Journal articles on the topic 'Asthma – Hormone therapy'
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Bossios, Apostolos. "Hormone Replacement Therapy and Asthma." Chest 160, no. 1 (July 2021): 3–4. http://dx.doi.org/10.1016/j.chest.2021.03.020.
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Edwards, Alun L., M. Sarah Rose, Lois E. Donovan, and Gordon T. Ford. "Premenstrual Exacerbation of Life-Threatening Asthma: Effect of Gonadotrophin Releasing Hormone Analogue Therapy." Canadian Respiratory Journal 3, no. 3 (1996): 203–6. http://dx.doi.org/10.1155/1996/691249.
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Variability in the severity of asthma during various phases of the menstrual cycle has been frequently suspected. However, the hormonal changes that might affect mediators of bronchospasm have yet to be elucidated. The case of a 41-year-old woman suffering from longstanding asthma with life-threatening exacerbations is reported. The patient was treated with buserelin, a gonadotropin releasing hormone (GnRH) analogue, which created a temporary chemical menopause and thus permitted diagnosis of a premenstrual exacerbation of asthma and offered insight into potential therapy. GnRH analogues may therefore be of value in assessing women with severe asthma suspected to vary with the menstrual cycle. The addition of estrogens and progestins at the same time as treatment with GnRH analogue may be of value in determining the role of these hormones in the pathogenesis of menstrually related exacerbations of asthma.
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SMITH, JENNIE. "Estrogen-Only Hormone Therapy Linked to Asthma." Family Practice News 40, no. 4 (March 2010): 38. http://dx.doi.org/10.1016/s0300-7073(10)70358-3.
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Bønnelykke, Klaus, Ole Raaschou-Nielsen, Anne Tjønneland, Charlotte Suppli Ulrik, Hans Bisgaard, and Zorana Jovanovic Andersen. "Postmenopausal hormone therapy and asthma-related hospital admission." Journal of Allergy and Clinical Immunology 135, no. 3 (March 2015): 813–16. http://dx.doi.org/10.1016/j.jaci.2014.11.019.
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Hansen, Erik Soeren Halvard, Kristian Aasbjerg, Amalie Lykkemark Moeller, Elisabeth Juul Gade, Christian Torp-Pedersen, and Vibeke Backer. "Hormone Replacement Therapy and Development of New Asthma." Chest 160, no. 1 (July 2021): 45–52. http://dx.doi.org/10.1016/j.chest.2021.01.054.
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Baldaçara, Raquel Prudente de Carvalho, and Ivaldo Silva. "Association between asthma and female sex hormones." Sao Paulo Medical Journal 135, no. 1 (January 5, 2017): 4–14. http://dx.doi.org/10.1590/1516-3180.2016.011827016.
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ABSTRACT CONTEXT AND OBJECTIVE: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions (premenstrual asthma, use of oral contraceptives, menopause, hormone replacement therapy and pregnancy). DESIGN AND SETTING: Narrative review of the medical literature, Universidade Federal do Tocantins (UFT) and Universidade Federal de São Paulo (Unifesp). METHODS: We searched the CAPES journal portal, a Brazilian platform that provides access to articles in the MEDLINE, PubMed, SciELO, and LILACS databases. The following keywords were used based on Medical Subject Headings: asthma, sex hormones, women and use of oral contraceptives. RESULTS: The associations between sex hormones and asthma remain obscure. In adults, asthma is more common in women than in men. In addition, mortality due to asthma is significantly higher among females. The immune system is influenced by sex hormones: either because progesterone stimulates progesterone-induced blocking factor and Th2 cytokines or because contraceptives derived from progesterone and estrogen stimulate the transcription factor GATA-3. CONCLUSIONS: The associations between asthma and female sex hormones remain obscure. We speculate that estrogen fluctuations are responsible for asthma exacerbations that occur in women. Because of the anti-inflammatory action of estrogen, it decreases TNF-α production, interferon-γ expression and NK cell activity. We suggest that further studies that highlight the underlying physiopathological mechanisms contributing towards these interactions should be conducted.
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Romieu, I., A. Fabre, A. Fournier, F. Kauffmann, R. Varraso, S. Mesrine, B. Leynaert, and F. Clavel-Chapelon. "Postmenopausal hormone therapy and asthma onset in the E3N cohort." Thorax 65, no. 4 (February 8, 2010): 292–97. http://dx.doi.org/10.1136/thx.2009.116079.
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Lange, P., J. Parner, E. Prescott, C. Suppli Ulrik, and J. Vestbo. "Exogenous female sex steroid hormones and risk of asthma and asthma-like symptoms: a cross sectional study of the general population." Thorax 56, no. 8 (August 1, 2001): 613–16. http://dx.doi.org/10.1136/thx.56.8.613.
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BACKGROUNDRecent evidence suggests a role for hormonal factors in the aetiology of asthma.METHODSData from a large study of women selected from the general population were used to relate treatment with oral hormonal contraceptives (OCP) and postmenopausal hormone replacement therapy (HRT) to the following asthma indicators: self-reported asthma, wheezing, cough at exertion, and use of medication for asthma. The study sample comprised 1536 premenopausal and 3016 postmenopausal women who participated in the third round of the Copenhagen City Heart Study in 1991–4. A total of 377 women were taking OCP (24.5% of premenopausal women) and 458 were on HRT (15.2% of postmenopausal women).RESULTSIn premenopausal women 4.8% reported having asthma. The prevalence of self-reported asthma, wheeze, use of asthma medication, and cough at exertion was not significantly related to use of OCP. In postmenopausal women the prevalence of self-reported asthma was 6.2%. A weak but consistent association was observed between HRT and self-reported asthma (OR 1.42 (95% CI 0.95 to 2.12)), wheeze (OR 1.29 (95% CI 1.02 to 1.64)), cough at exertion (OR 1.34 (95% CI 1.01 to 1.77)), and use of asthma medication (OR 1.45 (95% CI 0.97 to 2.18)).CONCLUSIONSIn this study of the general population no relationship was found between the use of OCP and asthma. Although an association was observed between HRT and asthma and asthma-like symptoms, this was relatively weak and it is concluded that there is no necessity to change present prescription practice.
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Kuklina, G. M., I. V. Sivokozov, N. N. Makaryants, and E. I. Shmelev. "Successful Use of Bronchial Thermoplastics in a Female Patient with Severe Bronchial Asthma." Doctor.Ru 19, no. 11 (2020): 38–41. http://dx.doi.org/10.31550/1727-2378-2020-19-11-38-41.
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Objective: To describe the use of bronchial thermoplastics (BT) in a female patient with severe hormone-dependent bronchial asthma (BA). Key Points. Because of the history of unsuccessful use of the basic BA therapy and continuous inefficient use of the systemic glucocorticosteroids, the patient underwent a three-session BT. Her condition stabilised on day 5–6 following each BT session: shortness of breath retracted, stridor and sputum discharge disappeared. During a follow-up visit in 6 months, the patient had basic therapy (budesonide with formoterol (Symbicort) 160/4.5μg, 2 doses bid, methylprednisolone 4mg, once daily); she had no complains. The patient had vesicular respiration without stridor; forced expiratoty volume1 was 95%, lung capacity was 113%. Conclusion. Three BT sessions allowed minimising glucocorticosteroids dose, adjusting basic therapy and achieving long-term BA remission. Keywords: bronchial asthma, bronchial thermoplastics, glucocorticosteroids.
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АKULOVА, E. А., O. V. STEPАNOVА, O. V. LOVАCHEVА, А. А. SEYLIEV, K. G. SHАPOVАLOV, and O. А. ROZENBERG. "CHANGES IN HEMODYNAMICS DURING THE COURSE OF SURFACTANT THERAPY IN PATIENTS WITH HORMONE-DEPENDENT ASTHMA." TUBERCULOSIS AND LUNG DISEASES 97, no. 4 (2019): 25–29. http://dx.doi.org/10.21292/2075-1230-2019-97-4-25-29.
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Gomez Real, F. "Hormone replacement therapy, body mass index and asthma in perimenopausal women: a cross sectional survey." Thorax 61, no. 1 (October 21, 2005): 34–40. http://dx.doi.org/10.1136/thx.2005.040881.
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Nau, Felix, Justin Miller, Jordy Saravia, Terry Ahlert, Bangning Yu, Kyle I. Happel, Stephania A. Cormier, and Charles D. Nichols. "Serotonin 5-HT2receptor activation prevents allergic asthma in a mouse model." American Journal of Physiology-Lung Cellular and Molecular Physiology 308, no. 2 (January 15, 2015): L191—L198. http://dx.doi.org/10.1152/ajplung.00138.2013.
