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This page shows you the latest news and research items in this category.

Cranial nerve palsy in diabetes: ‘Hunt’ for the diagnosis
Abstract A 55‐year‐old diabetic woman presenting with right sixth nerve palsy was diagnosed initially as having diabetic cranial neuropathy. Worsening headache and reported blurring of the right optic disc margin warranted further evaluation. CT scan of the brain was normal and a diagnosis of idiopathic intracranial hypertension was made. Her headache worsened and a partial pupil involving third nerve palsy evolved, at which point she was referred to our institution. Cranial MRI revealed features suggestive of Tolosa‐Hunt syndrome and she responded dramatically to steroid therapy. While third nerve palsy is the most ...
Source: Practical Diabetes International - June 13, 2013 Category: Endocrinology Authors: S Meenakshi‐Sundaram, SN Karthik, S Bharathi, A Periyakaruppan, T Badrinarayanan, K Swaminathan Tags: Case report Source Type: research

Steroids in Duchenne dystrophy
The mills of God grind slowly. The medical profession are not far behind. It is almost 40years since Drachman et al. in an open study of 14 patients with Duchenne dystrophy, aged 3–10years, for periods ranging from 1 to 28months, concluded that steroids might have some palliative benefit, and that further studies were needed. Some 14years later Brooke and his colleagues took up the challenge and showed in a multicentric study of 33 patients, aged 5–15years, (12 of whom had a ready lost ambulation), a definite improvement in muscle function on 1.5mg/kg/day of prednisone, compared with the natural history of their 170 hi...
Source: Neuromuscular Disorders - June 6, 2013 Category: Neurology Authors: V. Dubowitz Tags: Personal Point of View Source Type: research

RA: Only 1 in 5 Patients Take Oral Meds as PrescribedRA: Only 1 in 5 Patients Take Oral Meds as Prescribed
Only 20% of patients with RA took at least 80% of prescribed doses; overall adherence to oral DMARDs and steroid therapy ranged from 58% to 71%. Nonadherent patients had significantly worse outcomes. Medscape Medical News (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - June 5, 2013 Category: Consumer Health News Tags: Rheumatology News Source Type: news

Retinal vasculitis in two pediatric patients with systemic lupus erythematosus: a case report
We report two pediatric female patients with systemic lupus erythematosus (SLE) who presented with decreased vision. Both patients were found to have retinal vasculitis and occlusive disease. The first patient also presented with vitreous hemorrhage and later non-arteritic ischemic optic neuropathy. She was treated with panretinal photocoagulation and steroid therapy and later in her disease course was treated with rituximab and cyclophosphamide. Her vision remained decreased. The second patient was treated with rituximab and monthly cyclophosphamide infusions early in her disease course, and her vision improved dramatical...
Source: Pediatric Rheumatology - June 4, 2013 Category: Rheumatology Authors: Katherine DonnithorneRussell ReadRobert LowePeter WeiserRandy CronTimothy Beukelman Source Type: research

Proliferative glomerulonephritis with monoclonal IgG deposits in a patient with autoimmune hemolytic anemia.
Abstract A 25-year-old woman was admitted because of proteinuria. A renal biopsy showed mesangial/endocapillary proliferative glomerulonephritis with IgG2-κ deposits. Electron microscopy showed immune complex-type deposits. She also had Coombs-positive hemolytic anemia, anticardiolipin antibodies, and antinuclear antibodies. Middle-dose steroid therapy led to improvement of proteinuria and hemolytic anemia. Six years later, she developed crescentic glomerulonephritis with IgG2-κ deposits during pregnancy. Middle-dose steroid therapy improved renal dysfunction. This is an exceptional case of proliferative glomerul...
Source: Clinical Nephrology - June 1, 2013 Category: Urology & Nephrology Authors: Fujiwara T, Komatsuda A, Ohtani H, Togashi M, Sawada KI, Wakui H Tags: Clin Nephrol Source Type: research

Phaeohyphomycosis caused by Cladophialophora bantiana.
CONCLUSIONS: Phaeohyphomycosis is an uncommon infection with severe limitations on the clinical clues that can help in early diagnosis. Fungal species identification is mandatory for epidemiological and therapeutic reasons. The MICs could be useful in selecting the appropriate antifungal agent. Avoid the unnecessary exposure to soil or other media potentially contaminated with fungal spores should be recommended to any immunosuppressed patient. PMID: 23727472 [PubMed - as supplied by publisher] (Source: Revista Iberoamericana de Micologia)
Source: Revista Iberoamericana de Micologia - May 28, 2013 Category: Biology Authors: Martínez-Lamas L, Alvarez M, Llovo J, Gené J, Cano J Tags: Rev Iberoam Micol Source Type: research

