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Flexible bronchoscopy as a valuable tool in the evaluation of persistent wheezing in childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Flexible bronchoscopy provided rapid and definitive diagnosis for our patients with persistent wheezing without any major complications. This study is one of the largest studies concerning persistent wheezing. Early bronchoscopic evaluation can reduce cost by providing rapid and accurate diagnosis and preventing unnecessary investigations and drug administration. Flexible bronchoscopy is a safe procedure and should be considered in the evaluation of children with persistent wheezing. (Source: International Journal of Pediatric Otorhinolaryngology)
Source: International Journal of Pediatric Otorhinolaryngology - November 20, 2009 Category: ENT & OMF Authors: Erkan Cakir, Refika Hamutcu Ersu, Zeynep Seda Uyan, Sedat Oktem, Bulent Karadag, Okan Yapar, Ozge Pamukcu, Fazilet Karakoc, Elif Dagli Tags: Research papers Source Type: journals

Recent advances in autoimmune pancreatitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Autoimmune pancreatitis (AIP) is distinct from calcifying and obstructive forms of chronic pancreatitis. Clinically and histologically it has two distinct subsets: (i) lymphoplasmacytic sclerosing pancreatitis or type 1 AIP which appears to be a systemic disease characterised by abundant infiltration of affected organs with immunoglobulin G4 (IgG4)-positive plasma cells and (2) duct-centric or type 2 AIP characterised by granulocyte epithelial lesions in the pancreas without systemic involvement. In AIP a marked lymphoplasmacytic infiltrate that responds dramatically to steroid therapy suggests an autoimmune aetiology. How...
Source: Gut - November 18, 2009 Category: Gastroenterology Authors: Park, D H, Kim, M-H, Chari, S T Tags: GUT Recent advances in basic science, Pancreas and biliary tract, Pancreatitis Source Type: journals

Combination therapy with steroids and mizoribine in juvenile SLE: a randomized controlled trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, our combined steroid and MZB drug therapeutic regimen was not shown to be significantly better than the steroid-only therapy as initial treatment for juvenile SLE. Whether MZB administered in a higher dose would be therapeutically advantageous can only be answered by further studies. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00467-009-1341-4Authors Yuriko Tanaka, Dokkyo Medical University Koshigaya Hospital Department of Pediatrics 2-1-50 Minamikoshigaya Koshigaya City Saitama Japan 343-8555Norishige Yoshikawa, Wakayama Medical University Department of Pediatrics Wakayama Japa...
Source: Pediatric Nephrology - November 9, 2009 Category: Urology & Nephrology Tags: Pediatric Nephrology Source Type: journals

Treatment of erythrodermic psoriasis in HCV+ patient with adalimumabEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Erythrodermic psoriasis is a severe and disabling variant of psoriasis. The authors present the case of a 48-year-old man with psoriasis and hemophilia presented with a history of hepatitis C virus (HCV) infection treated with pegylated interferon alpha-2a and ribavirin therapy. At the end of antiviral therapy, skin manifestation progressively worsened, becoming erythrodermic, with lack of efficacy of steroid therapy. The authors decided to start biological therapy with induction dose of adalimumab (Humira, Abbott Laboratories, Abbott Park, Chicago, IL) 80 mg at Week 0 and 40 mg weekly. In our case, this resulted in a high...
Source: Dermatologic Therapy - November 3, 2009 Category: Dermatology Authors: Antonio Giovanni Richetta, Elisa Maiani, Valentina Carlomagno, Valentina Carboni, Carlo Mattozzi, Simona Giancristoforo, Stefano Calvieri Tags: SIDeMaST Source Type: journals

Drug-induced interstitial nephritis in a child with idiopathic nephrotic syndrome.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a case of drug-induced acute interstitial nephritis (AIN), complicated with ARF, in a 2(1/2) -year-old girl with active INS. The child was referred to the Hippokration General Hospital, Thessaloniki, Greece hospital with steroid-resistant NS; renal biopsy was performed, which did not show any remarkable findings and cyclosporine was admi-nistered in addition to steroid therapy. The first day after biopsy, the child developed gross hematuria and abdominal pain and an antibiotic was added to her treatment. In the following days, fever, vomiting, hypertension and ARF occurred. Ultrasound study revealed enlarged kid...
Source: Saudi Journal of Kidney Diseases and Transplantation - October 30, 2009 Category: Urology & Nephrology Authors: Printza N, Koukourgianni F, Saleh T, Goga C, Papachristou F Tags: Saudi J Kidney Dis Transpl Source Type: journals