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Asthma is an inflammatory disease of the lung characterized by airways hyper-responsiveness (AHR), inflammation, and mucus hyperproduction. Current mainstream therapies include bronchodilators that relieve bronchoconstriction and inhaled glucocorticoids to reduce inflammation. The small molecule hormone and neurotransmitter serotonin has long been known to be involved in inflammatory processes; however, its precise role in asthma is unknown. We have previously established that activation of serotonin 5-hydroxytryptamine (5-HT)2Areceptors has potent anti-inflammatory activity in primary cultures of vascular tissues and in the whole animal in vasculature and gut tissues. The 5-HT2Areceptor agonist, ( R)-2,5-dimethoxy-4-iodoamphetamine [( R)-DOI] is especially potent. In this work, we have examined the effect of ( R)-DOI in an established mouse model of allergic asthma. In the ovalbumin mouse model of allergic inflammation, we demonstrate that inhalation of ( R)-DOI prevents the development of many key features of allergic asthma, including AHR, mucus hyperproduction, airways inflammation, and pulmonary eosinophil recruitment. Our results highlight a likely role of the 5-HT2receptors in allergic airways disease and suggest that 5-HT2receptor agonists may represent an effective and novel small molecule-based therapy for asthma.
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Juul Gade, Elisabeth, Simon Francis Thomsen, Svend Lindenberg, and Vibeke Backer. "Female Asthma Has a Negative Effect on Fertility: What Is the Connection?" ISRN Allergy 2014 (March 27, 2014): 1–6. http://dx.doi.org/10.1155/2014/131092.
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Reproductive changes such as impaired fertility and adverse pregnancy outcomes have been related to female asthma. We recently found that time to pregnancy is prolonged in asthmatic females especially in women with moderate to severe asthma and in those above 30 years of age. Despite their reproductive difficulties the asthmatics ultimately conceived just as many biological children as healthy throughout their reproductive lives. This knowledge therefore raises questions about how asthma affects fertility pathophysiologically. The purpose of this review is to describe the existing knowledge in this field and suggest hypotheses of causal relationships, which may form the basis for future studies in this field. The aim is, in particular, in the literature to examine whether there is any evidence to suggest that the systemic inflammation that characterizes asthma, can affect fertility. The issue is potentially clinically important for asthmatic, infertile individuals and society because treatment of the general systemic inflammation associated with the asthmatic disease combined with hormone stimulation might be the optimal target for an effective infertility therapy, possibly decreasing the need for in vitro fertilization.
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Willsie, S. K. "Hormone replacement therapy, body mass index and asthma in perimen-opausal women: a cross sectional survey." Yearbook of Pulmonary Disease 2007 (January 2007): 46–47. http://dx.doi.org/10.1016/s8756-3452(08)70299-8.
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Zhang, Guo-Qiang, Jin-Liang Chen, Ying Luo, Maya B. Mathur, Panagiotis Anagnostis, Ulugbek Nurmatov, Madar Talibov, et al. "Menopausal hormone therapy and women’s health: An umbrella review." PLOS Medicine 18, no. 8 (August 2, 2021): e1003731. http://dx.doi.org/10.1371/journal.pmed.1003731.
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Background There remains uncertainty about the impact of menopausal hormone therapy (MHT) on women’s health. A systematic, comprehensive assessment of the effects on multiple outcomes is lacking. We conducted an umbrella review to comprehensively summarize evidence on the benefits and harms of MHT across diverse health outcomes. Methods and findings We searched MEDLINE, EMBASE, and 10 other databases from inception to November 26, 2017, updated on December 17, 2020, to identify systematic reviews or meta-analyses of randomized controlled trials (RCTs) and observational studies investigating effects of MHT, including estrogen-alone therapy (ET) and estrogen plus progestin therapy (EPT), in perimenopausal or postmenopausal women in all countries and settings. All health outcomes in previous systematic reviews were included, including menopausal symptoms, surrogate endpoints, biomarkers, various morbidity outcomes, and mortality. Two investigators independently extracted data and assessed methodological quality of systematic reviews using the updated 16-item AMSTAR 2 instrument. Random-effects robust variance estimation was used to combine effect estimates, and 95% prediction intervals (PIs) were calculated whenever possible. We used the term MHT to encompass ET and EPT, and results are presented for MHT for each outcome, unless otherwise indicated. Sixty systematic reviews were included, involving 102 meta-analyses of RCTs and 38 of observational studies, with 102 unique outcomes. The overall quality of included systematic reviews was moderate to poor. In meta-analyses of RCTs, MHT was beneficial for vasomotor symptoms (frequency: 9 trials, 1,104 women, risk ratio [RR] 0.43, 95% CI 0.33 to 0.57, p < 0.001; severity: 7 trials, 503 women, RR 0.29, 95% CI 0.17 to 0.50, p = 0.002) and all fracture (30 trials, 43,188 women, RR 0.72, 95% CI 0.62 to 0.84, p = 0.002, 95% PI 0.58 to 0.87), as well as vaginal atrophy (intravaginal ET), sexual function, vertebral and nonvertebral fracture, diabetes mellitus, cardiovascular mortality (ET), and colorectal cancer (EPT), but harmful for stroke (17 trials, 37,272 women, RR 1.17, 95% CI 1.05 to 1.29, p = 0.027) and venous thromboembolism (23 trials, 42,292 women, RR 1.60, 95% CI 0.99 to 2.58, p = 0.052, 95% PI 1.03 to 2.99), as well as cardiovascular disease incidence and recurrence, cerebrovascular disease, nonfatal stroke, deep vein thrombosis, gallbladder disease requiring surgery, and lung cancer mortality (EPT). In meta-analyses of observational studies, MHT was associated with decreased risks of cataract, glioma, and esophageal, gastric, and colorectal cancer, but increased risks of pulmonary embolism, cholelithiasis, asthma, meningioma, and thyroid, breast, and ovarian cancer. ET and EPT had opposite effects for endometrial cancer, endometrial hyperplasia, and Alzheimer disease. The major limitations include the inability to address the varying effects of MHT by type, dose, formulation, duration of use, route of administration, and age of initiation and to take into account the quality of individual studies included in the systematic reviews. The study protocol is publicly available on PROSPERO (CRD42017083412). Conclusions MHT has a complex balance of benefits and harms on multiple health outcomes. Some effects differ qualitatively between ET and EPT. The quality of available evidence is only moderate to poor.
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Kurth, T., R. G. Barr, J. M. Gaziano, and J. E. Buring. "Randomised aspirin assignment and risk of adult-onset asthma in the Women’s Health Study." Thorax 63, no. 6 (March 13, 2008): 514–18. http://dx.doi.org/10.1136/thx.2007.091447.
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Background:Randomised data in men show a small but significant reduction in the risk of adult-onset asthma among those given aspirin. The results from an observational study in women suggest that frequent use of aspirin decreases the risk of adult-onset asthma, but randomised data in women are lacking. A study was undertaken to test the effect of 100 mg aspirin or placebo on alternate days on the risk of adult-onset asthma in the Women’s Health Study.Methods:A randomised, double-blind, placebo-controlled clinical trial of aspirin and vitamin E was performed in apparently healthy women with no indication or contraindication to aspirin therapy and no history of asthma at study entry. Female health professionals self-reported an asthma diagnosis on yearly questionnaires.Results:Among 37 270 women with no reported history of asthma prior to randomisation and during 10 years of follow-up, there were 872 new cases diagnosed with asthma in the aspirin group and 963 in the placebo group (hazard ratio 0.90; 95% CI 0.82 to 0.99; p = 0.027). This apparent 10% lower relative risk of incident adult-onset asthma among those assigned to aspirin was significantly modified by body mass index, with no effect in women with a body mass index of ⩾30 kg/m2. The effect of aspirin on adult-onset asthma was not significantly modified by age, smoking status, exercise levels, postmenopausal hormone use or randomised vitamin E assignment.Conclusions:In this large randomised clinical trial of apparently healthy adult women, administration of 100 mg aspirin on alternate days reduced the relative risk of a newly reported diagnosis of asthma.Trial registration number:NCT00000479
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Kalashnikova, A. A., N. V. Bychkova, N. I. Davydova, M. V. Zhdanova, M. K. Evloeva, and G. A. Novik. "IDENTIFICATION OF ANTIGEN-SPECIFIC HORMONE-RESISTANT BLOOD LYMPHOCYTES TO PREDICT EFFICIENCY OF GLUCOCORTICOID THERAPY IN BRONCHIAL ASTHMA." Medical Immunology (Russia) 13, no. 2-3 (July 22, 2014): 155. http://dx.doi.org/10.15789/1563-0625-2011-2-3-155-166.
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Dratva, J. "Use of oestrogen only hormone replacement therapy associated with increased risk of asthma onset in postmenopausal women." Evidence-Based Medicine 15, no. 6 (September 22, 2010): 190–91. http://dx.doi.org/10.1136/ebm1135.
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Mallamma T, Prakash Goudanavar, Nagaraja Sreeharsha, and Santosh Fattepur. "Chrono Modulated Therapy-A Review." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (December 21, 2020): 2884–90. http://dx.doi.org/10.26452/ijrps.v11ispl4.4575.
