. Furthermore, the rate of neuropsychiatric side effects observed in these patients was low. These observations support repository corticotropin injection as a viabl...

Relation between time interval from antenatal corticosteroids administration to delivery and neonatal outcome in twins

Tue, 22 Mar 2016 23:00:00 +0100

ConclusionThere is a relation between neonatal outcomes in twins and time interval between ACS administration and birth. Therefore, a single ACS course should be administered with caution in order to allow for the completion of the treatment without exceeding an interval of 7 days to delivery. © 2016 Japan Society of Obstetrics and Gynecology (Source: Journal of Obstetrics and Gynaecology Research)

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Effect of retinoic acid on human adrenal corticosteroid synthesis

Tue, 22 Mar 2016 23:00:00 +0100

Publication date: 15 April 2016 Source:Life Sciences, Volume 151 Author(s): Antonella Sesta, Maria Francesca Cassarino, Laura Tapella, Luigi Castelli, Francesco Cavagnini, Francesca Pecori Giraldi Aims Retinoic acid has recently yielded promising results in the treatment of Cushing's disease, i.e., excess cortisol secretion due to a pituitary corticotropin (ACTH)-secreting adenoma. In addition to its effect on the tumoral corticotrope cell, clinical results suggest an additional adrenal site of action. Aim of this study was to evaluate whether retinoic acid modulates cortisol synthesis and secretion by human adrenals in vitro. Main methods Primary cultures from 10 human adrenals specimens were incubated with 10nM, 100nM and 1μM retinoic acid with and without 10nM ACTH for 24h. Co...

Utility of impulse oscillometry in patients with moderate to severe persistent asthma

Tue, 22 Mar 2016 23:00:00 +0100

We have previously shown in a cohort of patients with asthma that impulse oscillometry (IOS) and spirometry are equally useful in predicting asthma control as assessed by prescriptions of oral corticosteroid and inhaled albuterol using health informatics.1 These were patients referred from primary care for screening into clinical trials. We wanted to know how IOS and spirometry were related to the asthma control questionnaire (ACQ) in a real-life secondary care clinic setting. In particular, we were interested in finding out whether IOS outcomes reflecting the frequency-dependent heterogeneity in smaller airways,2 namely, the difference in resistance between 5 Hz and 20 Hz (R5-R20) and the area under the reactance curve (AX), were more closely related to asthma control, as has previousl...

Complete neurogenic blepharoptosis after minor facial trauma: a case report

Tue, 22 Mar 2016 23:00:00 +0100

We describe our experience of a patient who recovered 7 weeks after treatment with corticosteroids, and review other cases. (Source: The British Journal of Oral and Maxillofacial Surgery)

Clinical features and prognostic factors of spinal cord sarcoidosis: a multicenter observational study of 20 BIOPSY-PROVEN patients

Tue, 22 Mar 2016 23:00:00 +0100

Abstract Sarcoidosis of the spinal cord is a rare disease. The aims of this study are to describe the features of spinal cord sarcoidosis (SCS) and identify prognostic markers. We analyzed 20 patients over a 20-year period in 8 French hospitals. There were 12 men (60 %), mostly Caucasian (75 %). The median ages at diagnosis of sarcoidosis and myelitis were 34.5 and 37 years, respectively. SCS revealed sarcoidosis in 12 patients (60 %). Eleven patients presented with motor deficit (55 %) and 9 had sphincter dysfunction (45 %). The median initial Edmus Grading Scale (EGS) score was 2.5. The cerebrospinal fluid (CSF) showed elevated protein level (median: 1.00 g/L, interquartile range (IQR) 0.72–1.97), low glucose level (median 2.84 mmol/L, IQR 1.42–3.45), and elevated wh...

[Smoking, smoking cessation and Crohn's disease].

Tue, 22 Mar 2016 23:00:00 +0100

CONCLUSION: Smokers suffering from CD must routinely be made aware of the disadvantages of smoking, benefits of abstinence and helped to quit smoking. PMID: 27016849 [PubMed - as supplied by publisher] (Source: Presse Medicale)

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Off-Label Uses of Topical Calcineurin InhibitorsOff-Label Uses of Topical Calcineurin Inhibitors

Tue, 22 Mar 2016 05:13:25 +0100

Studies show that topical calcineurin inhibitors may be effective in treating a variety of skin conditions, and as an alternative to long-term topical corticosteroids. What's the latest evidence? Skin Therapy Letter (Source: Medscape Allergy Headlines)

Steroid-responsive IgG4-related disease with isolated prostatic involvement: An unusual presentation with elevated serum PSA

Mon, 21 Mar 2016 23:00:00 +0100

We report an asymptomatic young man who was diagnosed to have IgG4 related prostatitis on TRUS-guided prostate biopsy done for elevated serum PSA, in the absence of any other systemic involvement. The treatment with steroid resulted in normalization of S PSA levels. (Source: Indian Journal of Urology)

Adjunctive corticosteroids improve the need for mechanical ventilation and shorten hospital duration in patients hospitalised with community-acquired pneumonia

Mon, 21 Mar 2016 23:00:00 +0100

Commentary on: Siemieniuk RA, Meade MO, Alonso-Coello P, et al.. Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis. Ann Intern Med 2015;163:519–28. Context Respiratory tract infections and pneumonia in particular are the third leading cause of death worldwide. The prognosis of community-acquired pneumonia (CAP) dramatically improved with the availability of antibiotics; however, it still carries a high risk for long-term morbidity and mortality, which has not changed over the past few decades. Systemic corticosteroids have anti-inflammatory effects that attenuate the inflammatory process in CAP which can potentially be harmful. Adjunct treatment with corticosteroids has been discussed since the 1950s and many stu...