Pediatric lupus nephritis: more options, more chances?
Abstract Lupus nephritis (LN) is more common and severe in childhood-onset systemic lupus erythematosus (SLE) than in adults. It is one of the major causes of acute kidney injury (AKI) and chronic kidney disease (CKD) in children. Steroid therapy has been used as the first-line treatment for SLE since 1970, and has improved the survival of SLE patients from ∼ 50% to >80%. Over the years many immunosuppressive drugs, including pulse methylprednisolone, oral cyclophosphamide, pulse intravenous cyclophosphamide, mycophenolate mofitil, rituximab, and tacrolimus, have been combined with prednisolone, further improv...
Source: Lupus - May 26, 2013 Category: Rheumatology Authors: Vachvanichsanong P, McNeil E Tags: Lupus Source Type: research

Different targets for treating focal segmental glomerular sclerosis.
In conclusion, recent reports have allowed a new insight into the pathogenetical mechanism regulating proteinuria in INS, offering new targets for treating severe cases. PMID: 23689570 [PubMed - in process] (Source: Contributions to Nephrology)
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Coppo R Tags: Contrib Nephrol Source Type: research

Autopsy findings of fatal cryptogenic organizing pneumonia.
In conclusion, the author reported an autopsy case of fatal COP. PMID: 23696931 [PubMed - in process] (Source: International Journal of Clinical and Experimental Pathology)
Source: International Journal of Clinical and Experimental Pathology - May 25, 2013 Category: Pathology Authors: Terada T Tags: Int J Clin Exp Pathol Source Type: research

Need for prolonged immunosupressive therapy in CLIPPERS-a case report
Conclusion: CLIPPERS presents with distinctive clinical and MRI-findings and may be diagnosed after excluding other differential diagnoses. Patients are treated with corticosteroids with good clinical results. Since short term glucocorticoid treatment results into relapse of the disease, longer term immunosuppressive therapy appears to be mandatory for sustained improvement, although accompanied by severe side effects. (Source: BMC Neurology)
Source: BMC Neurology - May 24, 2013 Category: Neurology Authors: Juerd WijntjesErnest WoudaCarl SiegertGiorgos KarasAnnemarie Vlaar Source Type: research

Clinical strategies for identifying autoimmune pancreatitis from pancreaticobiliary malignancy to avoid unnecessary surgical resection
CONCLUSIONSElevated serum γ‐globulin level can be used as a preoperative “sentinel” indicator for differentiating IgG4‐related AIP from pancreaticobiliary malignancy. Serum tests of IgG or IgG4 levels should be further performed in those with elevated serum γ‐globulin which aids to identify AIP in order to avoid unnecessary operation. (Source: Chinese Journal of Digestive Diseases)
Source: Chinese Journal of Digestive Diseases - May 22, 2013 Category: Gastroenterology Authors: Wen Chuan Wu, Xiu Zhong Yao, Da Yong Jin, Dan Song Wang, Wen Hui Lou, Xin Yu Qin Tags: Original Article Source Type: research

Long-term results of intratympanic prednisolone injection in patients with idiopathic sudden sensorineural hearing loss.
Conclusion: The results demonstrate the stability of the efficacy over time of the intratympanic prednisolone protocol and they suggest that the spontaneous recovery does not significantly influence the long-term evaluation of intratympanic therapy. A 10-day follow-up after 3 days of intratympanic prednisolone administration can be considered a sufficient period to evaluate the effectiveness of the undertaken therapy. Objective: To assess the stability of the efficacy over time of intratympanic steroid therapy for patients with idiopathic sudden sensorineural hearing loss. Methods: A total of 122 patients received an intra...
Source: Acta Oto-Laryngologica - May 22, 2013 Category: ENT & OMF Authors: Filipo R, Attanasio G, Cagnoni L, Masci E, Russo FY, Cartocci G, Di Mario A, Covelli E Tags: Acta Otolaryngol Source Type: research

Shorter Duration Steroid Therapy May Offer Similar Effectiveness In Reducing COPD Exacerbations
Among patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) requiring hospital admission, a 5-day glucocorticoid treatment course was non-inferior (not worse than) to a 14-day course with regard to re-exacerbation during 6 months of follow-up, according to a study published online by JAMA. The study is being released early online to coincide with its presentation at the American Thoracic Society international conference... (Source: Health News from Medical News Today)
Source: Health News from Medical News Today - May 21, 2013 Category: Consumer Health News Tags: COPD Source Type: news