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Chrono therapeutic drug delivery systems stay attaining prominence in the area of pharmaceuticals. It decreases dosing incidence, toxicity, and distributes a drug that matches the circadian rhythm of that definite disease when the signs are exciting to sorrier.ChrDDS is the essentially time-controlled drug delivery system. It offers a patient with a staggered profile of the therapeutic agent. It makes some consecutive changes in the ADME process. This mechanism is lag time independent of environmental variables including pH, enzymes, gastrointestinal motility. The circadian rhythm regulates many body functions in humans, such as metabolism, behaviour, sleep patterns, and hormone production. Chronotherapy has gained attention as a novel and rational approach to exploit the best. Presently, drugs are delivered in a controlled release like an IR, ER, & PR. Certain conditions that follow circadian rhythms include hypertension, diabetes, cardiovascular, asthma, neurological disorders, ulcer conditions, etc. Various technologies such as time-controlled, pulsed, triggered and programmed drug delivery devices have been developed and extensively studied in recent years for chronopharmaceutical drug delivery are Diffucaps, OROS, Codas, 3D printing, Egalet, Port, etc. this system is designed according to body-clock. Special drug delivery technology must be relied upon to synchronize drug concentrations to rhythms in disease activity with the body’s 24-hour rhythms to extend therapeutic effectiveness and reduce/avoid side effects. In this article, the various concepts like a mechanism of circadian rhythms, current obstacles to the production of chronopharmaceutical drug, circadian chronotherapy in various diseases, a profile of launched Chronopharmaceutical dosage forms, various technologies for systemic delivery,chronopathalogy have been reviewed.
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Orbelo, Diana, Dale C. Ekbom, and Dana M. Thompson. "Dysphonia Associated with Lingual Thyroid Gland and Hypothyroidism: Improvement after Lingual Thyroidectomy." Annals of Otology, Rhinology & Laryngology 120, no. 12 (December 2011): 775–79. http://dx.doi.org/10.1177/000348941112001202.
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We present a unique and medically complex case of improved voice after lingual thyroidectomy. A 10-year-old boy with multifactorial dysphonia presented with bilateral vocal fold lesions and sulci in the context of hypothyroidism as a result of a congenital lingual thyroid gland. Despite hormone replacement, medical treatment for asthma, allergy, cough, and possible reflux, as well as voice therapy, the dysphonia persisted. Significant improvement in both subjective and objective voice measures was achieved after surgical removal of the lingual thyroid gland, which allowed for maintenance of a consistent euthyroid state. Lingual thyroidectomy is typically reserved for cases of bleeding and dysphagia. This case supports dysphonia as a possible additional indication for lingual thyroidectomy.
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Zhukova, Olga V. "Methodology for determining the correlation of the clinical efficacy of therapy with the addition of a drug (for example, anti-asthma therapy in children)." Research Results in Pharmacology 5, no. 1 (March 28, 2019): 97–101. http://dx.doi.org/10.3897/rrpharmacology.5.33633.
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Introduction: In the recent years, much attention has been paid to the use of leukotriene receptor antagonists (LTRA) in the treatment of bronchial asthma (BA). It has been even proposed to use them as alternatives to hormone therapy. Yet, there are studies demonstrating the advantage of montelukast as similar to placebo. The objective was to create a methodology for determining the correlation of the clinical efficacy of therapy with the addition of a drug (on example, clinical efficacy of montelukast in an anti-asthmatic therapy in pediatric patients).Materials and methods: The data on prescribed regimens was retrospectively extracted from the inpatient records of 608 BA patients admitted to hospital in 2014–2015. Mathematical evaluation was based on the risk factor concept.Results and discussion: The absolute efficacies (AEs) was estimated to be 91.85% (95% CI 90.15–93.55%) in the exposed group; the attributable efficacy (AtE) was found to be 17.00% (95% CI 10.91–23.09%); the relative efficacy (RE) was found to be 1.23 (95% CI 0.21–2.24); and the population attributable efficacy (PAtE) was found to be 7.55% (95% CI 2.49–12.61%).Conclusions: The AtE, RE, and PAtE were statistically significant. The RE was found to be 1.23. However, the lower limit of its 95% CI (0.21–2.24) was less than 1, indicating that the increase in clinical efficacy was not found to be statistically significant. In the studied sample positive outcome rates were 91.85% (95% CI 90.15–93.55%) in the exposed group and 74.85% (95% CI 72.49–77.21%) in the comparator group. He presented methodology for determining the correlation of the clinical efficacy of the pharmacotherapy regimen with the addition of a drug can be successfully applied in the future.
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Elliott, L., S. J. Arbes, and D. C. Zeldin. "Hormone replacement therapy and asthma incidence in menopausal women from the third national health and nutrition examination survey (NHANES III, 1988-1994)." Journal of Allergy and Clinical Immunology 115, no. 2 (February 2005): S170. http://dx.doi.org/10.1016/j.jaci.2004.12.692.
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Assaggaf, Hamza, and Quentin Felty. "Gender, Estrogen, and Obliterative Lesions in the Lung." International Journal of Endocrinology 2017 (2017): 1–13. http://dx.doi.org/10.1155/2017/8475701.
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Gender has been shown to impact the prevalence of several lung diseases such as cancer, asthma, chronic obstructive pulmonary disease, and pulmonary arterial hypertension (PAH). Controversy over the protective effects of estrogen on the cardiopulmonary system should be of no surprise as clinical trials of hormone replacement therapy have failed to show benefits observed in experimental models. Potential confounders to explain these inconsistent estrogenic effects include the dose, cellular context, and systemic versus local tissue levels of estrogen. Idiopathic PAH is disproportionately found to be up to 4 times more common in females than in males; however, estrogen levels cannot explain why males develop PAH sooner and have poorer survival. Since the sex steroid hormone 17β-estradiol is a mitogen, obliterative processes in the lung such as cell proliferation and migration may impact the growth of pulmonary tissue or vascular cells. We have reviewed evidence for biological differences of sex-specific lung obliterative lesions and highlighted cell context-specific effects of estrogen in the formation of vessel lumen-obliterating lesions. Based on this information, we provide a biological-based mechanism to explain the sex difference in PAH severity as well as propose a mechanism for the formation of obliterative vascular lesions by estrogens.
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WILSON, Andrew M., Erika J. SIMS, Allan D. STRUTHERS, and Brian J. LIPWORTH. "Inhaled corticosteroid therapy reduces the early morning peak in cortisol and aldosterone." Clinical Science 95, no. 4 (October 1, 1998): 513–17. http://dx.doi.org/10.1042/cs0950513.
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1.As mineralocorticoid and adrenocorticoid activity are both under the diurnal control of adrenocorticotropic hormone secretion, we aimed to evaluate whether the normal circadian rhythm of cortisol and aldosterone secretion was suppressed by inhaled corticosteroid therapy. 2.Ten normotensive patients with mild–moderate asthma, mean age 24.0 (S.D. 9.8) years and mean arterial pressure 90.7 (9.8) mmHg, were studied in a double-blind, randomized crossover design comparing placebo with fluticasone propionate, 1000 ;μg administered twice daily at 08:00 ;h and 20:00 ;h. After 5 days of repeated dosing at steady state, measurements were made of plasma cortisol and aldosterone at midnight and 08:00 ;h. 3.With placebo there was a significant (P< 0.05) difference between cortisol values at 08:00 ;h (588.6±83.8 ;nmol/l) and midnight (109.6±35.0 ;nmol/l), whereas after treatment with fluticasone propionate there was no significant difference between levels at 08:00 ;h (143.3±57.4 ;nmol/l) and midnight (64.3±22.3 ;nmol/l). For cortisol at 08:00 ;h there was also a significant (P< 0.05) difference between placebo and fluticasone propionate. The same pattern was observed for aldosterone. Plasma aldosterone levels at 08:00 ;h after treatment with placebo (129.6±30.9 ;nmol/l) were significantly different (P< 0.05) to those seen at midnight (40.4±6.2 ;nmol/l). After treatment with fluticasone propionate, there was no significant difference between levels at midnight (55.4±11.7 ;nmol/l) and 08:00 ;h (64.8±12.7 ;nmol/l). 4.These results show that inhaled corticosteroid therapy abolishes the circadian rhythm of aldosterone and cortisol secretion. This may have possible implications for patients taking inhaled corticosteroids in terms of the beneficial cardiac effects of suppressing early morning aldosterone.
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Bhumbra, Nasreen A., Eric G. Sahloff, Sandra J. Oehrtman, and James M. Horner. "Exogenous Cushing Syndrome with Inhaled Fluticasone in a Child Receiving Lopinavir/Ritonavir." Annals of Pharmacotherapy 41, no. 7-8 (July 2007): 1306–9. http://dx.doi.org/10.1345/aph.1k075.