Best evidence supports topical corticosteroids and routine saline irrigations for medical treatment of chronic rhinosinusitis

Mon, 21 Mar 2016 23:00:00 +0100

Commentary on: Rudmik L, Soler ZM. Medical therapies for adult chronic sinusitis: a systematic review. JAMA 2015;314:926–39. Context Chronic rhinosinusitis (CRS) affects between 7% and 15.5% of the US population. In Europe, the latest estimates put prevalence at 10.9%.1 2 The condition produces symptoms such as nasal congestion, facial pressure/pain, purulent nasal drainage and is associated with significant fatigue and decreased productivity. While complications from the disease are rare, CRS is often treated with antibiotics, based on an older understanding that CRS results from bacterial infection. Newer data strongly suggest that CRS results from chronic inflammation of the sinonasal mucosa.3 Among otolaryngologists, the treatment strategy has shifted towards the use of antiinfla...

Ultrasound-guided corticosteroid injections for adhesive capsulitis more effective than placebo

Mon, 21 Mar 2016 23:00:00 +0100

Commentary on: Prestgaard T, Wormgoor ME, Haugen S, et al.. Ultrasound-guided intra-articular and rotator interval corticosteroid injections in adhesive capsulitis of the shoulder: a double-blind, sham-controlled randomized study. Pain 2015;156:1683–91. Context Adhesive capsulitis (frozen shoulder or painful stiff shoulder) is relatively common. It is idiopathic: known associated factors include trauma, diabetes, prolonged immobilisation, age, stroke and autoimmune disease. While self-limited, pain and decreased range of motion can last up to 2–3 years. Therefore, there is practical value in therapeutic interventions to hasten symptom resolution. Arthroscopic examination suggests involvement of both the capsule and the rotator interval, defined as the space between the sub...

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Genetic associations of the response to inhaled corticosteroids in children during an asthma exacerbation

Mon, 21 Mar 2016 23:00:00 +0100

ConclusionHomozygosity for the G allele at rs41423247 of the glucocorticosteroid receptor (NR3C1) gene is associated with a higher improvement in FEV1 at 4 hours in children with moderate to severe asthma exacerbation treated with high dose ICS. This observation may have important clinical implications especially for children who use systemic steroids frequently for recurrent asthma exacerbations.This article is protected by copyright. All rights reserved. (Source: Pediatric Allergy and Immunology)

Id: 37: silent but deadly cytomegalovirus triggering autoimmune hepatitis

Mon, 21 Mar 2016 23:00:00 +0100

Discussion Autoimmune hepatitis is a chronic hepatocellular inflammation and necrosis of unknown cause. The most supported pathogenesis of AIH postulates that a combination of environmental triggers, failure of immune system tolerance and a genetic predisposition that may induce a T cell–mediated immune attack against the liver. Case studies in the literature report AIH being triggered by virus and drugs. There is evidence of cross-reactivity between anti-LKM1 and antibodies against homologous regions of cytomegalovirus (exon CMV130-135). This case could explain an association between cytomegalovirus infection and autoimmune hepatitis. As clinicians, it is difficult to diagnose autoimmune hepatitis because its presentation can be acute, severe, asymptomatic or chronic. Diagnosis requ...

Id: 55: fibrillary glomerulonephritis:looks like amyloid but its not!

Mon, 21 Mar 2016 23:00:00 +0100

Discussion A study of 66 cases identified most common histologic patterns as mesangial, membranoproliferative, endocapillary proliferative, crescentic and necrotizing, membranous and diffuse sclerosing in order of likelihood.This case had focal segmental and global glomerulosclerosis that is a rare finding. In the same study immunofluorescence staining was positive for IgG in 100%, C3 in 92% and both kappa and lambda in 84% cases. This case also demonstrated positive staining for IgG, kappa and lambda. The pathognomonic finding is presence of fibrillary deposits in the mesangium and glomerular capillary walls distinct from amyloidosis.The size of fibrils ranges from 8–15 nm in Amyloid and 12–24 nm in FGN. IgG is usually monoclonal in AL Amyloid as compared to polyclon...

Assessing differences in inhaled corticosteroid response by self-reported race-ethnicity and genetic ancestry among asthmatic subjects

Mon, 21 Mar 2016 23:00:00 +0100

Inhaled corticosteroids (ICSs) are the preferred treatment for achieving asthma control. However, little is known regarding the factors contributing to treatment response and whether treatment response differs by population group. (Source: Journal of Allergy and Clinical Immunology)

Are corticosteroids useful in all degrees of severity and rapid recovery of Bell's palsy?