Successful management of airway hemangioma with propranolol
We report successful management of a proliferating, large, mixed infantile hemangioma with subglottic extension in an Indian infant using oral propranolol in a dose of 2mg/kg/day without any side effects. Induction of early involution and freedom from the side effects of steroid therapy seem encouraging for using propranolol as a first line treatment modality in the management of troublesome hemangiomas. (Source: International Journal of Dermatology)
Source: International Journal of Dermatology - May 17, 2013 Category: Dermatology Authors: Vibhu Mendiratta, Bincy Varghese, Ram Chander, Ankit Parakh, Ravi S. Solanki Tags: Pharmacology and therapeutics Source Type: research

The evaluation of protein Z levels of children with acute lymphoblastic leukaemia during induction therapy
The objective of this study was to evaluate the protein Z levels of children with acute lymphoblastic leukaemia (ALL) during induction therapy. Although several studies investigated the association between steroid and L-asparaginase (L-ASP) administration and levels of coagulation proteins such as protein C, protein S and antithrombin in children with ALL, protein Z levels have not been examined in any study yet. Peripheral blood was drawn from the study group before chemotherapy (PZ0) at diagnosis, at 12th day (PZ1), 15th day (PZ2), 18th day (PZ3) and 21st day (PZ4) of treatment wherein L-ASP treatment is given along with...
Source: Blood Coagulation and Fibrinolysis - May 10, 2013 Category: Hematology Tags: Original Articles Source Type: research

Daily or alternative, that is the question: steroid therapy for Duchenne muscular dystrophy patients
Daily steroid use brings longer ambulation time but also more adverse effects, except for orthopaedic complications Duchenne muscular dystrophy (DMD) is an X-linked muscular dystrophy known to affect one in 3600 live male births and leads to progressive proximal muscle weakness in the first years, and orthopaedic, respiratory and cardiac complications in the teens. Typically the patients would lose the ability of ambulation at around the age of 10 years and decease in young adulthood if untreated. In recent years, corticosteroid treatment has been proved to prolong ambulation, improve quality of life and survival. Moreover...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 7, 2013 Category: Neurosurgery Authors: Liang, W.-C., Nishino, I. Tags: Genetics, Muscle disease, Neuromuscular disease, Child and adolescent psychiatry, Musculoskeletal syndromes, Trauma, Injury Editorial commentaries Source Type: research

Acute renal failure by ingestion of Euphorbia paralias.
Abstract Euphorbia paralias is known in traditional medicine as an anti-inflammatory agent, a purgative and for its local anesthetic property. To the best our knowledge, renal toxicity of this substance has not been previously reported. In this paper, we report the case of a 29-year-old male who developed renal damage following ingestion of Euphorbia paralias. He had been on follow-up for nephrotic syndrome since 1986, although irregularly, with several relapses but each responding well to steroid therapy. A kidney biopsy had not been performed earlier due to refusal by the patient. He was off steroids since April ...
Source: Saudi Journal of Kidney Diseases and Transplantation - May 1, 2013 Category: Urology & Nephrology Authors: Boubaker K, Ounissi M, Brahmi N, Goucha R, Hedri H, Abdellah TB, El Younsi F, Maiz HB, Kheder A Tags: Saudi J Kidney Dis Transpl Source Type: research

Rejection Is a Strong Graft Survival Predictor in Live Donor Pediatric Renal Transplantation Using Cyclosporine, Mycophenolate Mofetil, and Steroids: 5-Year Outcomes in a Single Mexican Center
Abstract: Long-term graft function and survival are of particular importance in children assuming that they have a longer transplantation life span than most adults. Because acute rejection episodes (ARE) continue to have a serious impact on graft loss, we analyzed the effects of ARE on 5-year survival and function in our population. Fifty-seven living donor kidney transplant recipients (34 males) younger than 18 years of age (13.5 ± 2.6 years; range, 5–17) were follow up for at feast 12 months using cyclosporine, mycophenolate mofetil, and steroid therapy with or without induction treatment between February 2003 and D...
Source: Transplantation Proceedings - May 1, 2013 Category: Transplant Surgery Authors: G. Martinez-Mier, H. Enriquez-De los Santos, M.T. Méndez-López, S.F. Avila-Pardo, L.F. Budar-Fernandez, F. Gonzalez-Velazquez Tags: Renal Transplantation Source Type: research

[A case of eosinophilic granulomatosis with polyangiitis with extra-vascular granuloma and eosinophilic vasculitis diagnosed by transbronchial lung biopsy].
Abstract A 62-year-old man was suffering from bronchial asthma and referred to our institution with dry cough and dyspnea on exertion in November, 2010. He was diagnosed with eosinophilic granulomatosis with polyangiitis (EPGA, formerly Churg-Strauss syndrome) by chest radiographic findings, blood eosinophilia, mononeuritis multiplex and cardiomyopathy. Steroid therapy was started and he was rapidly improved. Steroid therapy had been tapered off by May, 2012. After 2 months, however, progressive dyspnea, neural symptoms, deafness, re-elevation of blood eosinophils and bilateral multifocal infiltrations appeared. He...
Source: Arerugi - May 1, 2013 Category: Allergy & Immunology Authors: Hara Y, Kanoh S, Fujikura Y, Kawano S, Misawa K, Kawana A Tags: Arerugi Source Type: research