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Objective: To describe a case of Cushing syndrome in a child during concurrent use of inhaled fluticasone propionate, nasal mometasone, and a highly active antiretroviral regimen including lopinavir/ritonavir. Case Summary: A 9-year-old boy with HIV infection and asthma developed moon fades, increased facial hair, and increased weight after fluticasone propionate inhalation (1 puff; 220 μg) therapy was begun. His antiretroviraI regimen contained the protease inhibitor combination lopinavir/ritonavir at a dose of 216/54 mg twice daily, and he had been stable for the previous 5 years. He had also been receiving intranasal mometasone for 11 months for the management of allergic rhinitis. Serum Cortisol and adrenocorticotropic hormone levels were consistent with adrenal suppression, These physical findings and symptoms and laboratory values normalized after discontinuation of the fluticasone propionate. The Naranjo probability scale indicated that a probable interaction occurred between lopinavir/ritonavir and fluticasone propionate, loading to subsequent adrenal suppression. Discussion: Protease inhibitors are associated with numerous drug interactions due to inhibition of the CYP3A4 isoenzyme. Pharmaceutical agents used to treat comorbidities in HIV-infected individuals often can interact with protease inhibitors, leading to toxic drug concentrations or untoward effects. Inhaled corticosteroids such as fluticasone propionate are often necessary to treat asthma in young children and are metabolized by CYP3A4. Interactions between protease inhibitors and inhaled fluticasone propionate have been reported in the adult population, but reports are limited in the pediatric literature. Conclusions: This case raises awareness of the interaction between fluticasone propionate and lopinavir/ritonavir and adverse effects in children receiving both medications.
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Panjawatanan, Panadeekarn, Vijaykumar Sekar, and Joseph Hughes. "A Case of Parathyroid Adenoma Three Decades Post Radioactive Iodine Therapy: Is It Just a Coincidence or Real Risk?" Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A908. http://dx.doi.org/10.1210/jendso/bvab048.1854.
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Abstract Background: External radiation to the head and neck is a known risk factor for the development of parathyroid adenoma. But the incidence is very rare in internal radiation recipients. Here we describe a case of parathyroid adenoma after 30 years of radioactive iodine therapy for Graves’ disease. Clinical Case: A 50-year-old female presented during an annual visit with progressive fatigue, polyuria, polydipsia, nocturia, muscle weakness, and some memory impairment. She had a past medical history of Graves’ disease treated with radioactive iodine therapy 30 years ago with subsequent hypothyroidism, controlled essential hypertension, asthma, and obesity BMI 32.5 kg/m2. There was no history of nephrolithiasis, fractures, pituitary tumor, or acid reflux. Family history was noted for thyroid diseases, no calcium issues or hyperparathyroidism. Neck examination did not reveal any thyromegaly or palpable nodule. Laboratory tests showed calcium 11.4 mg/dL (8.6-10.3), ionized calcium 6.1 mg/dL (4.2-5.4), parathyroid hormone 213.9 pg/mL (12-88), total vitamin D 22 ng/mL (31-100), TSH 0.47 uIU/mL (0.34-3.00), Free T4 1.1 ng/dL (0.6-1.6), creatinine 0.7 mg/dL (0.6-1.2), eGFR >60 ml/min/1.73 m2, 24-hr urine calcium 405 mg (40-350). Bone density revealed T-score -4.9 at the lumbar spine, -2.8 at the total hip, -3.1 at the femoral neck, and -2.9 at distal 1/3 radius. Neck ultrasound showed atrophy of the thyroid gland with a lobulated hypoechoic area measuring up to 1.3 x 0.9 x 0.9 cm without internal blood flow at posterior inferior to the right lobe of the thyroid gland. Parathyroid SPECT/CT scan revealed no evidence of parathyroid adenoma. The hypoechoic lesion was suspected to be a lymph node according to imaging studies. However, according to laboratory and bone density results, we suspected primary hyperparathyroidism in which the patient required surgery due to current symptoms. The patient underwent surgery with an intraoperative finding of a nodule at the superior of the right parathyroid gland. A frozen section of the nodule was sent which confirmed parathyroid adenoma. The gland, weighted 483 mg, was removed with subsequent improvement of intraoperative parathyroid hormone level from 238.5 pg/mL to 26.5 pg/mL. Follow up calcium was at 9.5 mg/dL. The patient was supplemented with calcium and vitamin D afterward. Her symptoms improved significantly. Conclusion: Hypercalcemia in a patient with prior history of radioactive iodine therapy should raise concern for parathyroid adenoma. Imaging of the parathyroid gland should be cautiously interpreted with laboratory tests as it could be a false negative. Due to patient met criteria for surgery, the surgical approach should be pursued for both diagnostic confirmation and definite treatment. Intraoperative parathyroid hormone monitoring is beneficial in equivocal imaging and in reflecting successful resection of uniglandular disease.
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Soden, J., A. Stevens, and DW Ray. "Genetic engineering of the glucocorticoid receptor by fusion with the herpes viral protein VP22 causes selective loss of transactivation." Journal of Endocrinology 172, no. 3 (March 1, 2002): 615–25. http://dx.doi.org/10.1677/joe.0.1720615.
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The development of methods for engineering proteins with novel properties opens the way to manipulating intracellular processes in a therapeutically useful way. Glucocorticoids, acting via glucocorticoid receptors (GR), are potent anti-inflammatory agents, acting to oppose nuclear factor kappa B (NF kappa B) function. The herpes viral protein, VP22, has been reported to confer intercellular trafficking activity on 'cargo' proteins, potentially facilitating gene therapy with intracellular proteins. VP22GR, resulting from the addition of VP22 to the N terminal of GR, was equipotent with the wild-type GR in opposing NF kappa B p65-driven expression of an NF kappa B reporter gene. Surprisingly, VP22GR was incapable of inducing transactivation of positive glucocorticoid reporter genes (MMTV-luc and TAT3-luc). Furthermore, the VP22GR had powerful dominant negative activity on both endogenous and exogenous GR transactivation. VP22GR was cytoplasmic in quiescent cells, and after hormone addition underwent nuclear translocation to share the same distribution as the GR. The ability of the VP22GR to selectively confer and enhance glucocorticoid-dependent transrepression of NF kappa B may be of use therapeutically in e.g. transplant rejection, inflammatory arthritis or asthma.
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Tong, Tammy Y. N., Paul N. Appleby, Kathryn E. Bradbury, and Timothy J. Key. "Cross-sectional analyses of participation in cancer screening and use of hormone replacement therapy and medications in meat eaters and vegetarians: the EPIC-Oxford study." BMJ Open 7, no. 12 (December 2017): e018245. http://dx.doi.org/10.1136/bmjopen-2017-018245.
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ObjectivesTo examine differences in health-related behaviours such as screening or testing for cancer, use of hormone replacement therapy (HRT) and use of other medications in different diet groups.DesignWe studied 31 260 participants across four diet groups (18 155 meat eaters, 5012 fish eaters, 7179 vegetarians, 914 vegans) in the UK EPIC-Oxford cohort. Information was collected in 5-year (around 2000–2003) or 10-year (around 2007) follow-up questionnaires regarding participation in breast screening, cervical screening, prostate-specific antigen (PSA) testing, use of HRT and use of medications for the past 4 weeks. Using Poisson regression, we estimated the prevalence ratios (PR) for each behaviour across people of different diet groups, using meat eaters as the reference group.ResultsCompared with meat eaters, vegetarian (PR: 0.94, 95% CI 0.89 to 0.98) and vegan (PR: 0.82, 95% CI 0.71 to 0.95) women reported lower participation in breast screening, and vegetarian men were less likely to report PSA testing (PR: 0.82, 95% CI 0.71 to 0.96). No differences were observed among women for cervical screening. In women, all non-meat-eating groups reported lower use of HRT compared with meat eaters (P heterogeneity <0.0001). Lower reported use of any medication was observed for participants in all non-meat-eating groups with no (P<0.0001) or one (P=0.0002) self-reported illness. No heterogeneity was observed across the diet groups for the reported use of specific medication for high blood pressure, high blood cholesterol, asthma, diabetes and thyroid disease.ConclusionsDifferences in self-reported breast screening, PSA testing, HRT use and overall medication use were observed across the diet groups. Whether such differences contribute to differential long-term disease risks requires further study.
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Royce, Simon G., Amelia Sedjahtera, Chrishan S. Samuel, and Mimi L. K. Tang. "Combination therapy with relaxin and methylprednisolone augments the effects of either treatment alone in inhibiting subepithelial fibrosis in an experimental model of allergic airways disease." Clinical Science 124, no. 1 (September 7, 2012): 41–51. http://dx.doi.org/10.1042/cs20120024.