Anticyclic Citrullinated Peptide Antibody-Positive Paraneoplastic Polyarthritis in a Patient With Metastatic Pancreatic Cancer.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the case of a patient who initially presented with an asymmetrical, rapid onset polyarthritis. It resembled atypical RA with positive rheumatoid factor and anticyclic citrullinated peptide (CCP) antibodies. A good response to steroid therapy was noted. A few weeks later, he was diagnosed with metastatic pancreatic cancer that resulted in his mortality. His clinical course suggested that his rheumatic symptoms were a paraneoplastic manifestation of his underlying malignancy. Anticyclic citrullinated peptide antibodies have not been previously described in cancer polyarthritis. Awareness of this atypical, seroposit...
Source: The American Journal of the Medical Sciences - October 30, 2009 Category: Journals (General) Authors: Kumar S, Sethi S, Irani F, Bode BY Tags: Am J Med Sci Source Type: journals

Bevacizumab as Therapy for Radiation Necrosis in Four Children With Pontine GliomasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: In children with pontine gliomas, bevacizumab may provide both therapeutic benefit and diagnostic information. More formal evaluation of bevacizumab in these children is needed. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - October 26, 2009 Category: Radiology Authors: Arthur K. Liu, Margaret E. Macy, Nicholas K. Foreman Tags: Brain Source Type: journals

A case report of cranial polyneuropathy in Behcet’s diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a 19-year-old man with BD who presented with cranial polyneuropathy secondary to aseptic meningitis. He made a gradual though incomplete recovery with steroid therapy. Cranial polyneuropathy secondary to meningeal involvement can be a presentation of n-BD, and Behcet’s disease should be a consideration in patients with idiopathic cranial polyneuropathy. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10072-009-0162-3Authors Ali Alrefai, Jordan University of Science and Technology (JUST) Department of Neuroscience PO Box 3030 Irbid 22110 JordanKhalid El-Salem, Jordan University of Science an...
Source: Neurological Sciences - October 6, 2009 Category: Neurology Tags: Neurological Sciences Source Type: journals

Matrix metalloproteinases-7, -8, -9 and TIMP-1 in the follow-up of diisocyanate-induced asthmaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Our data suggest that reduced TH-2 type inflammation in DIA after inhaled steroid medication is reflected as elevated MMP-9 and MMP-9/TIMP-1 levels in BAL. MIF may be the inducer of MMP-9. This might point to some protective role for MMP-9 in DIA. (Source: Allergy)
Source: Allergy - October 4, 2009 Category: Allergy & Immunology Authors: P. Piirilä, A. Lauhio, M.-L. Majuri, A. Meuronen, M. Myllärniemi, T. Tervahartiala, K. Vuorinen, A. Laitinen, H. Alenius, V. L. Kinnula, T. Sorsa Source Type: journals

Safety and Efficacy of Steroid-Free Immunosuppression with Tacrolimus and Daclizumab in Liver Transplant Recipients: 6-Year Follow-up in a Single CenterEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: A CS-free regimen of Tac/Dac is as effective as Tac/Cs in achieving good patient and graft survival. However, no substantial benefits insofar as the safety of Tac/Dac therapy were evident during long-term follow-up. (Source: Transplantation Proceedings)
Source: Transplantation Proceedings - October 1, 2009 Category: Transplant Surgery Authors: B. Foroncewicz, K. Mucha, E. Ryszkowska, M. Ciszek, J. Ziółkowski, D. Porowski, M. Krawczyk, L. Pączek Tags: Liver Transplantation Source Type: journals

Steroid Therapy of Septic ShockEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the subject of steroid treatment of patients with septic shock and weighs the advantages and disadvantages of steroid treatment. It reviews and contrasts several low- and high-dose steroid studies, and makes recommendations for future practice. (Source: Critical Care Clinics)
Source: Critical Care Clinics - October 1, 2009 Category: Intensive Care Authors: Charles L. Sprung, Serge Goodman, Yoram G. Weiss Source Type: journals

S100A8/A9: a mediator of severe asthma pathogenesis and morbidity?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Nearly 12% of children and 6% of adults in Canada have been diagnosed with asthma. Although in most patients symptoms are controlled by inhaled steroids, a subpopulation (~10%) characterized by excessive airway neutrophilia, is refractory to treatment; these patients exhibit severe disease, and account for more than 50% of asthma health care costs. These numbers underscore the need to better understand the biology of severe asthma and identify pro-asthma mediators released by cells, such as neutrophils, that are unresponsive to common steroid therapy. This review focuses on a unique protein complex consisting of S100A8...
Source: Canadian Journal of Physiology and Pharmacology - October 1, 2009 Category: Drugs & Pharmacology Authors: Halayko AJ, Ghavami S Tags: Can J Physiol Pharmacol Source Type: journals