Clinicopathological study of glomerular diseases associated with sarcoidosis : A multicenter study
Conclusions: A wide spectrum of glomerular lesions is associated with sarcoidosis. The close temporal relationship observed in some patients suggests common causative molecular mechanisms of glomerular injury but complete remission of both diseases in response to exclusive steroid therapy is infrequent. (Source: Orphanet Journal of Rare Diseases)
Source: Orphanet Journal of Rare Diseases - April 30, 2013 Category: Internal Medicine Authors: Thomas StehléDominique JolyPhilippe VanhilleJean-Jacques BoffaPhilippe RémyLaurent MesnardMaxime HoffmannPhilippe GrimbertGabriel ChoukrounFrançois VrtovsnikJérôme VerineDominique DesvauxFrancine WalkerPhilippe LangMatthieu MahevasDil SahaliVincent A Source Type: research

Clinicopathological study of glomerular diseases associated with sarcoidosis: a multicenter study
Conclusions: A wide spectrum of glomerular lesions is associated with sarcoidosis. The close temporal relationship observed in some patients suggests common causative molecular mechanisms of glomerular injury but complete remission of both diseases in response to exclusive steroid therapy is infrequent. (Source: Orphanet Journal of Rare Diseases)
Source: Orphanet Journal of Rare Diseases - April 30, 2013 Category: Internal Medicine Authors: Thomas StehléDominique JolyPhilippe VanhilleJean-Jacques BoffaPhilippe RémyLaurent MesnardMaxime HoffmannPhilippe GrimbertGabriel ChoukrounFrançois VrtovsnikJérôme VerineDominique DesvauxFrancine WalkerPhilippe LangMatthieu MahevasDil SahaliVincent A Source Type: research

Rituximab in adult patients with multi-relapsing/steroid-dependent minimal change disease and focal segmental glomerulosclerosis: a report of 5 cases.
CONCLUSIONS: Our results indicate that RTX is effective and cessation of additional immunosuppressants could be achieved in all patients reported in this study. RTX may be an effective alternative therapy in adult patients with multirelapsing/steroid-dependent nephrotic syndrome due to MCD or FSGS. PMID: 23624956 [PubMed - as supplied by publisher] (Source: Wiener Klinische Wochenschrift)
Source: Wiener Klinische Wochenschrift - April 27, 2013 Category: Journals (General) Authors: Kronbichler A, König P, Busch M, Wolf G, Mayer G, Rudnicki M Tags: Wien Klin Wochenschr Source Type: research

Brief Report: Shortened Telomere Length in Patients With Systemic Lupus Erythematosus
ConclusionTelomere length is shortened in SLE patients compared to controls and does not appear to be a reflection of disease activity or immune cell turnover. Subsets of patients such as those positive for Ro antibodies may be particularly susceptible to premature biologic aging. The predictive value of telomere length as a biomarker of future risk of damage/mortality in SLE requires longitudinal evaluation. (Source: Arthritis and Rheumatism)
Source: Arthritis and Rheumatism - April 23, 2013 Category: Rheumatology Authors: Sahena Haque, Chadi Rakieh, Fiona Marriage, Pauline Ho, Rachel Gorodkin, Lee Suan Teh, Neil Snowden, Philip J. R. Day, Ian N. Bruce Tags: Systemic Lupus Erythematosus Source Type: research

DRESS syndrome: Part II. Management and therapeutics
The appropriate management of the drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is paramount because it is associated with significant morbidity and mortality. This syndrome shares clinical features with other dermatologic conditions, including other severe cutaneous drug reactions, requiring the clinician to carefully examine the proposed criteria to make the appropriate diagnosis. Once the diagnosis of DRESS syndrome has been established, the next step in management is immediate cessation of the causative medication(s). In cases in which the culprit drug is not obvious, clinicians must use their ...
Source: Journal of the American Academy of Dermatology - April 22, 2013 Category: Dermatology Authors: Zain Husain, Bobby Y. Reddy, Robert A. Schwartz Tags: Continuing Medical Education Source Type: research