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Although CSs (corticosteroids) demonstrate potent effects in the control of airway inflammation in asthma, many patients continue to experience symptoms and AHR (airway hyper-responsiveness) despite optimal treatment with these agents, probably due to progressive airway remodelling. Identifying novel therapies that can target airway remodelling and/or airway reactivity may improve symptom control in these patients. We have demonstrated previously that the anti-fibrotic hormone RLN (relaxin) can reverse airway remodelling (epithelial thickening and subepithelial fibrosis) and AHR in a murine model of AAD (allergic airways disease). In the present study, we compared the effects of RLN with a CS (methylprednisolone) on airway remodelling and AHR when administered independently or in combination in the mouse AAD model. Female mice at 6–8 weeks of age were sensitized and challenged to OVA (ovalbumin) over a 9-week period and treated with methylprednisolone, RLN, a combination of both treatments or vehicle controls. Methylprednisolone was administered intraperitoneally on the same day as nebulization for 6 weeks, whereas recombinant human RLN-2 was administered via subcutaneously implanted osmotic mini-pumps from weeks 9–11. RLN or methylprednisolone alone were both able to significantly decrease subepithelial thickness and total lung collagen deposition; whereas RLN but not methylprednisolone significantly decreased epithelial thickness and AHR. Additionally, combination therapy with CS and RLN more effectively reduced subepithelial collagen thickness than either therapy alone. These findings demonstrate that RLN can modulate a broader range of airway remodelling changes and AHR than methylprednisolone and the combination of both treatments offers enhanced control of subepithelial fibrosis.
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Ito, Kazuhiro, Steve Getting, and Catherine Charron. "Mode of Glucocorticoid Actions in Airway Disease." Scientific World JOURNAL 6 (2006): 1750–69. http://dx.doi.org/10.1100/tsw.2006.274.
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Synthetic glucocorticoids are the most potent anti-inflammatory agents used to treat chronic inflammatory disease, such as asthma. However, a small number (<5%) of asthmatic patients and almost all patients with chronic obstructive pulmonary disease (COPD) do not respond well, or at all, to glucocorticoid therapy. If the molecular mechanism of glucocorticoid insensitivity is uncovered, it may in turn provide insight into the key mechanism of glucocorticoid action and allow a rational way to implement treatment regimens that restore glucocorticoid sensitivity. Glucocorticoids exert their effects by binding to a cytoplasmic glucocorticoid receptor (GR), which is subjected to post-translational modifications. Receptor phosphorylation, acetylation, nitrosylation, ubiquitinylation, and other modifications influence hormone binding, nuclear translocation, and protein half-life. Analysis of GR interactions to other molecules, such as coactivators or corepressors, may explain the genetic specificity of GR action. Priming with inflammatory cytokine or oxidative/nitrative stress is a mechanism for the glucocorticoid resistance observed in chronic inflammatory airway disease via reduction of corepressors or GR modification. Therapies targeting these aspects of the GR activation pathway may reverse glucocorticoid resistance in patients with glucocorticoid-insensitive airway disease and some patients with other inflammatory diseases, such as rheumatoid arthritis and inflammatory bowel disease.
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de Oliveira, Ana Paula Ligeiro, Helori Vanni Domingos, Gabriela Cavriani, Amilcar Sabino Damazo, Adriana Lino dos Santos Franco, Sonia Maria Oliani, Ricardo Martins Oliveira-Filho, Bernardo Boris Vargaftig, and Wothan Tavares de Lima. "Cellular recruitment and cytokine generation in a rat model of allergic lung inflammation are differentially modulated by progesterone and estradiol." American Journal of Physiology-Cell Physiology 293, no. 3 (September 2007): C1120—C1128. http://dx.doi.org/10.1152/ajpcell.00286.2006.
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We evaluated the role of estradiol and progesterone in allergic lung inflammation. Rats were ovariectomized (Ovx) and, 7 days later, were sensitized with ovalbumin (OA) and challenged after 2 wk with inhaled OA; experiments were performed 1 day thereafter. Ovx-allergic rats showed reduced cell recruitment into the bronchoalveolar lavage (BAL) fluid relative to sham-Ovx allergic rats, as was observed in intact allergic rats treated with ICI-182,780. Estradiol increased the number of cells in the BAL of Ovx-allergic rats, whereas progesterone induced an additional reduction. Cells of BAL and bone marrow (BM) of Ovx-allergic rats released elevated amounts of IL-10 and reduced IL-1β and TNF-α. BM cells of Ovx-allergic rats released increased amounts of IL-10 and lower amounts of IL-4. Estradiol treatment of Ovx-allergic rats decreased the release of IL-10 but increased that of IL-4 by BM cells. Estradiol also caused an increased release of IL-1β and TNF-α by BAL cells. Progesterone significantly increased the release of IL-10, IL-1β, and TNF-α by BAL cells and augmented that of IL-4 by BM cells. Degranulation of bronchial mast cells from Ovx rats was reduced after in vitro challenge, an effect reverted by estradiol but not by progesterone. We suggest that the serum estradiol-to-progesterone ratio might drive cellular recruitment, modulating the pulmonary allergy and profile of release of anti-inflammatory or inflammatory cytokines. The existence of such dual hormonal effects suggests that the hormone therapy of asthmatic postmenopausal women and of those suffering of premenstrual asthma should take into account the possibility of worsening the pulmonary conditions.
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Grbovic, Leposava, and Miroslav Radenkovic. "Therapeutic use of glucocorticoids and immunosuppressive agents." Srpski arhiv za celokupno lekarstvo 133, Suppl. 1 (2005): 67–73. http://dx.doi.org/10.2298/sarh05s1067g.
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Pharmacotherapy of autoimmune thyroid disease (AITD) is complex. Apart from the replacement hormone therapy, antithyroid agents, beta adrenoceptor blockers and other drugs, in regard to the present symptoms, it also includes the administration of glucocorticoids and immunosuppressive agents. Physiological actions of glucocorticoids are significant in number, well known and described in details. The most prominent pharmacological properties of glucocorticoids, that are important for their clinical use, are antiinflammatory and immunosuppressive actions. In this article, the most notable clinical pharmacology aspects of glucocorticoids have been presented, including the basic principles of their therapeutic use, as well as the most important indications with the examples of dosing regiments (rheumatic disorders, renal diseases, allergic reactions, bronchial asthma, gastrointestinal inflammatory diseases, thrombocytopenia, organ transplantation, and Graves? ophthalmopathy). In addition, adverse and toxic effects of glucocorticoids as well as their interactions with other drugs have been described. Immunosuppressive agents have important role in treatment of immune disorders, including the reduction of immune response in autoimmune diseases and organ transplantation. Apart from glucocorticoids, immunosuppressive agents consist of calcineurin inhibitors (cyclosporine, tacrolimus), antiproliferative and antimetabolic agents (sirolimus, azathioprine, mycophenolate mofetil, methotrexate, cyclophosphamide), monoclonal antibodies: anti-CD3 antibody (muromonab-CD3), anti- CD25 antibody (daclizumab), anti-TNF-alpha antibody (infliximab). In this part, the most updated facts about mechanism of action, rational therapeutic use, as well as adverse and toxic effects of immunosuppressive agents have been reviewed.
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Damayanti, Triya, and Sri Pudyastuti. "Asthma in Pregnancy: Mechanism and Clinical Implication." Jurnal Respirologi Indonesia 40, no. 4 (October 23, 2020): 251–61. http://dx.doi.org/10.36497/jri.v40i4.125.
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Asthma in pregnancy can influence clinical status of an asthma patient. Study showed that one third of asthma patients were worsening, one third stable and one third improving. During pregnancy, lung function, ventilation pattern and gas diffusion are influenced by biochemistry (hormonal) and mechanic. Mechanism in pregnancy with asthma including hypoxia, inflammation, corticosteroids therapy, history of exacerbation, smoking mother and changes in placenta function. Hormonal status during pregnancy is different with non-pregnancy woman which hormonal level changes through the pregnancy time. Those changes can influence lung function in pregnancy. Treatment of asthma in pregnancy is giving optimal asthma therapy, therefore it can improve asthma control, also the quality of life of a mother and her fetus during pregnancy.
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Arshad Rabbani, Benish Adil, and Ramsha Ghazal Arshad. "ASSOCIATION OF GASTROESOPHAGEAL REFLUX SYMPTOMS (FREQUENCY AND SEVERITY) WITH BODY MASS INDEX IN FEMALES WITH GASTROESOPHAGEAL REFLUX DISEASE." Journal of University Medical & Dental College 11, no. 3 (October 1, 2020): 9–16. http://dx.doi.org/10.37723/jumdc.v11i3.428.
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ABSTRACT
BACKGROUND & OBJECTIVE: Overweight individuals have a greater tendency to develop gastroesophageal reflux disease (GERD). This study aims at comparing gastroesophageal reflux symptoms (frequency and severity) in females with different body mass index (BMI) categories.