Mon, 21 Mar 2016 23:00:00 +0100

Conclusions The results provide preliminary evidence that corticosteroids were not effective in all grades of dysfunction and for achieving a rapid remission in the early phase of BP, highlighting the need to define standard and rigorous criteria to prescribe corticosteroids in these patients. Objectives The main aim of this study was to investigate whether the use of corticosteroids better associated than paralleled with neuromuscular training (C + FNT) is more effective than facial neuromuscular training (FNT) applied alone, in terms of recovery degree and facial symmetry during the early phase of Bell's palsy (BP). Patients and methods A prospective single-blinded study involved 73 patients: the C + FNT group (n = 42; median age = 37.5 years) and FNT group (n = 31; media...

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Factors associated with operative treatment of enthesopathy of the extensor carpi radialis brevis origin.

Mon, 21 Mar 2016 21:15:02 +0100

CONCLUSIONS: It seems likely that an emphasis on the preferences and values of the patient rather than the surgeon would decrease the variation in surgery rates for eECRB observed in this study. Methods for optimizing the influence of patient preferences and values on decision making (eg, decision aids) merit additional study. PMID: 26995457 [PubMed - as supplied by publisher] (Source: Hand Surgery)

Review finds benefits of corticosteroids outweighs pneumonia risk in COPD

Mon, 21 Mar 2016 16:48:00 +0100

The risk of pneumonia associated with the use of inhaled corticosteroids by patients with chronic obstructive pulmonary disease is outweighed by the benefits of treatment, according to the findings of a safety review by the European Medicines Agency. (Source: The Pharmaceutical Journal)

Current Treatment Options for Auricular Hematomas

Mon, 21 Mar 2016 00:00:00 +0100

Ear disease, such as otitis externa, resulting in aggressive head shaking or ear scratching, is the most common cause of the development of aural hematomas in dogs and cats. An underlying immunologic cause has also been proposed to explain cartilage and blood vessel fragility. Numerous options exist for management of aural hematomas, from medical management alone with corticosteroids, to simple hematoma centesis, to surgical intervention. Because this condition is usually secondary to another disease process, regardless of mode of treatment, likelihood of recurrence is low if the underlying condition is managed properly. (Source: Veterinary Clinics of North America: Small Animal Practice)

Asthma during pregnancy and congenital malformations: The challenging task of separating the medication effect from asthma itself

Mon, 21 Mar 2016 00:00:00 +0100

We have read with interest the article by Garne et al1 which adds new information on the impact of asthma treatments during pregnancy on the prevalence of congenital malformations. The study concluded that the use of inhaled β2-agonists (short- and long-acting combined) is associated with an increased risk of cleft palate and gastroschisis, whereas the use of inhaled corticosteroids (ICSs) showed no increased risk for any of the examined malformations. We fear however that such a statement could negatively affect the confidence of clinicians and mothers in short-acting β2-agonists (SABAs), specifically salbutamol, which was the most frequently used β2-agonist in this study. (Source: Journal of Allergy and Clinical Immunology)

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Comparison of transforaminal and interlaminar epidural steroid injections for the treatment of chronic lumbar pain

Mon, 21 Mar 2016 00:00:00 +0100

Conclusions This study showed that interlaminar epidural steroid injections can be as effective as transforaminal epidural steroid injections when performed at the nearest level of lumbar pathology using fluoroscopy in 12-month intervals. (Source: Brazilian Journal of Anesthesiology)

Improved outcome of acute severe ulcerative colitis while using early predictors of corticosteroid failure and rescue therapies

Mon, 21 Mar 2016 00:00:00 +0100

Intravenous corticosteroids remain the first line therapy for severe attacks of ulcerative colitis although up to 30–40% of patients do not respond to treatment. The availability of alternative therapies to colectomy and the knowledge of early predictors of response to corticosteroids should have improved the clinical outcomes of patients with severe refractory ulcerative colitis. The aim of the study is to describe the current need, way of use, and efficacy of rescue therapies, as well as colectomy rates in patients with severe ulcerative colitis flares. (Source: Digestive and Liver Disease)

Safety of an Oral Fixed Combination of Netupitant and Palonosetron (NEPA): Pooled Data From the Phase II/III Clinical Program.

Sun, 20 Mar 2016 23:00:00 +0100

CONCLUSION: NEPA was well-tolerated, with an AE profile as expected for the regimen. Sample size, demographic characteristics, study design, chemotherapy, and antiemetic regimen differences across the four studies may have contributed to differences in frequencies of neutropenia and alopecia. Adding an NK1RA to a CINV prophylaxis regimen can improve outcomes without additional toxicity. IMPLICATIONS FOR PRACTICE: Supportive care for cancer should ideally be efficacious, convenient, and well-tolerated. There have been concerns about cardiac safety with current antiemetic prophylactic agents, namely dolasetron and ondansetron. This pooled safety analysis demonstrates that the new oral fixed combination therapy NEPA can be safely added to an antiemetic regimen without increased toxicity. ...