New insights into the pathophysiology of idiopathic nephrotic syndrome.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Corticoresistant idiopathic nephrotic syndrome (INS) is a glomerulopathy of unknown etiology whose original aspect is its recurrence after kidney transplantation in 30 to 50% of patients with end-stage renal disease. This suggests the involvement of circulating factors that would alter the glomerular filtration barrier, but whose nature remains elusive. Although a T cell immune origin has been suggested, the actual role of these cells in INS recurrence is still unclear. Here we present an 8-year-old patient with corticoresistant INS who developed a recurrence of her initial disease after kidney transplantation. Rituxim...
Source: Clinical Immunology - September 30, 2009 Category: Allergy & Immunology Authors: Bruneau S, Dantal J Tags: Clin Immunol Source Type: journals

Gallium-67 citrate imaging for the assessment of radiation pneumonitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract In order to evaluate its usefulness in the assessment of radiation pneumonitis, gallium-67 citrate (67Ga) imaging was performed before and after radiation therapy (RT) on 103 patients with lung cancer. In 23 patients with radiation pneumonitis detected radiographically, abnormal67Ga uptake in sites other than tumors was found in all post-RT67Ga lung images. Three patterns of uptake were found: (A), focal uptake corresponding to the RT field (n= 10); (B), diffuse uptake including the RT field (n=4), and (C), diffuse uptake outside the RT field (n=9). The area of67Ga uptake was consistent with that of i...
Source: Annals of Nuclear Medicine - September 29, 2009 Category: Radiology Tags: Annals of Nuclear Medicine Source Type: journals

Clinical Application of Exhaled Breath Condensate Analysis in Asthma: Prediction of FEV 1 Improvement by Steroid TherapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Respiration (DOI:10.1159/000243551) (Source: Respiration)
Source: Respiration - September 28, 2009 Category: Respiratory Medicine Source Type: journals

[Sub-acute encephalopathy that responds to steroids without any evidence of autoimmune thyroid disease: a case of non-vasculitic autoimmune meningoencephalitis.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSIONS. With no evidence of autoimmune thyroid disease, although non-specific autoimmunity was present, the patient was diagnosed as having non-vasculitic autoimmune meningoencephalitis. PMID: 19774530 [PubMed - in process] (Source: Revista de Neurologia)
Source: Revista de Neurologia - September 24, 2009 Category: Neurology Authors: Lopez-Ariztegui N, Lobato-Casado P, Munoz-Escudero F, Polo-Martin M, Montes-Gonzalo MC, Alvarez-Tejerina A Tags: Rev Neurol Source Type: journals

A new cold autoagglutinin specificity: the third external loop of band 3.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: This is to our knowledge the first observation of a CA specific for band 3. The coexistence of IgM and IgG molecules, a very unusual feature for a CA, may be related to the peptidic nature of the target antigen. PMID: 19778339 [PubMed - as supplied by publisher] (Source: Transfusion)
Source: Transfusion - September 21, 2009 Category: Hematology Authors: Janvier D, Lam Y, Galicier L, Bierling P Tags: Transfusion Source Type: journals

Free perforation of the small intestine in collagenous sprue.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 67-year-old man with celiac disease developed recurrent diarrhea, profound weakness and weight loss, with evidence of marked protein depletion. His clinical course was refractory to a strict gluten-free diet and steroid therapy. Postmortem studies led to definition of unrecognized collagenous sprue that caused ulceration and small intestinal perforation. Although PCR showed identical monoclonal T-cell populations in antemortem duodenal biopsies and postmortem jejunum, careful pathological evaluation demonstrated no frank lymphoma. Rarely, overt or even cryptic T-cell lymphoma may complicate collagenous sprue, however...
Source: World Journal of Gastroenterology : WJG - September 20, 2009 Category: Gastroenterology Authors: Freeman HJ, Webber DL Tags: World J Gastroenterol Source Type: journals

Primary sclerosing cholangitis with elevated serum IgG4 levels and/or infiltration of abundant IgG4-positive plasma cellsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Immunoglobin G4-related sclerosing cholangitis (IgG4-SC) is recognized as one of the systemic sclerosing diseases characterized by abundant IgG4-positive plasma cells with effective steroid therapy. On the other hand, primary sclerosing cholangitis (PSC), recognized as a sclerosing cholangitis of unknown origin without steroid efficacy, has been often clinically confused with IgG4-SC. To date, the prognosis of IgG4-SC is unclear, while the prognosis of PSC is well known to be poor. Therefore, it is clinically very important to be able to distinguish IgG4-SC from PSC. However, at the present time it ...
Source: Journal of Gastroenterology - September 17, 2009 Category: Gastroenterology Tags: Journal of Gastroenterology Source Type: journals

Blood Pressure in Children with Minimal Change Nephrotic Syndrome during Oedema and after Steroid Therapy: The Influence of Familial Essential HypertensionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Kidney Blood Press Res 2009;32:258-262 (DOI:10.1159/000238823) (Source: Karger Publishers)
Source: Karger Publishers - September 14, 2009 Category: Cancer & Oncology Source Type: journals