METHODOLOGY: This cross-sectional comparative research study was conducted over duration of 8 months. Both indoor and outdoor patients of medical unit – II Benazir Bhutto Hospital, Rawalpindi, fulfilling the inclusion criteria i.e. females 30-55 years of age with confirmed diagnosis of GERD and informed consent were included. Subjects with history of cigarette smoking, diabetes, use of postmenopausal hormone replacement therapy (HRT), anti-hypertensive or asthma medication were all excluded. Data were collected via proforma and analyzed on SPSS version 17.
RESULTS: Among 360 enrolled women, 08 (2.2%) subjects were underweight, 109 (30.3%) had normal BMI, 151 (41.9%) were overweight, 88 (24.4%) subjects were obese and 04 (1.1%) belonged to morbidly obese group. Among 109 subjects with normal BMI, 53 (48.6%) had mild, 40 (36.69%) moderate, 13 (11.9%) severe and 03 (2.75%) very severe GERD. Among 151 overweight subjects, 37 (24.50%) were with mild severity, 64 (42.38%) with moderate, 35 (23.17%) severe and 15 (9.93%) had very severe GERD. Among 04 morbidly obese subjects, 02 (50%) had severe while remaining 02 (50%) had very severe GERD (p=0.000).
CONCLUSION: Association of GERD symptoms and BMI were found in both normal and overweight women. Reflux symptoms may be exacerbated or even caused by moderate weight gain in people with normal weight.
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Salter, Mark, Keith Biggadike, Joyce L. Matthews, Michael R. West, Michael V. Haase, Stuart N. Farrow, Iain J. Uings, and David W. Gray. "Pharmacological properties of the enhanced-affinity glucocorticoid fluticasone furoate in vitro and in an in vivo model of respiratory inflammatory disease." American Journal of Physiology-Lung Cellular and Molecular Physiology 293, no. 3 (September 2007): L660—L667. http://dx.doi.org/10.1152/ajplung.00108.2007.
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Fluticasone furoate (FF) is a novel enhanced-affinity glucocorticoid that has been developed as topical therapy for allergic rhinitis. The pharmacological properties of FF have been investigated using a number of in vitro experimental systems. FF demonstrated very potent glucocorticoid activity in several key pathways downstream of the glucocorticoid receptor (GR) as follows: the transrepression nuclear factor-κB (NF-κB) pathway, the transactivation glucocorticoid response element pathway, and inhibition of the proinflammatory cytokine tumor necrosis factor-α. Furthermore, FF showed the greatest potency compared with other glucocorticoids for preserving epithelial integrity and reducing epithelial permeability in response to protease- and mechanical-induced cell damage. FF showed a 30- to >330,000-fold selectivity for GR-mediated inhibition of NF-κB vs. the other steroid hormone receptors, substantially better than a number of other clinically used glucocorticoids. In studies examining the respiratory tissue binding properties of glucocorticoids, FF had the largest cellular accumulation and slowest rate of efflux compared with other clinically used glucocorticoids, consistent with greater tissue retention. The in vivo anti-inflammatory activity of FF was assessed in the Brown Norway rat ovalbumin-induced lung eosinophilial model of allergic lung inflammation. At a dose of only 30 μg, FF achieved almost total inhibition of eosinophil influx in the lung, an inhibition that was greater than that seen with the same dose of fluticasone propionate. In conclusion, the potent and selective pharmacological profile of FF described here could deliver an effective, safe, and sustained topical treatment of respiratory inflammatory diseases such as allergic rhinitis and asthma.
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Kuruvilla, J. N. "Atypical variant of hypereosinophilic syndrome responsive to imatinib mesylate: A case report." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 16530. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.16530.
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16530 Background: Idiopathic hypereosinophilic syndrome (HES) was first described by Chusid et al in 1975. The diagnosis of HES rests on three features: A persistent eosinophil count of greater than >1500 cells/μL for more than 6 months, no other etiologies for eosinophilia, and symptoms of organ involvement. The requirement of end organ damage differentiates HES from benign eosinophilia, in which there is no organ damage, in spite of years of eosinophilia. Methods: We present a case of a 28-year-old African American male, admitted for shortness of breath and leg swelling. Past medical history was significant only for asthma. Results: Laboratory investigation demonstrated an average white blood cell count of 15,900 U/L and eosinophilia of 29.6% over a 6-month period. Stool studies for ova and parasite, Rheumatoid factor, antinuclear antibody, pANCA, cANCA and complements were within normal limits. Thyroid stimulating hormone, liver function studies, and erythrocyte sedimentation rate were within normal limits. IgE level was 158 (mildly high). Peripheral smear showed only mature eosinophils. A bone marrow biopsy showed a hypercellular marrow consistent with an atypical variant of HES. Cytogenetic studies did not reveal any clonal abnormalities. Trans-esophageal echocardiogram showed severe mitral regurgitation. During the hospital course the patient had a mitral valve replacement with a St. Jude’s mechanical valve and mitral valve pathology showed post inflammatory changes and ventricular myocardial biopsy staining for eosinophilic major basic protein confirmed eosinophilic changes. The patient remained refractory to aggressive steroid therapy, and was started on imatinib mesylate, which lead to a complete remission. Conclusions: HES is a very rare and often fatal condition. A 1989 French study showed a 5-year survival of 80%, and a 15-year survival of 42%. HES has three known variants: The atypical myeloproliferative variant of HES is often refractory to glucocorticosteroid therapy, but responds to treatment with the tyrosine kinase inhibitor, imatinib mesylate. No significant financial relationships to disclose.
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Field, Tiffany. "Pediatric Massage Therapy Research: A Narrative Review." Children 6, no. 6 (June 6, 2019): 78. http://dx.doi.org/10.3390/children6060078.
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This narrative review on pediatric massage literature from the last decade suggests that massage therapy has positive effects on several pediatric conditions. These include preterm infant growth, psychological problems including aggression, gastrointestinal problems including constipation and diarrhea, painful conditions including burns and sickle cell, muscle tone disorders including cerebral palsy and Down syndrome, and chronic illnesses including diabetes, asthma cancer, and HIV. Potential underlying mechanisms for the massage therapy effects include increased vagal activity and decreased stress hormones. Limitations of the literature include the need for more randomized controlled trials, longitudinal studies, and underlying mechanism studies.
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Stutz, Elisabeth Zemp, Jacqueline Wilde, Patricia Staedele, Margaret W. Gerbase, Nicole Probst-Hensch, Otto Braendli, Arnold von Eckardstein, and Ursula Ackermann-Liebrich. "Menopausal hormonal therapy and asthma-related symptoms (SAPALDIA 2)." Gender Medicine 3 (January 2006): S69—S70. http://dx.doi.org/10.1016/s1550-8579(06)80170-1.
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Leont’eva, N. M., I. V. Demko, E. A. Sobko, and O. P. Ishchenko. "Level of asthma symptom control and adherence to treatment in young patients." Russian Medical Inquiry 4, no. 4 (2020): 180–85. http://dx.doi.org/10.32364/2587-6821-2020-4-4-180-185.
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Background: asthma is a highly variable disease, with changes in the severity over months and years. In addition to achieving asthma control, many patients experience challenges in the long-term maintenance of this condition. Good symptom control is a volatile entity even in mild asthma. The loss of asthma control is accounted for by poor adherence to treatment due the fears of taking hormonal therapy, contact with an allergen, respiratory viral infections, and the inconvenience of using the inhaler resulting in incorrect inhaler technique. Aim: to assess the control over asthma and adherence to treatment in young patients with mild-to-moderate asthma. Patients and Methods: 146 patients with verified mild-to-moderate asthma were examined. All patients were divided into two groups based on disease severity. Results: at the time of examination, the lack of the control over asthma symptoms was reported in 89% of the patients. In mild asthma, mean Asthma Control Test (AST) score was 17 [15; 21] and АCQ-5 (Asthma Control Questionnaire) score was 1.8 [1.4; 2.2]. Meanwhile, in moderate asthma, mean AST score was 15 [12; 21] and АCQ-5 score was 1.8 [1.4; 2.2]. Poor medication adherence measured by the Morisky Green Levine Medication Adherence Scale was revealed in 94% of the patients with mild asthma and 91% of the patients with moderate asthma. Conclusion: poor patient’s knowledge on asthma and little awareness of the long-term importance of regular basic therapy are the critical factors contributing to poor medication adherence. Therefore, novel approaches to patient education as well as optimized and personalized therapeutic strategies are currently important for achieving and maintaining the control over asthma symptoms. KEYWORDS: asthma, asthma control, stable course, young patients, adherence to treatment. FOR CITATION: Leont’eva N.M., Demko I.V., Sobko E.A., Ishchenko O.P. Level of asthma symptom control and adherence to treatment in young patients. Russian Medical Inquiry. 2020;4(4):180–185. DOI: 10.32364/2587-6821-2020-4-4-180-185.
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Boulet, Louis-Philippe. "Influence of obesity on the prevalence and clinical features of asthma." Clinical & Investigative Medicine 31, no. 6 (December 1, 2008): 386. http://dx.doi.org/10.25011/cim.v31i6.4926.