Sustained and profound analgesic benefits in people with osteoarthritis of the knee using FX006, an intra-articular extended-release formulation of triamcinolone acetonide: Results from a double-blind, randomized, parallel-group, dose-ranging study

Sun, 20 Mar 2016 18:07:32 +0100

Purpose: Intra-articular (IA) corticosteroids traditionally confer excellent, although short-lived, analgesia in osteoarthritis (OA). FX006 is an extended-release formulation of triamcinolone acetonide (TCA) in poly(lactic-co-glycolic acid) microspheres. In a previous study, FX006 40 mg demonstrated a maximal analgesic effect superior to standard TCA suspension 40 mg after IA injection in patients (pts) with knee OA. This phase 2b study was undertaken to establish dose response for FX006 between 20 and 40 mg. (Source: Osteoarthritis and Cartilage)

Correlates of hyaluronic acid and corticosteroid injections among patients with radiographically confirmed osteoarthritis

Sun, 20 Mar 2016 18:07:31 +0100

Purpose: Intra-articular injections such as hyaluronate and corticosteroid injections are increasingly used in persons with osteoarthritis (OA). Despite the rapid proliferation of these treatments and clinical guidelines regarding their use, information on the characteristics of people receiving them is scarce. We sought to describe use of injections among adults with radiographically confirmed knee OA and to identify correlates of injection use. (Source: Osteoarthritis and Cartilage)

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Intramuscular corticosteroid injection versus placebo effective in pain reduction in patients with hip osteoarthritis

Sun, 20 Mar 2016 18:07:31 +0100

Purpose: Several international guidelines recommend intra-articular (IA) corticosteroid injections for patients with hip OA experiencing moderate to severe pain and no responding to oral analgesics. However, injection into the hip joint is challenging and needs ultrasound or fluoroscopic guidance. This makes it almost impossible in general practice. Moreover, an IA injection can lead to septic arthritis. An IA injection in the year preceeding total hip replacement increases the risk of infection leading to early revision surgery. (Source: Osteoarthritis and Cartilage)

Use of physical therapy and corticosteroid injections in the management of knee osteoarthritis in the U.S. military health system

Sun, 20 Mar 2016 18:07:30 +0100

Purpose: The prevalence of osteoarthritis (OA) in active duty military members is much higher than age-matched groups in the general population. OA is one of the most common and costly conditions encountered in military healthcare. Physical therapy management has been shown to result in clinically relevant improvements in pain, function and disability levels in patients with knee OA. However, several studies have shown that in civilian healthcare settings, very few patients with knee OA receive physical therapy treatment. (Source: Osteoarthritis and Cartilage)

Triamcinolone induced folate receptor expression in OA is associated with skewing of macrophages towards an anti-inflammatory phenotype

Sun, 20 Mar 2016 18:07:29 +0100

Purpose: Folate-based radiotracers have been used in patients with cancer and inflammatory diseases to visualize folate receptor expressing cells using PET or SPECT techniques. Activated macrophages express folate receptor beta (FR-β) and this allows specific imaging of these cells in-vivo. From previous work using SPECT imaging to visualize folate receptor expressing macrophages in both animal models and in patients with OA we know that macrophages are present in OA affected joints. However, it remains unclear what role these macrophages play in the different stages of OA and whether they can be influenced by treatment with corticosteroids. (Source: Osteoarthritis and Cartilage)

Intra-articular corticosteroids in addition to exercise for reducing pain sensitivity in knee osteoarthritis: exploratory outcome from a randomized controlled trial

Sun, 20 Mar 2016 18:07:28 +0100

Purpose: To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). (Source: Osteoarthritis and Cartilage)

Fluorinated steroids and their derivatives

Sun, 20 Mar 2016 00:00:00 +0100

This article presents an overview of preparative methods to fluorinated steroids as well as of the uses of these compounds. Graphical abstract (Source: Journal of Fluorine Chemistry)

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Investigation of Neurokinin‐1 Receptor Antagonism as a Novel Treatment for Chronic Bronchitis in Dogs

Sun, 20 Mar 2016 00:00:00 +0100

Conclusions and Clinical ImportancePreliminary results suggest that although maropitant may have antitussive properties leading to perceived clinical improvement, its failure to diminish airway inflammation makes it unsuitable for treatment of CCB. Future studies could evaluate maropitant as a cough suppressant for other respiratory disorders in dogs. (Source: Journal of Veterinary Internal Medicine)

Getting a leg up on bone comorbidities in lupus

Sat, 19 Mar 2016 13:10:52 +0100

MAUI, HAWAII – Patients with systemic lupus erythematosus (SLE) really need to be placed on bone protection therapy as soon as they start on corticosteroids because their risks of steroid-related... (Source: Clinical Endocrinology News)

Intra-articular Treatment of Knee Osteoarthritis: from Anti-inflammatories to Products of Regenerative Medicine.