Teaching NeuroImages: Basal ganglia involvement in facio-brachial dystonic seizures associated with LGI1 antibodies
A 30-year-old man developed right facio-brachial dystonic seizures (FBDS).1 Ictal and interictal EEGs were normal. CSF analysis was unremarkable. Brain MRI revealed a gadolinium-enhancing lesion involving the left caudate and globus pallidus (figure 1). Leucine-rich glioma inactivated protein-1 (LGI-1) antibodies were detected in the serum. Total-body CT scan revealed no malignancies. The patient underwent 5 cycles of plasmapheresis followed by long-term steroid therapy with complete benefit. A brain MRI performed after 5 months showed reduction of contrast enhancement (figure 2). LGI-1, a secreted protein complexed with v...
Source: Neurology - April 22, 2013 Category: Neurology Authors: Plantone, D., Renna, R., Grossi, D., Plantone, F., Iorio, R. Tags: MRI, All Immunology, Autoimmune diseases RESIDENT AND FELLOW SECTION Source Type: research

Aggravation of Fatigue by Steroid Therapy in Terminally Ill Patients With Cancer.
In conclusion, the possibility of steroid-induced secondary fatigue in terminally ill cancer patients should be taken into consideration. PMID: 23588576 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - April 15, 2013 Category: Palliative Care Authors: Matsuo N, Yomiya K Tags: Am J Hosp Palliat Care Source Type: research

Evaluation and Management of Pruritus and Scabies in the Elderly Population
Pruritus is the most common dermatologic complaint in individuals older than 65 years. The elderly comprise a demographic that seeks medical attention for itch with greater frequency than other age groups. Managing pruritus in elderly patients represents a unique therapeutic challenge attributable to a range of circumstances that are of particular importance in this population. Topical steroid therapy must be administered carefully, and other forms of treatment, including phototherapy, may be difficult to maintain. The challenge of treating pruritus in the elderly might also stem from communication barriers that prevent de...
Source: Clinics in Geriatric Medicine - April 13, 2013 Category: Geriatrics Authors: Bharat Panuganti, Michelle Tarbox Source Type: research

Non‐surgical prevention and management of scoliosis for children with Duchenne muscular dystrophy: What is the evidence?
Abstract A review was performed to examine the evidence for non‐surgical interventions for preventing scoliosis and the need for scoliosis surgery in children with Duchenne muscular dystrophy. Medline and Embase databases and reference lists from key articles were searched. After the inclusion and exclusion criteria were applied, 13 studies were critically appraised independently by two reviewers. The included studies examined spinal orthoses and steroid therapy. There were no studies with high levels of evidence (randomised or other controlled trials). The studies with the highest level of evidence were non‐randomised...
Source: Journal of Paediatrics and Child Health - April 7, 2013 Category: Pediatrics Authors: Adrienne Harvey, Louise Baker, Katrina Williams Tags: Review Article Source Type: research

Are IL-10+ regulatory Th17 cells implicated in the sustained response to glucocorticoid treatment in patients with giant cell arteritis? Comment on the paper of Espigol-Frigole et al
We have read with interest the recently published paper of Espigol-Frigole et al1 in which the authors confirmed that interleukin (IL)-17 is highly expressed in giant cell arteritis (GCA) lesions.1–3 They also demonstrated for the first time that IL-17 expression in temporal artery biopsies (TABs) was correlated with a better outcome. Among other interesting results, the identification of Foxp3+IL-17+ T cells by confocal microscopy in TAB made the authors to hypothesize that these cells could be induced regulatory T cells (Treg) that may facilitate the remission of the disease under steroid therapy. Evidence has been...
Source: Annals of the Rheumatic Diseases - April 4, 2013 Category: Rheumatology Authors: Samson, M., Audia, S., Janikashvili, N., Bonnotte, B. Tags: Electronic pages Source Type: research

Cardiac Sarcoidosis
A 55-year-old African American woman was admitted to our institution after a syncopal episode while at rest. Echocardiography showed anterior and anteroseptal mid-basal wall hypertrophy with an associated wall motion abnormality. The results of dipyridamole myocardial perfusion imaging were negative. Computed tomography of the chest revealed a slightly enlarged anterior mediastinal lymph node. Cardiac magnetic resonance showed normal biventricular systolic function and increased thickness of the left ventricular mid-basal anterior and anteroseptal walls (A and Online Video 1, cine steady-state free precession short-axis vi...
Source: Journal of the American College of Cardiology - April 3, 2013 Category: Cardiology Authors: Bernard Kadosh, Jeremy Steele, Iosif Gulkarov, Igor Mamkin Tags: IMAGES IN CARDIOLOGY Source Type: research