Community acquired influenza requiring hospitalization: Vaccine status is unrelated to morbidity in children with cancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Community acquired influenza can be severe and there are few data regarding hospitalization for children with cancer and influenza. Association between prior vaccination and infection severity has not been studied, although vaccination is standard practice.Patients with malignancy or prior stem cell transplant (SCT) were identified using a database of children with laboratory confirmed influenza (2000-2005). Other data collected included receipt of vaccine, absolute neutrophil count (ANC) and absolute lymphocyte count (ALC). These were compared with intensive care unit (ICU) stay, respiratory complications and hospital day...
Source: Pediatric Blood and Cancer - September 8, 2009 Category: Cancer & Oncology Authors: Leslie S. Kersun, Susan E. Coffin, Kateri H. Leckerman, Mary Ingram, Anne F. Reilly Source Type: journals

Is 18F-fluorodeoxyglucose positron emission tomography meaningful for estimating the efficacy of corticosteroid therapy in patients with autoimmune pancreatitis?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions FDG-PET pattern at baseline, and a decrease in FDG uptake after a short steroid trial can be useful for discriminating AIP from PC. Content Type Journal ArticleCategory Original articleDOI 10.1007/s00534-009-0172-9Authors Minoru Shigekawa, Aichi Cancer Center Hospital Department of Gastroenterology Nagoya JapanKenji Yamao, Aichi Cancer Center Hospital Department of Gastroenterology Nagoya JapanAkira Sawaki, Aichi Cancer Center Hospital Department of Gastroenterology Nagoya JapanKazuo Hara, Aichi Cancer Center Hospital Department of Gastroenterology Nagoya JapanTadayuki Takagi, Aichi Cancer ...
Source: Journal of Hepato-Biliary-Pancreatic Surgery - September 3, 2009 Category: Surgery Tags: Journal of Hepato-Biliary-Pancreatic Surgery Source Type: journals

Consistency of sputum eosinophilia in difficult-to-treat asthma: A 5-year follow-up studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
To the Editor: Several inflammatory phenotypes have been described in patients with difficult-to-treat asthma, including the eosinophilic and noneosinophilic phenotypes. Eosinophilic airway inflammation that persists despite vigorous anti-inflammatory treatment has been associated with more severe asthma, frequent exacerbations, and loss of lung function. Notably, persistent sputum eosinophilia has therapeutic consequences, because it allows tailored steroid therapy as well as targeted treatment with new biologicals in severe refractory asthma. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - August 31, 2009 Category: Allergy & Immunology Authors: Ilonka H. van Veen, Anneke ten Brinke, Stefanie A. Gauw, Peter J. Sterk, Klaus F. Rabe, Elisabeth H. Bel Tags: Letters to the Editor Source Type: journals

Early Sirolimus Therapy in Renal Transplant Recipients at High Risk: Is It Justified?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Early treatment with combined SRL-MMF-steroid may be effective as a CNI-free immunosuppression regimen in patients at high risk; however, there is a high rate of adverse effects during long-term follow-up. (Source: Transplantation Proceedings)
Source: Transplantation Proceedings - August 31, 2009 Category: Transplant Surgery Authors: M.A. Halim, T. Al-Otaibi, K.V. Johny, M.H. Hamid, S. Al-Waheeb, H. Hasaneen, W.H. Awadain, K.M. Nawas, A. El-Sayed, T. Said, M.P. Nair, M.R.N. Nampoory Tags: Kidney Transplantation Source Type: journals

Cord blood transplantation with a reduced-intensity conditioning regimen for patients with relapsed aggressive multiple myeloma after cytoreduction with bortezomib.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Two multiple myeloma patients relapsed after autologous stem cell transplantation (ASCT). Conventional chemotherapy, including thalidomide, showed very little effect, but both patients responded well to a standard dose of bortezomib. One patient was treated with two additional cycles of bortezomib, but his clinical course suddenly deteriorated. Unrelated cord blood transplantation (CBT) with reduced-intensity conditioning regimen (RIC) was performed in refractory disease. After CBT, the clinical course was aggravated by tumor lysis syndrome and other conditions, thus resulting in patient death on day 34. Thereafter, we...
Source: International Journal of Hematology - August 28, 2009 Category: Hematology Authors: Kasahara I, Nishio M, Yamamoto S, Endo T, Fujimoto K, Yamaguchi K, Takeda Y, Goto H, Sato N, Koike T Tags: Int J Hematol Source Type: journals

Cyclosporine and steroid therapy in children with steroid-resistant nephrotic syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, a high remission rate was achieved in our patient cohort using a combined cyclosporine/prednisolone treatment regimen in children with SRNS who had MC/DMP and a combined cyclosporine/prednisolone plus MPT regimen in children who had FSGS. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00467-009-1264-0Authors Yuko Hamasaki, Tokyo Metropolitan Kiyose Children’s Hospital Department of Pediatric Nephrology 1-3-1 Umezono Kiyose-city, Tokyo 204-8567 JapanNorishige Yoshikawa, Wakayama Medical University Department of Pediatrics Wakayama JapanShinzaburo Hattori, Kumamoto Health Science Un...
Source: Pediatric Nephrology - August 28, 2009 Category: Urology & Nephrology Tags: Pediatric Nephrology Source Type: journals