Sat, 19 Mar 2016 10:51:02 +0100

CONCLUSIONS: Currently, knee OA treatment does not address the progressively inflammatory environment of the joint. More investigation is needed regarding products of regenerative medicine, but they may ultimately have profound implications in the way knee OA is managed. PMID: 26985986 [PubMed - as supplied by publisher] (Source: The Physician and Sportsmedicine Online)

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Greater Trochanteric Pain Syndrome.

Sat, 19 Mar 2016 10:29:02 +0100

Authors: Redmond JM, Chen AW, Domb BG Abstract Patients who have lateral hip pain historically have been diagnosed with trochanteric bursitis and treated with nonsteroidal anti-inflammatory medications, corticosteroid injections, and physical therapy. Although this strategy is effective for most patients, a substantial number of patients continue to have pain and functional limitations. Over the past decade, our understanding of disorders occurring in the peritrochanteric space has increased dramatically. Greater trochanteric pain syndrome encompasses trochanteric bursitis, external coxa saltans (ie, snapping hip), and abductor tendinopathy. A thorough understanding of the anatomy, examination findings, and imaging characteristics aids the clinician in treating these patients. Open...

How to treat a frozen shoulder? A survey among shoulder specialists in the Netherlands and Belgium.

Sat, 19 Mar 2016 07:00:03 +0100

Authors: Kraal T, Visser C, Sierevelt I, Beimers L Abstract A frozen shoulder is a common cause of a painful and stiff shoulder. A web-based survey was conducted to obtain insight in the current preferences about the -diagnosis and treatment of a frozen shoulder. A response rate of 54% was reached among shoulder specialized orthopaedic surgeons from the Netherlands and Belgium. Non-steroidal anti-inflammatory drugs and intra-articular corticosteroid injections are used frequently in the first phase of the condition. Physiotherapy is assumed to be more important in the final phase. The results of the survey indicate a wide variety of treatment strategies in the different phases of a frozen shoulder. Three out of four respondents considered that the management of a frozen shoulder co...

Predicting outcomes after severe and moderate traumatic brain injury: an external validation of impact and crash prognostic models in a large Spanish cohort - Castaño-Leon AM, Lora D, Munarriz PM, Cepeda S, Paredes I, de la Cruz J, Gómez Lopez PA, Lagares A.

Sat, 19 Mar 2016 06:34:47 +0100

Prognostic models that were developed by the International Mission on Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) study group and the Corticosteroid Randomization After Signification Head injury (CRASH) collaborators are th... (Source: SafetyLit)

Extramedullary Cardiac Multiple Myeloma—A Case Report and Contemporary Review of the Literature

Sat, 19 Mar 2016 00:00:00 +0100

We present the case of a 61-year-old female patient 47 days after autologous stem cell transplant for MM who developed cardiac tamponade owing to extramedullary recurrence of myeloma, pulmonary embolism, and takotsubo cardiomyopathy. We performed a review of the published studies of all cases of MM presenting at diagnosis or relapse with cardiac or pericardial involvement in the past 25 years. Including our patient, 34 patients with plasmacytoma involving cardiac or pericardial structures were identified from the literature search. Approximately equal numbers of patients were male and female (42% and 57%, respectively). The mean age was 62 years. Primary plasmacytomas accounted for 12% of the cases. A history of MM, EMP, or monoclonal gammopathy of uncertain significance was noted in two t...

Adrenal insufficiency exists for both swallowed budesonide and fluticasone propionate in the treatment of eosinophilic esophagitis

Sat, 19 Mar 2016 00:00:00 +0100

The report by Golekoh et al1 examined the prevalence of adrenal insufficiency in children with eosinophilic esophagitis treated with swallowed fluticasone propionate (FP) or budesonide and found that all patients on budesonide had normal testing. This contrasts with our study,2 in which we documented an adrenal insufficiency prevalence of 43% with budesonide. They consequently explain these contrasting results by suggesting that our study population was treated concomitantly with inhaled corticosteroids for asthma. (Source: The Journal of Pediatrics)

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Increased serum VDBP as a risk predictor for steroid resistance in asthma patients

Sat, 19 Mar 2016 00:00:00 +0100

Asthmatic symptoms usually can be controlled with corticosteroids, but partly asthmatic patients do not respond to corticosteroids, steroid resistance (SR) play a significant role in the poorly responding. However, no approach can accurately predict steroid responsiveness in asthma patients, so prediction of SR with noninvasive means has become a critical issue. (Source: Respiratory Medicine CME)

Clinical improvement by Tiotropium plus olodaterol

Sat, 19 Mar 2016 00:00:00 +0100

In this study, patients were allowed to continue their inhaled corticosteroid (ICS) therapy, and 34.8 to 41.9% of patients had ICS in each group of the patients. (Source: Respiratory Medicine CME)

Successful Additional Corticosteroid Treatment in a Patient with Mycoplasma pneumoniae Pneumonia in whom a Monobacterial Infection was Confirmed by a Molecular Method Using Bronchoalveolar Lavage Fluid.