IgG4-related disease: a case report and review of cases reported in China.
Abstract IgG4-related inflammatory pseudotumors are lesions characterized by plasma cell-rich histologic pattern, abundant IgG4-positive plasma cells and high serum IgG4 levels. A 64-year-old man was admitted to our hospital for an ultrasound-documented space-occupying lesion of the left kidney. Renal tumor of the left kidney was suspected based upon results of computed tomography and nuclear magnetic resonance, and laparoscopic radical nephrectomy was conducted. The final diagnosis of IgG4-related inflammatory pseudotumor was made based on histopathological examination and IgG4 immunostaining. The patient received...
Source: Clinical Nephrology - April 2, 2013 Category: Urology & Nephrology Authors: Yang J, Liu W, Jiang R Tags: Clin Nephrol Source Type: research

Cardiac Sarcoidosis
A 55-year-old African American woman was admitted to our institution after a syncopal episode while at rest. Echocardiography showed anterior and anteroseptal mid-basal wall hypertrophy with an associated wall motion abnormality. The results of dipyridamole myocardial perfusion imaging were negative. Computed tomography of the chest revealed a slightly enlarged anterior mediastinal lymph node. Cardiac magnetic resonance showed normal biventricular systolic function and increased thickness of the left ventricular mid-basal anterior and anteroseptal walls (A and Online Video 1, cine steady-state free precession short-axis vi...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - April 1, 2013 Category: Cardiology Source Type: research

Plasma exchange for steroid-refractory relapses in multiple sclerosis: an observational, MRI pilot study.
CONCLUSION: A marked to moderate clinical improvement post-PE accompanied by a lack of radiologic resolution of the active lesion is not indicative of poor prognosis. PMID: 23541130 [PubMed - in process] (Source: Clinical Therapeutics)
Source: Clinical Therapeutics - April 1, 2013 Category: Drugs & Pharmacology Authors: Meca-Lallana JE, Hernández-Clares R, León-Hernández A, Genovés Aleixandre A, Cacho Pérez M, Martín-Fernández JJ Tags: Clin Ther Source Type: research

Metabolic syndrome in Chinese patients with systemic lupus erythematosus: no association with plasma cortisol level.
Abstract Our objective was to determine metabolic syndrome (MS) prevalence in Chinese patients with systemic lupus erythematosus (SLE) and to investigate the conditions that contribute to its development. 116 patients with SLE classified according to the American College of Rheumatology (ACR) classification criteria, and 115 controls were enrolled. MS was defined by the joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and Int...
Source: Lupus - April 1, 2013 Category: Rheumatology Authors: Liu SY, Han LS, Guo JY, Zheng ZH, Li H, Zhang L, Zhang X, He YJ, Gao GM, Liu ZS, Zeng XF Tags: Lupus Source Type: research

Successful EGFR-TKI Rechallenge of Leptomeningeal Carcinomatosis after Gefitinib-induced Interstitial Lung Disease
We report the case of a 49-year-old non-smoking Japanese woman with backache and difficulty in walking. She was diagnosed as having advanced lung adenocarcinoma, and an epithelial growth factor receptor mutation (in-frame deletions in exon 19) was found. After radiation therapy of bone metastases with spinal cord compression and brain metastases, gefitinib was administered. On day 2, she developed acute interstitial lung disease. Gefitinib therapy was discontinued and treatment with high-dose steroid therapy improved the interstitial lung disease. Cisplatin plus pemetrexed was initiated as second-line chemotherapy, but she...
Source: Japanese Journal of Clinical Oncology - March 26, 2013 Category: Cancer & Oncology Authors: Nakamichi, S., Kubota, K., Horinouchi, H., Kanda, S., Fujiwara, Y., Nokihara, H., Yamamoto, N., Tamura, T. Tags: Case Report Case ReportS Source Type: research

[Regional anesthesia in patients with pre-existing infections or immunosuppression].
Abstract Regional anesthesia is the most effective procedure for acute pain therapy. Whether neuraxial and peripheral blocks in patients with pre-existing infectious conditions, immune deficits or other risk factors increase the risk of additional infections is unclear. Analyzing the available literature currently seems to indicate that the incidence of severe infectious complications is generally low. Diabetes, steroid therapy or malignant diseases are apparently present in many cases in which infections associated with regional anesthesia and analgesia have been described. A strict contraindication in patients wi...
Source: Der Anaesthesist - March 1, 2013 Category: Anesthesiology Authors: List F, Kessler P, Volk T Tags: Anaesthesist Source Type: research

Nocardia spp infections among hematological patients: results of a retrospective multicenter study
Conclusions: Although rare, nocardiosis should be considered in the differential diagnosis of pulmonary and central nervous system lesions among hematological patients. Lymphoproliferative disorders, prolonged steroid treatment, lymphopenia, and active hematological disease are the conditions that are worth considering as predisposing factors for the development of this disease. (Source: International Journal of Infectious Diseases)
Source: International Journal of Infectious Diseases - March 1, 2013 Category: Infectious Diseases Authors: C. Cattaneo, F. Antoniazzi, M. Caira, C. Castagnola, M. Delia, M. Tumbarello, G. Rossi, L. Pagano Tags: Original Reports Source Type: research