A prospective, randomised, placebo-controlled trial of postoperative oral steroid in allergic fungal sinusitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, postoperative oral steroid in a tapering dose produces significant subjective and objective improvement of patients with AFS. It is also effective in preventing early recurrence. Inclusion of postoperative oral steroid therapy for at least 12 weeks is recommended in all patients who undergo excisive surgery for AFS. Content Type Journal ArticleCategory RhinologyDOI 10.1007/s00405-009-1075-8Authors V. Rupa, Christian Medical College and Hospital Department of ENT Vellore 632004 IndiaMary Jacob, Christian Medical College and Hospital Department of Pathology Vellore IndiaMary Somini Mathews, Christi...
Source: European Archives of Oto-Rhino-Laryngology - August 28, 2009 Category: ENT & OMF Tags: European Archives of Oto-Rhino-Laryngology Source Type: journals

Delayed Recovery of Accelerated Acute RejectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the case of a 49-year-old female, under chronic hemodialysis therapy who received a living transplant from her husband. Both of them had the same blood type and the result of the mixed lymphocyte culture test was acceptable before transplantation. The operation was smooth and a combination therapy with cyclosporine, prednisolone, and mycophenolate mofetil (MMF) was given. However, oliguria developed on the second day after transplantation. After excluding the possibility of occlusive lesion, the first course of pulse steroid therapy was given under the impression of AAR, supported by renal biopsy. After the secon...
Source: Dialysis and Transplantation - August 27, 2009 Category: Urology & Nephrology Authors: Szu-Chia Chen, Mei-Chuan Kuo, Chi-Chih Hung, Chun-Hsiung Huang, Hung-Chun Chen Tags: Case Reports Source Type: journals

Glucocorticoid bioactivity does not predict response to steroid therapy in severe pediatric ulcerative colitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The pathophysiological basis for corticosteroid (CS) failure in ulcerative colitis (UC) is unknown. A transactivation glucocorticoid bioassay (GBA) was developed to measure the biological activity of CS by quantifying glucocorticoid response elements. This approach eliminates differences in bioavailability, chemistry, affinity, and other potential differences between the various steroids regarding their ability to activate the glucocorticoid receptor. In this multicenter prospective study, we aimed to evaluate whether CS bioavailability plays a role in CS refractoriness in severe pediatric UC.GBA (using COS-1 transfected c...
Source: Inflammatory Bowel Diseases - August 26, 2009 Category: Gastroenterology Authors: Dan Turner, Kaija-Leena Kolho, David R. Mack, Taneli Raivio, Neal Leleiko, Wallace Crandall, James Markowitz, Mark S. Silverberg, Olli A. Jänne, Joanne Stempak, Jeffrey Hyams, Anne M. Griffiths Source Type: journals

Disturbances of Esophageal Motility in Eosinophilic Esophagitis: A Case SeriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Esophageal manometry (EM) findings were reviewed in 14 (13 male) adults diagnosed with eosinophilic esophagitis (EE). One had complete nonperistaltic contractions (amplitude range = 30–180 mmHg) and incomplete relaxation of the lower esophageal sphincter (LES), suggesting vigorous achalasia. After 6 months of steroid therapy the repeat EM showed near-normal findings. One had total aperistalsis with contraction amplitudes less than 10 mmHg and a weak LES pressure (8 mmHg), criteria suggesting scleroderma. Two had low-amplitude (<30 mmHg) nonperistaltic contract...
Source: Dysphagia - August 26, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Azathioprine maintains long-term steroid-free remission through 3 years in patients with steroid-dependent ulcerative colitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Studies assessing the efficacy of azathioprine (AZA) in steroid-dependent ulcerative colitis (SD-UC) are scarce. The purpose of this trial was to explore the efficacy of AZA in maintaining steroid-free remission in SD-UC patients and the factors associated with sustained response.In this observational cohort study, 42 subjects with SD-UC were recruited for AZA therapy during a 3-year period. AZA was adjusted for a target dose of 2-3 mg/kg/day. Steroid therapy was tapered off following a standardized regimen. The primary endpoint was the annual rate of steroid-free response to AZA. Secondary endpoints included clinical recu...
Source: Inflammatory Bowel Diseases - August 23, 2009 Category: Gastroenterology Authors: Liliana Andrade Chebli, Leonardo Duque de Miranda Chaves, Felipe Ferreira Pimentel, Dolores Martins Guerra, Renata Maria de Freitas Barros, Pedro Duarte Gaburri, Alexandre Zanini, Julio Maria Fonseca Chebli Source Type: journals