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Obesity has been associated with an increased prevalence of asthma and poorer control of this disease. However, the mechanisms by which obesity can influence airway function and make asthma more difficult to control remain uncertain. The physiological changes associated with obesity can contribute to respiratory symptoms and these should be differentiated from those caused by asthma. Obesity can possibly influence the development of asthma through genetic, developmental, hormonal, neurogenic or mechanical influences. Breathing at low lung volumes and changes in the pattern of breathing in obese subjects may alter airway smooth muscle plasticity and airway function. The release by adipocytes of various cytokines and mediators such as Interleukin-6, TNF-α, eotaxin, and leptin, and the reduction of anti-inflammatory adipokines in obese subjects may possibly contribute to the development or increased clinical expression of asthma in promoting airway inflammation. Reduced asthma control and impaired response to asthma therapy have been reported in obese patients. Obesity-related co-morbidities such as Sleep Apnea and Gastro-esophageal reflux may also contribute to this poor control. Weight loss improves asthma control and reduces medication needs. Research is needed to better define the optimal management of obese asthmatic patients.
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BOCIAN, KATARZYNA M., and ELŻBIETA K. JAGUSZTYN-KRYNICKA. "The Controversy over Anti-Helicobacter pylori Therapy." Polish Journal of Microbiology 61, no. 4 (2012): 239–46. http://dx.doi.org/10.33073/pjm-2012-033.
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Helicobacter pylori is a Gram-negative spiral-shaped bacterium, member of epsilon-Proteobacteria specifically colonizing the gastric epithelium of humans. It causes one of the most common infections worldwide, affecting about half of the world's population. However, it should be noted that the prevalence of H. pylori, particularly in the Western world, has significantly decreased coinciding with an increase of some autoimmune and allergic diseases, such as asthma. Various epidemiological studies have also documented a negative association between H. pylori colonization and the presence of GERD (gastroesophageal reflux disease) and risk of esophageal cancer. Additionally, an upward trend of obesity recently observed in inhabitants of developed countries raised a question about the relationship between H. pylori infection and the human body mass index. The first part of this review describes common, recommended anti-H. pylori treatments. The second part, presents the results of recent experiments aimed at evaluating the association between H. pylori infections and gastro-esophageal diseases, the level of stomach hormones, the human body mass index and allergic diseases. Although some studies suggest an inverse association of H. pylori infection with some health problems of the modern world such as asthma, obesity or GERD, H. pylori should be considered as a harmful human pathogen responsible for serious and sometimes lethal diseases. Thus, many scientists advocate the eradication of H. pylori.
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Jalil, Fatima, Aleksandra Sliwinska, Aashish G. Samat, and Joseph Rosenblatt. "Mystery Case of Parathyroid Carcinoma Masquerading as a Thyroid Nodule." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A206—A207. http://dx.doi.org/10.1210/jendso/bvab048.419.
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Abstract Introduction: Parathyroid carcinoma is a rare malignancy with a prevalence of 0.005%. Patients typically present with symptoms of hypercalcemia and elevated parathyroid hormone (PTH) levels. Non-functional parathyroid carcinoma presenting with neck pain and normal calcium is a unique and challenging entity. We describe a challenging case of normocalcemic parathyroid carcinoma presenting as neck pain. Case Description: A 59-year old woman with a history of asthma, type 2 diabetes, and tobacco use presented with neck pain and swelling worsening over months. On physical exam, she was noted to have right-sided thyroid mass. CT scan of the neck showed an enlarged thyroid gland with a 1.6 cm nodule with evidence of the trachea’s compression. Subsequent thyroid US revealed a 2.1 cm dominant solid, hypoechoic nodule in the right thyroid lobe. Initial testing revealed normal calcium levels; however, PTH level was not available. FNA of the nodule was non-diagnostic with subsequent repeat FNA interpreted as benign mass. Due to suspicious imaging features and significant neck discomfort, she underwent right hemithyroidectomy. During the surgery, the nodule was noted to be invasive with evidence of extrathyroidal extension. Postoperatively calcium was 8.9 mg/dl (8.6–10.4 mg/dl), ionized calcium 4.7 mg/dl (4.8–5.6mg/dl), PTH 48 pg/mL (14–64 pg/ml), and vitamin D25OH 48 ng/dL (30-100ng/dl). TSH was mildly elevated at 4.59 uIU/ml (0.27–4.2 uIU/ml) with free T4 of 1.09 ng/dl (0.93–1.70ng/dl). The preliminary pathology report described follicular thyroid carcinoma; however, immunostains failed to confirm primary thyroid cancer. The lesion was negative for TTF-1, PAX8, TG, CEA, calcitonin, chromogranin, and synaptophysin. The tumor was strongly positive for GATA3, PTH and positive in nuclear staining for parafibroma. The specimen was evaluated by two pathologists who favored the diagnosis of parathyroid carcinoma. A separate incidental microscopic 4mm papillary thyroid carcinoma (PTC) was found and tested positive for BRAF mutation. Genetic testing for CDC73 was negative. PET scan showed increased uptake in the right thyroid bed. Given microscopic PTC and mildly elevated TSH, she was started on levothyroxine. The patient recovered successfully after the surgery with the resolution of symptoms. She was evaluated by an oncologist, and adjuvant radiation therapy was recommended. Conclusion: Non-functional parathyroid carcinoma is a unique entity, and its diagnosis may be delayed given an atypical presentation and normal endocrine function. Differentiation between nonfunctioning parathyroid carcinoma, parathyroid adenoma, and thyroid disease based on location and proximity to the thyroid may be challenging. Although concomitant thyroid disease is not uncommon, synchronous thyroid cancer is very rare.
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Lanham, Theresa N., and Farah Hena Morgan. "Management of Atrial Flutter in Thyroid Storm." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A941. http://dx.doi.org/10.1210/jendso/bvab048.1923.
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Abstract Introduction: Thyroid storm, life-threatening hyperthyroidism, commonly presents with tachyarrhythmias. We present a case of hyperthyroid-induced atrial flutter, refractory to beta-blockade, successfully treated with electrical cardioversion (CV) while biochemically hyperthyroid. Case Description: A 49-year-old female with history of asthma and no family or personal history of thyroid disease presented with new-onset atrial flutter and heart failure. The patient endorsed weight loss, hot flashes, anxiousness, tremors, and palpitations. She denied gastrointestinal symptoms or visual changes. She was afebrile with normal mentation. Heart rate was found to be 260 beats per minute (bpm) in atrial flutter. Exam demonstrated bilateral lower extremity edema, and profound exophthalmos. Labs were remarkable for thyroid stimulating hormone (TSH) <0.01 [ref: 0.27-4.2] uIU/mL, free T4 4.5 [ref: 0.8-1.8] ng/dL, free T3 15.5 [ref: 2.0-4.4] pg/mL, thyroid stimulating immunoglobulin (TSI) of 379 [ref: <140] % and a thyroid receptor antibody (TRab) of 10.02 [ref:<=2.0] IU/L. White blood cell count and liver function tests were normal. Chest x-ray (CXR) showed bilateral pulmonary edema and ultrasound showed an enlarged heterogeneous hypervascular thyroid gland. The patient was initially started on Methimazole 30 mg daily and Metoprolol 25 mg every six hours but on day two, the patient was transitioned to Propylthiouracil (PTU) 250 mg every 6 hours given continued atrial flutter and concern for thyroid storm given Burch-Wartofsky score was 50. She was also given potassium iodide for three days. Cardioversion was deferred, as it was felt that the severity of thyrotoxicosis would limit success. On day six, TFTs were improved with a free T4 of 2.2, free T3 3.6. On day 8, because of continued tachycardia >130 bpm with limitation of beta-blockade due to hypotension, she underwent a cardioversion which was successful. On discharge, free T4 was 1.7 and she was transitioned to Methimazole 40 mg daily. Discussion: Thyroid storm has a mortality rate of 10-20%, often related to tachyarrhythmias which can be difficult to treat during a hyperthyroid state. Tachycardia should initially be treated with beta-blockade and antithyroid therapy. Amiodarone is avoided due to concern for worsening hyperthyroidism. A literature review suggests that electrical CV should not be attempted until a patient is euthyroid for four months, as a majority will spontaneously revert once thyroid levels normalize. Conversely, other studies have found that the rate of recurrence of atrial fibrillation between clinically hyperthyroid and euthyroid patients was not statistically significant, suggesting CV should not be delayed until a patient is euthyroid. This suggests that further studies need to be completed to better elucidate appropriate timing in hyperthyroid patient’s refractory to pharmacologic treatment alone.
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Khavkin, A. I., A. D. Kolosova, and V. P. Novikova. "The biological role and clinical significance of leptin in pediatrics." Voprosy praktičeskoj pediatrii 15, no. 4 (2020): 69–74. http://dx.doi.org/10.20953/1817-7646-2020-4-69-74.
