Effectiveness of mepolizumab for eosinophilic pneumonia following bronchial thermoplasty

Bronchial thermoplasty (BT) is a bronchoscopic procedure for treating severe asthma using thermal energy to reduce airway smooth muscle. There are some reports of complications such as bronchitis and atelectasis due to transient inflammation and oedema, but, to the best of our knowledge, no studies have reported eosinophilic pneumonia (EP) due to BT. Mepolizumab is an anti ‐interleukin‐5 monoclonal antibody that is reportedly effective against eosinophilic inflammation such as bronchial asthma; however, only few studies have reported its use in treating EP. Here, we report the effectiveness of mepolizumab in treating EP following BT. A 57 ‐year‐old woman with poorly controlled diabetes was admitted to our hospital for additional treatment of severe asthma. Although bronchial thermoplasty was performed in the both upper lobes, cough and dyspnoea gradually appeared 2 weeks later. High‐resolution computed tomography revealed thi ckness of intralobular septa and a diffuse ground‐glass attenuation in the lung fields. Laboratory examination revealed elevated levels of serum eosinophils and total immunoglobulin E. Bronchoalveolar lavage fluid showed a remarkable increase of eosinophils as high as 48.5%, then eosinophilic pneu monia was diagnosed. Although treatment with steroids resulted in an improvement of eosinophilic pneumonia, the treatment was discontinued after 4 days because it worsened her diabetic condition. Since eosinophilic pneumonia recurred a...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research

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Antipsychotic medications are a vital part of controlling psychosis in schizophrenic patients. However, when those patients live in nursing facilities, we are obligated by CMS to undertake gradual dose reductions of antipsychotic medication if possible. Sometimes, these efforts are successful and sometimes they fail. Antipsychotic medications have many side effects, including sedation, diabetes, hyperlipidemia, weight gain, motor rigidity, impaired gait, and falls. Monitoring of blood glucose, lipids, and extrapyramidal symptoms is mandatory.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Pneumonia is the most common cause of hospitalization for nursing home residents. When deciding whether to treat a resident in the nursing home or transfer to a hospital, it is important to consider risks of hospitalization, including significant functional decline. Little is known about the functional status outcomes of nursing home residents hospitalized for pneumonia.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Background Streptococcus pneumonia is a significant cause of morbidity and mortality in adults who are immunocompromised and of advanced age. It is the standard of care to vaccinate all high-risk adults (18-64 years) and adults 65 years and older with 2 pneumococcal vaccines. However, pneumococcal immunization rates remain below the HealthyPeople2020 target goal of 90% nationally and locally.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Management of diabetes in post-acute settings needs special considerations. Hypoglycemia in the skilled nursing and rehabilitation facilities can lead to readmissions and complications including falls. Current EHR care-sets may not make a distinction between hospital and post-acute settings regarding diabetes management. The current diabetes management care-set in the EHR of our large healthcare system includes checking the blood sugar QID/AC/HS (before breakfast, lunch and dinner, and bedtime).
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Pneumonia is one of the most common infections identified in nursing home residents and has the highest mortality rate, yet the diagnosis and appropriate treatment can remain elusive due to its “atypical presentation” and lack of studies of antibiotic treatment.
Source: Caring for the Ages - Category: Health Management Tags: Journal Highlights Source Type: news
Authors: Lee YM, Park SH, Lee DH Abstract OBJECTIVE: The aim of this paper is to propose a new hypothesis for the role of lipophilic chemical mixtures stored in adipose tissue in the development of dementia. Specifically, we present how the dynamics of these chemicals can explain the unexpected findings from the Action for Health in Diabetes (Look AHEAD) study, which failed to show long-term benefits of intentional weight loss on cognition, despite substantial improvements in many known risk factors for dementia. Moreover, we discuss how the role of obesity in the risk of dementia can change depending on the dynami...
Source: The Journal of Alzheimers Association - Category: Psychiatry Tags: Alzheimers Dement Source Type: research
Publication date: Available online 25 February 2020Source: The Lancet Respiratory MedicineAuthor(s): Jaclyn A Smith, Michael M Kitt, Alyn H Morice, Surinder S Birring, Lorcan P McGarvey, Mandel R Sher, Yu-Ping Li, Wen-Chi Wu, Zhi Jin Xu, David R Muccino, Anthony P Ford, Jaclyn Smith, Lorcan McGarvey, Surinder Birring, James Hull, Warner W Carr, Alan B Goldsobel, Gary N Gross, John R Holcomb, Iftikhar Hussain
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research
Conclusion The results obtained from this research shows, in general, the fragility in the social and political infrastructure necessary to improve the living conditions of populations, particularly those that depend on family agriculture in drought prone areas. The conditions of social, economic and environmental vulnerabilities presented in the region can be amplified by the drought process, and can aggravate the impacts resulting drought events, thus disadvantaging the population of this region, as shown in the Fig. 1. The general perception of the interviewees of the health sector shows an agreement with what is found...
Source: PLOS Currents Disasters - Category: International Medicine & Public Health Authors: Source Type: research
Background:Studies report an association between respiratory disease such as asthma, COPD and low serum Vitamin D (VitD) levels.Aim:To assess serum VitD level as an independent risk factor for respiratory health outcomes in the Busselton Healthy Ageing Study.Methods:A cross-sectional questionnaire-based study of 3057 adults,born 1946-1964. Serum 25(OH)-VitD levels were measured by immunoassay on Abbott ARCHITECT platform (120 samples also assayed by LCMS) and were related to respiratory outcomes: asthma, bronchitis, hay fever/allergic rhinitis, pneumonia/pleurisy, OSA, wheeze, dyspnoea, cough/phlegm, chest tightness, repor...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 6.1 Epidemiology Source Type: research
Presidential candidate Hillary Clinton is recovering from a case of pneumonia she was diagnosed with last Friday. She was treated and advised to rest, but according to her doctor became “overheated and dehydrated” Sunday at a 9/11 memorial service.  Footage that showed Clinton needing to be helped to her car as she departed the service for a brief rest at her daughter’s apartment fueled speculation about medical conspiracies and “raised questions” about the state of her health and fitness to run for president. But the truth is that pneumonia is a common and highly treatable illness f...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
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