Acute eosinophilic myocarditis mimicking myocardial infarction.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Eosinophilic myocarditis is characterized by progressive myocardial damage that results in heart failure and death. Herein, we present the case of a 54-year-old man who presented with symptoms of acute myocardial infarction. Normal coronary angiographic results and the presence of elevated levels of peripheral-blood eosinophilia prompted an endomyocardial biopsy that revealed acute eosinophilic myocarditis. The early initiation of steroid therapy resulted in the patient's substantial clinical improvement and survival. Early diagnosis of eosinophilic myocarditis and its treatment with steroid agents in some patients can...
Source: Texas Heart Institute Journal - August 22, 2009 Category: Cardiology Authors: Thambidorai SK, Korlakunta HL, Arouni AJ, Hunter WJ, Holmberg MJ Tags: Tex Heart Inst J Source Type: journals

Early CT Findings of Tomotherapy-Induced Radiation Pneumonitis After Treatment of Lung MalignancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION. Radiation pneumonitis commonly developed with minimal clinical findings within 3 months after tomotherapy. The CT findings were nonspecific: focal, irregular-shaped ground-glass opacities with minimal fibrosis. However, the location of the radiation pneumonitis tended not to correspond to the planned target volume and had a centrifugal distribution. In addition, the immediate area around the target tended to be spared. (Source: American Journal of Roentgenology)
Source: American Journal of Roentgenology - August 19, 2009 Category: Radiology Authors: Park, H. J., Kim, K. J., Park, S. H., Kay, C.-S., Oh, J. S. Tags: Cardiopulmonary Imaging Source Type: journals

Acute inflammatory demyelinating polyneuropathy as the initial presentation of lupusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 28-year-old woman presented at the emergency department (ED) with acute bilateral leg weakness and lost the ability to walk 1 day after noticing bilateral leg numbness and intermittent pleuritic pain for 3 weeks. Physical examination revealed bilateral decreased muscle strength with score 4 symmetrically in the legs and decreased deep tendon reflex. Laboratory tests indicated lymphopenia but no other grossly remarkable findings. Cerebrospinal fluid analysis demonstrated albuminocytologic dissociation. Electrophysiologic survey also indicated sensory-motor demyelinating polyneuropathy. The clinical picture was compatible ...
Source: The American Journal of Emergency Medicine - August 18, 2009 Category: Emergency Medicine Authors: Tai-Yi Hsu, Shih-Hao Wang, Chang-Fu Kuo, Te-Fa Chiu, Yu-Che Chang Tags: Case Reports Source Type: journals

Growth in boys with idiopathic nephrotic syndrome on long-term cyclosporin and steroid treatmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Although steroid-free remission can usually be achieved with cyclosporin A (CsA) in patients with steroid-dependent nephrotic syndrome (SDNS), some CsA-treated patients require long-term steroid therapy. Data on growth in these patients are scarce. Sixty-four boys with SDNS receiving long-term CsA and steroid therapy were retrospectively analyzed. During the 10-year follow-up period, height standard deviation score (HSDS) remained in the normal range in 47 patients but was below −2 SD in 17 patients. The occurrence of growth retardation was influenced by height at diagnosis and the number of relaps...
Source: Pediatric Nephrology - August 11, 2009 Category: Urology & Nephrology Tags: Pediatric Nephrology Source Type: journals

M.P.5.06 Steroids and T2 relaxation time mapping of the gluteal muscles in patients with Duchenne muscular dystrophy (DMD): Longitudinal and quantitative assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: DMD is a fatal disease characterized by progressive muscle weakness and eventual early death. Steroid therapy can transiently improve weakness. T2 relaxation time mapping (T2 mapping), used primarily for articular cartilage, has infrequently been used for soft tissues. There are no longitudinal studies using T2 mapping of muscle, particularly in children. Objective: To determine the feasibility of T2 mapping as a quantitative method to longitudinally follow disease activity in children with DMD treated with steroids. Methods: Eleven boys with DMD ages 5–14 (mean age 7.2 years) underwent evaluation with Clinic...
Source: Neuromuscular Disorders - August 7, 2009 Category: Neurology Authors: H. Kim, T. Laor, B. Dardzinski, M. Chadehumbe, B.L. Wong Tags: 14th International Congress of the World Muscle Society Source Type: journals

T.P.3.03 Long-term, low-dosage, early steroid therapy in Duchenne muscular dystrophy prolongs ambulation and preserves respiratory and cardiac function. 13 years follow-upEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Duchenne muscular dystrophy (DMD) is an incurable disease of childhood. In the natural history course of DMD, loss of walking ability at the mean age of 9.5 years (range 6–13) is followed by restrictive respiratory syndrome, cardiomyopathy, and eventually death. The major aim of steroids in the ambulant phase of DMD is to prolong the ability to walk. RCT have shown that steroids improved muscle strength and function for six months to two years, but the overall long-term benefit remains unclear, and has to be weighed against the long-term side effects of steroids. In 1996 we started a prospective long-term open, parallel ...
Source: Neuromuscular Disorders - August 7, 2009 Category: Neurology Authors: L. Merlini, E. Malaspina, A. Cicognani, E. Franzoni, A.R. Armaroli, B. Talim, F. Gualandi, M.E. Michelini, A. Ferlini Tags: 14th International Congress of the World Muscle Society Source Type: journals