Steroid Therapy Effectively Delays Duchenne's Cardiomyopathy ⁎ ⁎
Duchenne muscular dystrophy (DMD), the most common form of muscular dystrophy, is caused by a defective gene located on the X chromosome responsible for dystrophin production. The vast majority (70% to 85%) of dystrophin mutations are deletions; point mutations in the coding sequence or the splicing site account for the remainder (1). Significant associations between dilated cardiomyopathy and dystrophin mutations in exons 12 and 14 and possible protection against dilated cardiomyopathy by exon 51 and 52 mutations have been reported (2). (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - February 25, 2013 Category: Cardiology Source Type: research

All-Cause Mortality and Cardiovascular Outcomes With Prophylactic Steroid Therapy in Duchenne Muscular Dystrophy
ConclusionsIn patients with DMD, steroid therapy is associated with a substantial reduction in all-cause mortality and new-onset and progressive cardiomyopathy. (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - February 25, 2013 Category: Cardiology Source Type: research

IgG4-related lymphadenopathy and IgG4-related lymphoma: moving targets
Abstract: IgG4 is the least common of all the IgG subclasses. In recent years an uncommon systemic disease characterized by variable manifestations that may include the presence of tumour-like sclerosing lesions in a variety of extranodal sites, lymphadenopathy, presence of increased numbers of IgG4+ plasma cells in affected tissues, elevated serum IgG4 level, frequent presence of autoantibodies and often, a good response to steroid therapy or Rituximab has been described. The disorder has been called IgG4-related sclerosing disease, IgG4-related systemic disease and IgG4-related autoimmune disease; currently the preferred...
Source: Diagnostic Histopathology - February 22, 2013 Category: Pathology Authors: Judith A. Ferry Tags: Mini-Symposium: IgG4-Related Disease Source Type: research

[Steroid intake before leukemia diagnosis impairs outcome in childhood acute lymphoblastic leukemia.]
CONCLUSION: Steroids can induce a delay in the management of ALL and seem to favor initial complications, and possibly increase diffuse locations as well as steroid resistance. Their prescription needs to be carefully managed, especially for uncharacteristic infectious symptoms. Then a complete blood count should be done. PMID: 23433842 [PubMed - as supplied by publisher] (Source: Archives de Pediatrie)
Source: Archives de Pediatrie - February 21, 2013 Category: Pediatrics Authors: Gatineau-Sailliant S, Buchbinder N, Callat MP, Nelken B, Pautard B, Vannier JP, Schneider P Tags: Arch Pediatr Source Type: research

Randomized Controlled Observer-blinded Treatment of Chronic Foot Eczema with Iontophoresis and Bath-PUVA.
Abstract The aim of this study was to investigate the effect of iontophoresis combined with local psoralen plus ultraviolet A (PUVA) therapy in chronic foot eczema. A randomized, observer-blinded, multi-centre study was conducted in 48 patients with chronic moderate-to-severe foot eczema randomized to one of 3 groups: In the iontophoresis group local bath-PUVA was preceded by iontophoresis. In the PUVA group only local PUVA was given. The corticosteroid group was treated with fluticasone. All treatments were given for 8 weeks, with an 8-week follow-up period. The primary efficacy parameter was eczema score describe...
Source: Acta Dermato-Venereologica - February 18, 2013 Category: Dermatology Authors: Tupker RA, Coenraads PJ, Zanen P, Schuttelaar ML Tags: Acta Derm Venereol Source Type: research

Antenatal steroid therapy and later stress responsiveness in the child
It has been suggested that both maternal stress and antenatal administration of synthetic glucocorticoids (sGC) may cause prolonged changes in hypothalamus-pituitary-adrenal axis regulation that could affect the child in later life, increasing the risks of cardiovascular, metabolic, neuroendocrine, and psychological problems. Now a study in Germany (Nina Alexander and colleagues. J Clin Endocrinol Metab 2012;97:3538–44; see also editorial, ibid: 3457–9) has shown increased cortisol reactivity to stress in 6–11-year-old children born at term after antenatal exposure to sGC. The study included the single-bo...
Source: Archives of Disease in Childhood - February 14, 2013 Category: Pediatrics Tags: Miscellanea Source Type: research

Correction
Archivist: De novo mutations and severe nonsyndromic intellectual disability (Arch Dis Child 2013;<B>98</B>:102). The second half of this paper was published in error as part of the same article. The new paper begins at "Antenatal steroid therapy..." and finishes at "for antenatal steroid therapy". The correct version is published in this issue with its own doi (10.1136/archdischild-2012-303542). We would like to apologise to the author for any embarrassment caused by our mistake. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - February 14, 2013 Category: Pediatrics Tags: Correction Source Type: research