Fri, 18 Mar 2016 23:15:02 +0100

Authors: Yamasaki K, Yatera K, Kato K, Noguchi S, Kawanami T, Fukuda K, Naito K, Akata K, Ishimoto H, Taniguchi H, Mukae H Abstract A 23-year-old Japanese woman was admitted to A hospital due to pneumonia. IgM for Mycoplasma pneumoniae was positive, and the patient was treated with imipenem/cilastatin, clindamycin, pazufloxacin and minocycline. However, both the chest radiological findings and the symptoms became exacerbated, and she was therefore transferred to our hospital. The bronchoalveolar lavage fluid was obtained, and a 16S rRNA gene sequencing analysis revealed a monobacterial infection of Mycoplasma pneumoniae. Therefore, corticosteroid treatment in addition to minocycline was administered, and the patients symptoms, laboratory data and chest radiographs improved. Cortico...

Corticosteroid Benefits for COPD Outweigh Pneumo Risk: PRACCorticosteroid Benefits for COPD Outweigh Pneumo Risk: PRAC

Fri, 18 Mar 2016 20:16:29 +0100

The EU regulators also concluded that the risk for pneumonia for patients with COPD using inhaled corticosteroids does not seem to vary from product to product. News Alerts (Source: Medscape Medical News Headlines)

Neurobiology of adaptation disorders.

Fri, 18 Mar 2016 04:28:02 +0100

Authors: de Kloet ER Abstract A fundamental issue in the neurobiology of adaptation disorders is how the hormones of the hypothalamic-pituitary-adrenal (HPA) axis protect the brain from such disorders, and how in a different context these very same stress hormones may enhance vulnerability. This contribution focuses on the corticosteroids which exert through two distinct nuclear receptor types control over gene networks underlying stress system activity in brain. The mineralocorticoid receptor mediates the pro-active mode of corticosteroid action involved in maintenance of basal stress system activity. The glucocorticoid receptor mediates the reactive feedback mode aimed to facilitate recovery from stress-induced disturbance. The balance between these pro-active and reactive modes ...

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Evaluation of the improvement of quality of life with Azithromycin in the treatment of eosinophilic nasal polyposis

Fri, 18 Mar 2016 00:00:00 +0100

Conclusion Azithromycin resulted in significant improvement of QoL, assessed by SNOT-22, in the studied population. (Source: Brazilian Journal of Otorhinolaryngology)

Idiopathic multicentric Castleman's disease: a systematic literature review

Fri, 18 Mar 2016 00:00:00 +0100

Publication date: Available online 17 March 2016 Source:The Lancet Haematology Author(s): Amy Y Liu, Christopher S Nabel, Brian S Finkelman, Jason R Ruth, Razelle Kurzrock, Frits van Rhee, Vera P Krymskaya, Dermot Kelleher, Arthur H Rubenstein, David C Fajgenbaum Background Multicentric Castleman's disease describes a group of poorly understood lymphoproliferative disorders driven by proinflammatory hypercytokinaemia. Patients have heterogeneous clinical features, characteristic lymph node histopathology, and often deadly multiple organ dysfunction. Human herpesvirus 8 (HHV8) causes multicentric Castleman's disease in immunosuppressed patients. The cause of HHV8-negative multicentric Castleman's disease is idiopathic; such cases are called idiopathic multicentric Castleman's di...

Blood eosinophils and treatment response in hospitalised exacerbations of chronic obstructive pulmonary disease: A case-control study

Fri, 18 Mar 2016 00:00:00 +0100

Conclusions In severe acute exacerbations of COPD requiring hospitalization, blood eosinophilia identifies a subgroup of subjects characterized by a prompt response to treatment with shorter hospital stay. (Source: Pulmonary Pharmacology and Therapeutics)

Immunoglobulin G4–Related Disease: Retrospective Analysis of 166 Patients

Fri, 18 Mar 2016 00:00:00 +0100

Conclusions: IgG4‐RD is a multisystem disorder that commonly affects older men, with a propensity for relapse, recurrence, and malignancy. This article is protected by copyright. All rights reserved. (Source: Arthritis and Rheumatism)

Cumulative corticosteroids over 52 weeks in patients with systemic lupus erythematosus: Pooled analyses from the phase III belimumab trials

Fri, 18 Mar 2016 00:00:00 +0100

Conclusion: An increase in cumulative corticosteroid dose over 1 year was observed for both treatments, but was significantly smaller for the belimumab group compared with placebo. More patients who received belimumab decreased oral corticosteroids, and fewer increased, compared with placebo. These data suggest that belimumab may be steroid sparing. This article is protected by copyright. All rights reserved. (Source: Arthritis and Rheumatism)

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Reduction of cerebral and corpus callosum volumes in childhood‐onset systemic lupus erythematosus. A volumetric magnetic resonance imaging analysis

Fri, 18 Mar 2016 00:00:00 +0100

Conclusion: Structural brain abnormalities were observed in 55.2% and associated with NP manifestations, aCL antibodies and corticosteroid use. Longitudinal studies have to follow these patients closely to determine permanent neurological damage. This article is protected by copyright. All rights reserved. (Source: Arthritis and Rheumatism)