T.P.2.07 Attenuation of adverse effects of prednisolone on δ-sarcoglycan-deficient cardiomyopathy by mineralocorticoid-receptor-antagonismEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
An inflammatory component to Duchenne muscular dystrophy (DMD), Limb-girdle muscular dystrophy (LGMD) and other dystrophin–glycoprotein complex-associated muscular dystrophies has been well documented, and steroid therapy increases respiratory and skeletal muscle strength in DMD and sarcoglycan-deficient LGMD patients. In addition, retrospective studies in patients with DMD have suggested that steroids have beneficial effects on left ventricular function when assessed by echocardiography. We have however recently reported severe adverse myocardial effects of steroid treatment in the δ-sarcoglycan-deficient (Sgcd-null) m...
Source: Neuromuscular Disorders - August 7, 2009 Category: Neurology Authors: A.M. Blain, R. Bauer, G. MacGowan, E. Greally, S. Laval, K. Bushby, V. Straub Tags: 14th International Congress of the World Muscle Society Source Type: journals

Acute Vogt–Koyanagi–Harada Disease in Enhanced Spectral-Domain Optical Coherence TomographyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The membranous structure that can be seen in eyes with acute VKH disease seems to represent a portion of the outer segment layer that has become separated from the inner segment layer by cystoid spaces. We hypothesize that the membranous form of the outer segment is bound with the action of inflammatory products, such as fibrin, and this membranous structure changes to a granular structure as steroid therapy “dissolves” the fibrin holding the outer segments together.Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. (Source: Ophthalmology)
Source: Ophthalmology - July 29, 2009 Category: Opthalmology Authors: Kenji Ishihara, Masanori Hangai, Mihori Kita, Nagahisa Yoshimura Tags: Original Articles Source Type: journals

Vacuum-assisted biopsy and steroid therapy for granulomatous lobular mastitis: Report of three casesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the cases of three patients with granulomatous lobular mastitis (GLM), who were treated successfully with low-dose steroid therapy. Furthermore, the findings of our review of 271 patients reported in the literature suggest that steroid therapy is the treatment of choice for GLM. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00595-008-3891-7Authors Sayaka Kuba, National Hospital Organization Department of Surgery Saga JapanJunzo Yamaguchi, National Hospital Organization Department of Surgery Saga JapanHiroshi Ohtani, Nagasaki University Department of Investigative Pathology, Graduate School o...
Source: Surgery Today - July 28, 2009 Category: Surgery Tags: Surgery Today Source Type: journals

Identification and characterization of IgG4-associated autoimmune hepatitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this study, we examined whether the IgG4 response contributes to the histopathological and clinical findings in AIH. Liver sections from 26 patients with AIH, 10 patients with primary biliary cirrhosis (PBC), three patients with primary sclerosing cholangitis (PSC) and 20 chronic hepatitis patients with hepatitis C virus (HCV) infection were immunostained for IgG4. We investigated the relationship among the histopathology, the responses to steroid therapy and the IgG4 staining. Nine of the 26 liver specimens from patients with AIH showed positive staining for IgG4 whereas none of the 10 samples from patients with PBC, t...
Source: Liver International - July 24, 2009 Category: Gastroenterology Authors: Hobyung Chung, Tomohiro Watanabe, Masatoshi Kudo, Osamu Maenishi, Yoshio Wakatsuki, Tsutomu Chiba Source Type: journals

Comparing hydrocortisone and methylprednisolone in patients with septic shock.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSIONS: Low-dose methylprednisolone and hydrocortisone might have a similar effect for the treatment of patients with septic shock. PMID: 19629409 [PubMed - as supplied by publisher] (Source: Advances in Therapy)
Source: Advances in Therapy - July 22, 2009 Category: Drugs & Pharmacology Authors: Yu TJ, Liu YC, Yu CC, Tseng JC, Hua CC, Wu HP Tags: Adv Ther Source Type: journals

Utility of 18F-FDG PET/CT for Differentiation of Autoimmune Pancreatitis With Atypical Pancreatic Imaging Findings From Pancreatic CancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION. In difficult cases, at PET/CT the presence of diffuse uptake of FDG by the pancreas or concomitant extrapancreatic uptake by the salivary glands can be used to aid in differentiation of autoimmune pancreatitis and pancreatic cancer. (Source: American Journal of Roentgenology)
Source: American Journal of Roentgenology - July 19, 2009 Category: Radiology Authors: Lee, T. Y., Kim, M.-H., Park, D. H., Seo, D. W., Lee, S. K., Kim, J. S., Lee, K. T. Tags: Nuclear Medicine and Molecular Imaging Source Type: journals