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The review is devoted to the study of the effects of leptin, as one of the most important hormones that regulate the body's vital processes. His participation in the regulation of carbohydrate metabolism and insulin levels in the blood was revealed; maintaining vascular tone; the formation of eating behavior (including newborns); sexual development, as well as a role in the occurrence of a predisposition or the development of a number of diseases. Enzyme and receptor systems by which leptin exerts its effects are presented. The results of leptin replacement therapy are considered and the goals of further study of the effects of this adipokine are outlined. Key words: leptin, leptin resistance, obesity, hunger, leptin receptor, bronchial asthma, children, leptin in pediatrics, endocrinology
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Chikanza, IC, D. Kozaci, and Y. Chernajovsky. "The molecular and cellular basis of corticosteroid resistance." Journal of Endocrinology 179, no. 3 (December 1, 2003): 301–10. http://dx.doi.org/10.1677/joe.0.1790301.
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Corticosteroids (CS) can modulate gene expression and are often used to treat a range of immunological and inflammatory diseases such as asthma, inflammatory bowel disease and rheumatoid arthritis. However, a proportion of patients fail to show an adequate response. On this basis patients have been subdivided into CS-sensitive (SS) and -resistant (SR) subgroups. The ability of CS to inhibit peripheral blood T cell proliferation in vitro has also been used similarly. In rheumatoid arthritis (RA), the in vitro-defined SS and SR subgroups correlate with the clinical responses to CS therapy. The mechanisms responsible for this observation are unknown but they appear to involve a number of known molecular events related to the described mechanisms of action of CS. These include alterations in the functional status of CS receptor-alpha, perturbations of the cytokine and hormonal milieu and intracellular signalling pathways. Peripheral blood mononuclear cells (MNCs) from SR significantly overexpress activated NF-kappaB. In vitro, CS fail to significantly inhibit concanavalin A (conA)-induced NF-kappaB activation in MNCs from SR RA patients. The alterations in the intracellular signalling pathways may explain in part our observations seen in SR RA subjects, CS fail to significantly inhibit conA-induced interleukin (IL)-2 and IL-4 secretion and lipopolysaccharide-induced IL-8 and IL-1beta secretion in vitro. CS therapy fails to reduce the circulating levels of IL-8 and IL-1beta in RA patients. In asthma, CS fail to induce L10 in SR asthma patients. Other molecular mechanisms such as enhanced AP-1 expression and alterations in the MAP kinase pathway are most likely to be involved too and we are currently investigating such possibilities. A full understanding of the molecular basis of SR will lead to the development of more rational therapeutic strategies.
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Francikowski, K., A. Kotulska, and E. J. Kucharz. "P285 Effect of hormonal replacement therapy on serum sVCAM-1 level in patients with bronchial asthma." European Journal of Internal Medicine 14 (September 2003): S111—S112. http://dx.doi.org/10.1016/s0953-6205(03)91548-2.
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Brock, Judith Maria, Adrian Billeter, Beat Peter Müller-Stich, and Felix Herth. "Obesity and the Lung: What We Know Today." Respiration 99, no. 10 (2020): 856–66. http://dx.doi.org/10.1159/000509735.
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Obesity is becoming more and more prevalent especially in Western industrial nations. The understanding of adipose tissue as an endocrine organ as well as the detection of adipocytokines – hormones that are secreted from the adipose tissue – gave reason to examine the interactions between adipose tissue and target organs. These efforts have been intensified especially in the context of bariatric surgery as promising weight loss therapy. Interactions between the lung and adipose tissue have rarely been investigated and are not well understood. There are obvious mechanical effects of obesity on lung function explaining the associations between obesity and lung diseases, in particular obesity hypoventilation syndrome, obstructive sleep apnea syndrome, asthma, and chronic obstructive pulmonary disease. The rise in the prevalence of obesity affects the epidemiology of pulmonary diseases as well. The aim of this review is to summarize the current knowledge on interactions, associations, and consequences of obesity and weight loss on lung function and lung diseases. Based on these data, areas for future research are identified.
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Dermendjiev, Svetlan, and Vesela Slavcheva Blagoeva. "Angioedema - Our Experience Focused On Socio-Demographic, Etiological and Clinical Characteristics of the Condition and Its Management." Open Access Macedonian Journal of Medical Sciences 7, no. 3 (January 28, 2019): 341–46. http://dx.doi.org/10.3889/oamjms.2019.040.
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BACKGROUND: Angioedema (AE) is acute oedema of the skin and mucous surfaces, involving the respiratory and gastrointestinal tracts. AE could be a life-threatening medical condition. Regardless of its growing clinical importance, many aspects of its aetiology and pathogenesis remain poorly understood. Its incidence, demographic characteristics, diagnosis and therapy, need further investigation.
AIM: This study reports our experience with angioedema concerning its social and demographic characteristics, aetiology, clinical features, diagnosis and treatment outcomes. Study design: Eighty-eight patients with AE were enrolled. The study is a retrospective analysis of patients treated in our Clinics.
METHODS: All participants were asked on a voluntary basis to fill out a specially designed questionnaire on the day of their discharge. Other important data sources included: patients’ history and notes during the hospital stay, information from previous admissions, etc. Parametric and non-parametric statistical methods were used for data processing. Data analysis was performed using SPSS (SPSS Inc., IBM SPSS Statistica) version 20.0
RESULTS: Based on our results, AE affects more frequently patients over 50 years of age, regardless of their sex. Urban residents prevail, among them - more commonly working women. Non-steroidal anti-inflammatory drugs (NSAIDs), hormones and antibiotics were among the most common triggers – in 8%, 4.5% and 11.4% of the cases respectively. In 9.09% of the patients, food-induced AE was seen, the most common foods reported, were – nuts, eggs and egg products. The common sites of involvement were periorbital area and lips. In only 9.1% of the patients, oedema progressed to spread to the upper respiratory tract. Cardiac conditions were the most frequent underlying disorders – 33%, of the patients, auto-immune thyroiditis was the second most common-14.8%, followed by musculo- skeletal disorders (10.2%) and diabetes (4.5%) Family history of allergy was seen in 8.4% of the patients, the most frequent allergic disorder, reported, was asthma. In patients with HAE, family history was present in 2.9% of the patients.
CONCLUSIONS: All patients received therapy with steroids and antihistamines, resulting in resolution of symptoms and no invasive procedures were necessary. Based on our results, the diagnosis of AE is often difficult and delayed and requires specialist evaluation. If recognised on time and adequately treated, the outcomes are favourable.
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Salgado, Teresa M., Meagen M. Rosenthal, Antoinette B. Coe, Tana N. Kaefer, Dave L. Dixon, and Karen B. Farris. "Primary healthcare policy and vision for community pharmacy and pharmacists in the United States." Pharmacy Practice 18, no. 3 (September 18, 2020): 2160. http://dx.doi.org/10.18549/pharmpract.2020.3.2160.
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The United States (US) has a complex healthcare system with a mix of public, private, nonprofit, and for-profit insurers, healthcare institutions and organizations, and providers. Unlike other developed countries, there is not a single payer healthcare system or a national pharmaceutical benefits scheme/plan. Despite spending over USD 10,000 per capita in healthcare, the US is among the worst performers compared to other developed countries in outcomes including life expectancy at birth, infant mortality, safety during childbirth, and unmanaged chronic conditions (e.g., asthma, diabetes). Primary care is delivered by physicians and advanced practice providers (i.e., nurse practitioners and physician assistants) in a variety of settings including large health systems, federally qualified health centers or free clinics that provide care to the underserved, or specific facilities for veterans or American Indian and Alaska native peoples. Since 2010, primary care delivery has shifted toward providing patient-centered, coordinated, comprehensive care focused on providing proactive, rather than reactive, population health management, and on the quality, versus volume, of care. Community pharmacy comprises a mix of independently owned, chain, supermarket and mass merchant pharmacies. Community pharmacies provide services such as immunizations, medication therapy management, medication packaging, medication synchronization, point-of-care testing and, in specific states where legislation has been passed, hormonal contraception, opioid reversal agents, and smoking cessation services. There has been criticism regarding the lack of standard terminology for services such as medication synchronization and medication therapy management, their components and how they should be provided, which hampers comparability across studies. One of the main challenges for pharmacists in the US is the lack of provider status at the federal level. This means that pharmacists are not allowed to use existing fee-for-service health insurance billing codes to receive reimbursement for non-dispensing services. In addition, despite there being regulatory infrastructure in multiple states, the extent of service implementation is either low or unknown. Research found that pharmacists face numerous barriers when providing some of these services. State fragmentation and the lack of a single pharmacy organization and vision for the profession are additional challenges.
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"Hormone replacement therapy linked to asthma." Nursing Standard 18, no. 32 (April 21, 2004): 10. http://dx.doi.org/10.7748/ns.18.32.10.s23.
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