Relapsing polychondritis and lymphocytic meningitis with varied neurological symptoms

Fri, 18 Mar 2016 00:00:00 +0100

Conclusion Relapsing polychondritis is a challenging disease that can rarely manifest with varied neurological symptoms; recognition is extremely important, because high-dose corticosteroids should be used as soon as possible in suspected cases. (Source: Revista Brasileira de Reumatologia)

Comparison of topically applied flurbiprofen or bromfenac ophthalmic solution on post‐operative ocular hypertension in canine patients following cataract surgery

Fri, 18 Mar 2016 00:00:00 +0100

ConclusionElevated postoperative IOP was observed in both treatment groups; however, bromfenac‐treated eyes were more likely to require intervention for elevated IOP. (Source: Veterinary Ophthalmology)

Vitamin D and Lung Function Decline in Adults With Asthma: The HUNT Study.

Fri, 18 Mar 2016 00:00:00 +0100

Authors: Brumpton BM, Langhammer A, Henriksen AH, Camargo CA, Chen Y, Romundstad PR, Mai XM Abstract We investigated whether low 25-hydroxyvitamin D (25(OH)D) levels were associated with more lung function decline in adults with asthma and whether this association was modified by smoking status or inhaled corticosteroid (ICS) use. We analyzed data on 395 adults with asthma from the Nord-Trøndelag Health Study (1995-2008), Norway. Plasma 25(OH)D and lung function were measured at baseline, and lung function measurements were repeated at follow-up, approximately 11 years later. Linear regression was used to estimate lung function decline. Participants with low 25(OH)D (<50 nmol/L) had more decline in lung function measurements for forced expiratory volume in 1 second (FEV1) (388 ...

Enantioselective endocrine disrupting effects of omeprazole studied in the H295R cell assay and by molecular modeling.

Thu, 17 Mar 2016 23:00:00 +0100

Authors: Sørensen AM, Hansen CH, Bonomo S, Olsen L, Jørgensen FS, Weisser JJ, Kretchmann AC, Styrishave B Abstract Enantiomers possess different pharmacokinetic and pharmacodynamics properties and this may not only influence the therapeutic effect of a drug but also its toxicological effects. In the present work we investigated the potential enantioselective endocrine disrupting effects of omeprazole (OME) and its two enantiomers on the human steroidogenesis using the H295R cell line. Differences in production of 16 steroid hormones were analyzed using LC-MS/MS. Additionally, to evaluate the differences in binding modes of these enantiomers, docking and molecular dynamics (MD) simulations of S-omeprazole (S-OME) and R-omeprazole (R-OME) in CYP17A1, CYP19A1 and CYP21A2 were carrie...

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The Case | The young philosopher with multiple sclerosis and proteinuria

Thu, 17 Mar 2016 18:07:03 +0100

A 31-year-old white man with relapsing-remitting multiple sclerosis was referred to the nephrology ward by the caregiver neurologist because of the presence of new-onset subnephrotic proteinuria (from 0.7–2 g/24 h). He had been diagnosed with relapsing-remitting multiple sclerosis 15 years earlier and was initially treated with corticosteroids, followed by interferon beta-1a since 2003. No relapses had occurred in the past 3 years, during which he had been in good overall health. (Source: Kidney International)

Granulomatosis With Polyangiitis in Otolaryngologist Practice: A Review of Current Knowledge.

Thu, 17 Mar 2016 12:25:03 +0100

Authors: Wojciechowska J, Krajewski W, Krajewski P, Kręcicki T Abstract Granulomatosis with polyangiitis (GPA) is an idiopathic vasculitis of medium and small arteries, characterized by necrotizing granulomatous inflammation. GPA typically affects upper and lower respiratory tract with coexisting glomerulonephritis. This disease is generally characterized by antineutrophil cytoplasm antibodies (ANCA), nevertheless, there are rare cases with negative ANCA. GPA affects people at any age, with predominance of the sixth and seventh decade of life. In 80%-95% of the patients the first symptoms of GPA are otorhinolaryngological manifestations of head and neck including nose/sinuses, ears, eyes, larynx/trachea, oral cavity, and salivary glands. Diagnosis of GPA is based on Criteria of th...

Influence of Antenatal Glucocorticosteroid Exposure on Osteoprotegerin and Receptor Activator of Nuclear Factor κB Ligand Levels in Newborn Infants

Thu, 17 Mar 2016 07:20:47 +0100

Conclusions: Preterm neonates exposed to ACS have higher serum levels of OPG, while premature neonates not exposed to ACS have serum OPG and RANKL levels similar to those measured in healthy term neonates.Horm Res Paediatr (Source: Hormone Research in Paediatrics)

Mycophenolate Mofetil Therapy in Children With Idiopathic Nephrotic Syndrome: Does Therapeutic Drug Monitoring Make a Difference?