Highlights from the literature
Inhaled steroid therapy for childhood asthma reduces final height by just over a centimetre according to the results of a multicentre US trial (N Engl J Med 2012;367:904–12) and this height is lost in the first 2 years of treatment. Adult height was measured in 943 of the 1041 participants enrolled into the Childhood Asthma Management Program trial in 1993–1995. At the age of 5–13 years children with mild or moderate asthma had been randomised to inhaled budesonide 200 μg twice daily, inhaled nedocromil 8 mg twice daily, or placebo, for 4–6 years. After adjustment, final heigh...
Source: Archives of Disease in Childhood - February 14, 2013 Category: Pediatrics Tags: Miscellanea Source Type: research

Pseudo-Susac's - A Case of Cochleo-Vestibulopathy Due to Intravascular Lymphoma (P02.256)
CONCLUSIONS: Intravascular lymphoma is challenging to diagnose and should be included in the differential diagnosis of suspected central nervous system vasculopathy. Brain biopsy may be required.Disclosure: Dr. Patel has nothing to disclose. Dr. Kattah has received personal compensation for activities with Biogen as a consultant. Dr. Kattah has receied personal compensation in an editorial capacity for Bayere. Dr. Pula has received personal compensation for activities with Bayer, Lundbeck, and Biogen. Dr. Gujrati has nothing to disclose. Dr. Newman-Toker has nothing to disclose. (Source: Neurology)
Source: Neurology - February 14, 2013 Category: Neurology Authors: Patel, P., Kattah, J., Pula, J., Gujrati, M., Newman-Toker, D. Tags: P02 Neuro-ophthalmology I Source Type: research

Cluster of Urrets-Zavalia syndrome: a sequel of toxic anterior segment syndrome.
CONCLUSIONS: Timely diagnosis, steroid therapy and close monitoring are the main keys for properly managing TASS. To our knowledge, we report, for the first time, the largest cluster of UZS occurring as a sequel of TASS. PMID: 23410729 [PubMed - as supplied by publisher] (Source: The British Journal of Ophthalmology)
Source: The British Journal of Ophthalmology - February 14, 2013 Category: Opthalmology Authors: Nizamani NB, Bhutto IA, Talpur KI Tags: Br J Ophthalmol Source Type: research

Asymmetric dimethylarginine (adma) in exhaled breath condensate and serum of asthmatic children.
CONCLUSIONS. We measured ADMA in EBC by UPLC-MS/MS, a reference analytical technique. Higher ADMA levels were found in asthmatic children, supporting a role for this mediator in asthma pathogenesis. This oxidative stress-related mediator also seems to be scarcely affected by steroid therapy. We speculate that ADMA might be a target for new therapeutic strategies designed to control oxidative stress in asthma. PMID: 23412513 [PubMed - as supplied by publisher] (Source: Chest)
Source: Chest - February 14, 2013 Category: Respiratory Medicine Authors: Carraro S, Giordano G, Piacentini G, Kantar A, Moser S, Cesca L, Berardi M, Di Gangi IM, Baraldi E Tags: Chest Source Type: research

The Overlap of Functional Abdominal Pain in Pediatric Crohn's Disease.
CONCLUSIONS:: A proportion of children with CD in remission have FAP. These children are at significant risk of depression. Future studies are needed to determine whether depression contributes to functional pain development or if pain itself leads to depression. Especially given that functional pain may exaggerate disease activity, clinicians caring for children with CD and FAP should consider evaluating for depressive disorders before escalating therapy. PMID: 23407043 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - February 12, 2013 Category: Anesthesiology Authors: Zimmerman LA, Srinath AI, Goyal A, Bousvaros A, Ducharme P, Szigethy E, Nurko S Tags: Inflamm Bowel Dis Source Type: research

Telomere length is shortened in SLE patients
Conclusions:Telomere length is shortened in SLE patients compared to controls and does not appear to be a reflection of disease activity or immune cell turnover. Subsets of patients such as those positive for Ro antibodies may be particularly susceptible to premature biological ageing. The predictive value of telomere length as a biomarker of future risk of damage/mortality requires longitudinal evaluation. © 2013 American College of Rheumatology. (Source: Arthritis and Rheumatism)
Source: Arthritis and Rheumatism - February 11, 2013 Category: Rheumatology Authors: Sahena Haque, Chadi Rakieh, Fiona Marriage, Pauline Ho, Rachel Gorodkin, Lee Suan Teh, Neil Snowden, Philip J.R. Day, Ian N. Bruce Tags: Brief Report Source Type: research