Autoimmune pancreatitis: An underdiagnosed autoimmune disease with clinical, imaging and serological features.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Since Sarles et al reported a case of pancreatitis associated with hypergammaglobulinemia, many cases have been described, which led to the current concept of "autoimmune pancreatitis (AIP)". Lymphoplasmacytic infiltration and fibrosis on histology together with elevated IgG levels or the presence of autoantibodies on laboratory examinations supported the concept of AIP. In recent years, based on histological and immunohistochemical examination of various organs of patients with AIP, a novel clinicopathological entity, IgG4-related slerosing disease, has been proposed. AIP is a systemic disease that is characterized by...
Source: Autoimmunity Reviews - July 17, 2009 Category: Allergy & Immunology Authors: Sánchez-Castañón M, de Las Heras-Castaño G, López-Hoyos M Tags: Autoimmun Rev Source Type: journals

Isolated diffuse invasive renal aspergillosis in an immunocompromized patient due to longstanding steroid treatment: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 53-year-old Indian lady suffered from type 2 diabetes and hypothyroidism and was on longstanding steroid therapy. She was urgently admitted to the hospital with a high white cell count and high creatinine. On imaging no space occupying lesions were shown. In spite of intensive therapy the patient died a week after admission. Post mortem examination revealed markedly enlarged kidneys with areas of necrosis, hemorrhagic infarction, inflammatory response and granulomas related to the widespread glomerular, tubulo-interstitial and vascular involvement by aspergillus. Renal disease may present as bilateral diffuse parenchymal...
Source: Cases Journal - July 15, 2009 Category: Journals (General) Source Type: journals

[Intermittent elevation deficiency.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 7-year-old boy presented with vertical double images. A paediatric examination and magnetic resonance imaging of the head did not show any pathological findings. The diagnosis was an acquired click syndrome of the superior oblique muscle. In cases with inflammatory and systemic origin the underlying disease should be treated. Local steroid therapy can be carried out for improvement of inflammation in the region of the superior oblique muscle with a high degree of suffering. PMID: 19593572 [PubMed - as supplied by publisher] (Source: Der Ophthalmologe)
Source: Der Ophthalmologe - July 11, 2009 Category: Opthalmology Authors: van Waveren M, Jägle H Tags: Ophthalmologe Source Type: journals

IgG4-related retroperitoneal fibrosis and sclerosing cholangitis independent of autoimmune pancreatitis. A recurrent case after a 5-year history of spontaneous remission.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: When we encounter fibrotic diseases of unknown etiology, we should measure serum IgG4 concentrations and monitor the disease activity over long periods even after achieving clinical remission. PMID: 19581751 [PubMed - in process] (Source: JOP)
Source: JOP - July 9, 2009 Category: Gastroenterology Authors: Miura H, Miyachi Y Tags: JOP Source Type: journals

Ulcerative colitis associated with IgG4 cholangitis: Similar features in two HLA identical siblingsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Appropriate investigation for IBD-associated cholangitis is mandatory to identify IAC, the recognition of which has particular therapeutic and prognostic implications. (Source: Journal of Hepatology)
Source: Journal of Hepatology - July 7, 2009 Category: Gastroenterology Authors: Sergio Negrin Dastis, Dominique Latinne, Christine Sempoux, André P. Geubel Tags: Case Report Source Type: journals

Chronic Fatigue Syndrome After Infectious Mononucleosis in AdolescentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSIONS: Infectious mononucleosis may be a risk factor for chronic fatigue syndrome in adolescents. Female gender and greater fatigue severity, but not reported steroid use during the acute illness, were associated with the development of chronic fatigue syndrome in adolescents. Additional research is needed to determine other predictors of persistent fatigue after infectious mononucleosis. (Source: PEDIATRICS)
Source: PEDIATRICS - June 28, 2009 Category: Pediatrics Authors: Katz, B. Z., Shiraishi, Y., Mears, C. J., Binns, H. J., Taylor, R. Tags: Office Practice ARTICLES Source Type: journals

Host‐Related Risk Factors and Clinical Features of Community‐Acquired Legionnaires Disease Due to the Paris and Lorraine Endemic Strains, 1998–2007, FranceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion. Several host characteristics were associated with the risk of infection by endemic strains of L. pneumophila serogroup 1. These findings may help to guide preventive measures. Factors predisposing patients to infection by specific strains need to be explored further. (Source: Clinical Infectious Diseases Latest Issue)
Source: Clinical Infectious Diseases Latest Issue - June 19, 2009 Category: Infectious Diseases Tags: article MAJOR ARTICLE Source Type: journals