Thu, 17 Mar 2016 06:34:58 +0100

Conclusions: In conclusion, we demonstrate MMF as an alternative treatment for children with complicated INS to maintain remission without serious side effects. Furthermore, we propose a higher therapeutic target range of MPA-AUC0–12 (>45 mg·h·L−1) than used in transplanted children underlining the crucial role of therapeutic drug monitoring. (Source: Therapeutic Drug Monitoring)

Efficacy and Safety of Autologous Blood Products Compared With Corticosteroid Injections in the Treatment of Lateral Epicondylitis: A Meta-Analysis of Randomized Controlled Trials

Thu, 17 Mar 2016 00:00:00 +0100

Conclusions Limited evidence supports the conclusion that CSIs are superior to ABPs for pain relief in the short term; however, this result was reversed in the intermediate and long term. ABPs seemed to be more effective at restoring function in the intermediate term. Because of the small sample size and the limited number of high-quality RCTs, more high-quality RCTs with large sample sizes are required to validate this result. (Source: PMandR)

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In-Hospital Disease Burden of Sarcoidosis in Switzerland from 2002 to 2012

Thu, 17 Mar 2016 00:00:00 +0100

by Susanne Pohle, Florent Baty, Martin Brutsche Sarcoidosis is a multisystem disease with an unpredictable and sometimes fatal course while the underlying pathomechanism is still unclear. Reasons of the increasing hospitalization rate and mortality in the United States remain in dispute but incriminated are a number of distinct comorbidities and risk factors as well as the application of more aggressive therapeutic agents. Studies reflecting the recent development in central Europe are lacking. Our aim was to investigate the recent mortality and hospitalization rates as well as the underlying comorbidities of hospitalized sarcoidosis patients in Switzerland. In this longitudinal, nested case-control study, a nation-wide database provided by the Swiss Federal Office for Statistics enclosin...

Is There an Additional Value of Inpatient Treatment for Patients with Atopic Dermatitis?

Thu, 17 Mar 2016 00:00:00 +0100

Authors: van der Schaft J, Keijzer WW, Sanders CJ, Groot AJ, van Os-Medendorp H, den Akker MM, Bruijnzeel-Koomen CA, de Bruin-Weller MS Abstract An inpatient treatment and education programme has been developed for patients with difficult to control atopic dermatitis (AD), with the aim of achieving adequate self-management and long-term disease control. This observational study included adult patients diagnosed with difficult to control AD, admitted for a structured inpatient treatment and education programme. The primary outcome was the Six Area, Six Sign Atopic Dermatitis (SASSAD) score. In total, 79 patients (mean ± SD age 38.8 ± 17.1 years) were included. The median duration of hospitalization was 11 days (interquartile range (IQR) 8-14). The mean percentage decrease ...

Clinical implications of mucosal remodeling from chronic rhinosinusitis

Thu, 17 Mar 2016 00:00:00 +0100

ConclusionEstablished mucosal remodeling predicts a greater reliance on topical therapies to reach similar clinical endpoints as those without remodeling. (Source: International Forum of Allergy and Rhinology)

Halometasone monohydrate (0.05%) in occupational contact dermatitis

Thu, 17 Mar 2016 00:00:00 +0100

Conclusions: Halometasone is efficacious with a good safety profile in patients with OCD, and there is no significant difference in efficacy of the drug in allergic and irritant OCD. (Source: Indian Journal of Pharmacology)

Erythema multiforme due to arsenic trioxide in a case of acute promyelocytic leukemia: A diagnostic challenge

Thu, 17 Mar 2016 00:00:00 +0100

Girish V Badarkhe, Amrita Sil, Sabari Bhattacharya, Uttam Kumar Nath, Nilay Kanti DasIndian Journal of Pharmacology 2016 48(2):216-218Erythema multiforme (EM) is an acute, self-limited, Type IV hypersensitivity reactions associated with infections and drugs. In this case of acute promyelocytic leukemia, EM diagnosed during the induction phase was mistakenly attributed to vancomycin used to treat febrile neutropenia during that period. However, the occurrence of the lesions of EM again during the consolidation phase with arsenic trioxide (ATO) lead to a re-evaluation of the patient and both the Naranjo and World Health Organization-Uppsala Monitoring Centre scale showed the causality association as “probable.” The rash responded to topical corticosteroids and antih...

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Impact of the Topical Ophthalmic Corticosteroid Loteprednol Etabonate on Intraocular Pressure

Thu, 17 Mar 2016 00:00:00 +0100

Abstract Corticosteroids are a mainstay therapeutic option for the treatment of ocular inflammation. However, safety remains a concern for clinicians, particularly with long-term use. Though highly effective at suppressing inflammatory and allergic responses, topical ophthalmic corticosteroids carry an inherent risk of side effects, including elevated intraocular pressure (IOP), a risk factor for the development of glaucoma. The corticosteroid loteprednol etabonate (LE) contains an ester rather than a ketone at the C-20 position, minimizing the potential for side effects, including IOP elevation. In early pivotal clinical trials of LE ophthalmic suspension for conjunctivitis (allergic, giant papillary), anterior uveitis, and post-operative inflammation, LE had minimal impact on IO...