Topical corticosteroid irrigations in chronic rhinosinusitis

ConclusionMany factors are associated with efficacious and adequate treatment of primary CRS. The pathology must be correctly diagnosed and be inflammatory in nature. The treatment paradigm should include wide and complete endoscopic sinus surgery for the adequate delivery of topical therapy. Topical therapy should be delivered in large ‐volume, low‐pressure devices with adequate dosing. Although there is some systemic absorption, multiple studies have demonstrated that long‐term, daily use of topical corticosteroids does not increase intraocular pressure, suppress the hypothalamic‐pituitary‐adrenal axis, or increase the risk of subcapsular cataracts. Therefore, topical corticosteroid irrigations should be considered a part of first‐line medical treatment in postsurgical CRS patients.
Source: International Forum of Allergy and Rhinology - Category: Allergy & Immunology Authors: Tags: REVIEW ARTICLE Source Type: research

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Authors: Ewy S, Pham H, Quan K, Su B, Tachdjian R Abstract Bullous pemphigoid (BP) is a rare blistering skin disease that is commonly treated with corticosteroids and immunosuppressive agents. Here, we present a 74-year-old woman with severe BP following a leg fracture who was successfully treated with omalizumab. We started her on a regimen of omalizumab 300 mg subcutaneously every 4 weeks, and within a week she reported significantly decreased pain and faster healing time of lesions. Incidentally, bilateral erythematous, non-blistering dermatitis developed 5 centimeters distal to the injection sites within a week...
Source: Journal of Drugs in Dermatology - Category: Dermatology Tags: J Drugs Dermatol Source Type: research
Is there an increased risk of developing de novo inflammatory bowel disease while under treatment with anti-TNF-alpha for other chronic inflammatory or immune-mediated diseases?Alimentary Pharmacology &Therapeutics
Source: Medscape Allergy Headlines - Category: Allergy & Immunology Tags: Gastroenterology Journal Article Source Type: news
In conclusion, our findings identify ALCAM as a novel therapeutic target for preventing corneal allograft rejection in high-risk patient populations. Moreover, given the documented contribution of ALCAM to (lymph)angiogenesis, DC migration, and T cell activation, ALCAM blockade might represent a therapeutic strategy for treating other immune-mediated inflammatory conditions, such as solid organ transplant rejection, allergy or autoimmune diseases. Experimental Procedures Cloning, Expression, and Purification of I/F8-Fc and KSF-Fc For cloning of I/F8-Fc and KSF-Fc the respective scFv sequence was amplified from previousl...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Publication date: November–December 2018Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 6Author(s): Luke E. Barry, Ciaran O'Neill, Chris Patterson, Joan Sweeney, David Price, Liam G. HeaneyBackgroundTreatment of severe asthma may include high-dose systemic corticosteroid therapy, which is associated with substantial comorbidity. There is evidence to suggest that this burden is not evenly distributed across age, sex, and corticosteroid exposure levels.ObjectiveTo examine the associations between age, sex, comorbidity, and patterns of health care cost across groups differentiated by...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Increased intraocular pressure (IOP) and cataracts are known risks of systemic steroid exposure.  EDS-FLU (exhalation delivery system with fluticasone) 372mcg produces higher systemic exposure than fluticasone nasal spray 400mcg, but lower systemic exposure than orally inhaled fluticasone 440mcg.  Ocular effects were extensively studied in EDS-FLU clinical trials.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: P457 Source Type: research
Introduction: Transition from specialist paediatric to adult services is a crucial time &while this process is well established in other chronic conditions (e.g. Cystic Fibrosis) there is a lack of information in an asthma setting.Aims &Objectives: We were interested in the features of young adults (YAs) transitioning from paediatric to adult asthma services.Methods: We retrospectively reviewed our referrals from the paediatric sector over the last 4years.Results: All 42 referrals [40.5% female] transitioned between the ages of 16-18yrs. Almost half the males were below the 25th centile for height at the time of tr...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric Asthma and Allergy Source Type: research
Vici Syndrome is a rare disorder characterized by callosal agenesis, cataracts, oculocutaneous hypopigmentation, cardiomyopathy and combined immunodeficiency. The condition is due to recessive mutations in the EPG5 gene on chromosome 18q12.3.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
In a new study, physicians' enthusiasm levels for EHR's seem to resemble this EKG:Do physicians really experience a satisfaction 'J-curve' with EHRs? Max Green July 6, 2016 http://www.beckershospitalreview.com/healthcare-information-technology/do-physicians-really-experience-a-satisfaction-j-curve-with-ehrs.html There's a school of thought about EHR adoption that suggests physicians experience an initial decrease in their positive perceptions of the technology, but over time those levels creep back up and ultimately surpass their pre-implementation perceptions. But does that J-curve actually exists for EHR...
Source: Health Care Renewal - Category: Health Management Tags: Becker ' s Hospital Review EPIC healthcare IT dissatisfaction JAMIA Max Green Source Type: blogs
Ben shared his 3-week experience living the Wheat Belly lifestyle after being diagnosed with celiac disease: “My family doctor diagnosed me with celiac and wheat allergies. These pictures were taken 3 weeks apart: prior to the diagnosis and three weeks later, a photo of me after following the Wheat Belly books that my doctor recommended I get. “I still feel like I eat like a king. I am just a lot more cautious about what I put into my body and I am seeing the results!” You can see that Ben’s face shows the changes we expect to see as inflammation recedes: reduced cheek and around-the-eyes edema, la...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Wheat Belly Success Stories celiac gluten grains Inflammation Source Type: blogs
I presume this is, in part, a response to the Jan. 21 letter from AMA and the other medical societies as I wrote about two days ago at http://hcrenewal.blogspot.com/2015/01/meaningful-use-not-so-meaningul.html:CMS intends to modify requirements for Meaningful Usehttp://blog.cms.gov/2015/01/29/cms-intends-to-modify-requirements-for-meaningful-use/January 29By Patrick Conway, MDToday, we at the Centers for Medicare &Medicaid Services (CMS) are pleased to announce our intent to engage in rulemaking to update the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs beginning in 2015. These intended chang...
Source: Health Care Renewal - Category: Health Management Tags: CMS healthcare IT difficulties healthcare IT dissatisfaction healthcare IT myths MD Patrick Conway Source Type: blogs
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