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2023 NOV 16 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- According to news reporting based on a preprint abstract, our journalists obtained the following [...]

2022 JAN 13 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- According to news reporting based on a preprint abstract, our journalists obtained the following [...]

2021 MAY 20 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- A new study on corpus luteum hormones is now available. According to news originating [...]

Providing health insurance to uninsured children with known asthma can result in improved asthma outcomes, including fewer asthma attacks and less frequent asthma-related hospitalizations and emergency department (ED) visits (Szilagyi [...], Objective. To test the hypotheses that reported asthma prevalence is higher among insured than uninsured children and that insurance-based differences in asthma diagnosis, treatment, and health care utilization are associated with disease severity.Data Sources. National Health and Nutrition Examination Survey, 2003-2008.Study Design. We used multivariate logistic regression to examine the relationship between insurance and asthma symptom severity with asthma diagnosis, treatment, and acute care utilization.Principal Findings. In multivariate analysis, insured children had greater odds of reporting a current diagnosis of asthma than uninsured children (odds ratio [OR] = 2.08, 95% confidence interval [CI]: 1.47-2.94). When interactions between insurance and asthma impairment were included, insurance was associated with greater odds of diagnosis among children with intermittent (OR = 4.08, 95% CI: 1.57-10.61), but not persistent, symptoms. Among children with intermittent symptoms, insurance was associated with inhaled corticosteroid use (OR = 4.51, 95% CI: 1.18-17.24) and asthma-related acute care utilization (OR = 5.21, 95% CI: 1.21-23.53); these associations were nonsignificant among children with persistent symptoms.Conclusion. Being insured increases only the likelihood that a child with intermittent, not persistent, asthma symptoms will receive an asthma diagnosis and control medication, and it may not reduce acute care utilization. Although universal insurance may increase detection and management of undiagnosed childhood asthma, theorized cost savings from reduced acute care utilization might not materialize.Key Words. Asthma, children, insurance, asthma impairment, health services utilization

Superficial punctate keratitis (SPK) is characterized by the destruction of small clusters of cells on the corneal epithelium. SPK can result from a number of different underlying conditions and can [...], Untreated, some forms of superficial punctate keratitis (SPK) can cause pain, impair vision, and produce other symptoms. Topical corticosteroids can effectively control the inflammation that drives symptom formation in SPK, but the safety of these drugs must be carefully considered when selecting a treatment. My drug of choice for the treatment of SPK is LOTEMAX® (loteprednol etabonate ophthalmic suspension 0.5%), a potent corticosteroid that combines excellent steroid efficacy with a safety profile that makes it a highly appropriate agent for treating inflammatory conditions of the cornea.

Byline: Andrew J. Lodge, Paul J. Chai, C.William Daggett, Ross M. Ungerleider, James Jaggers Abstract: Introduction: Cardiopulmonary bypass produces an inflammatory response that can cause significant postoperative pulmonary dysfunction and total body edema. This study evaluates the efficacy of preoperative methylprednisolone administration in limiting this injury in neonates and compares the effect of giving methylprednisolone 8 hours before an operation to the common practice of adding methylprednisolone to the cardiopulmonary bypass circuit prime. Methods: A control group of neonatal pigs (control; n = 6) received no preoperative medication. One experimental group (n = 6) received methylprednisolone sodium succinate (30 mg/kg) both 8 and 1.5 hours before the operation. A second experimental group received no preoperative treatment, but methylprednisolone (30 mg/kg) was added to the cardiopulmonary bypass circuit prime. All animals underwent cardiopulmonary bypass and 45 minutes of deep hypothermic circulatory arrest. Hemodynamic and pulmonary function data were acquired before cardiopulmonary bypass and at 30 and 60 minutes after bypass. Results: In the control group, pulmonary compliance, alveolar-arterial gradient, and pulmonary vascular resistance were significantly impaired after bypass (P < .01 for each by analysis of variance). In the group that received methylprednisolone, compliance (P = .02), alveolar-arterial gradient (P = .0003), pulmonary vascular resistance (P = .007), and extracellular fluid accumulation (P = .003) were significantly better after bypass when compared with the control group. Results for the group that received no preoperative treatment fell between the control group and the group that received methylprednisolone. Conclusions: When given 8 hours and immediately before the operation, methylprednisolone improves pulmonary compliance after bypass, alveolar-arterial gradient, and pulmonary vascular resistance compared with no treatment. The addition of methylprednisolone to the cardiopulmonary bypass circuit prime is beneficial but inferior to preoperative administration. (J Thorac Cardiovasc Surg 1999;117:515-22) Author Affiliation: Department of Surgery, Duke University Medical Center, Durham, NC. Article History: Received 6 April 1998; Revised 9 July 1998; Revised 7 October 1998; Accepted 6 November 1998 Article Note: (footnote) [star] Address for reprints: James Jaggers, MD, Division of Thoracic Surgery, Department of Surgery, Box 3474, Duke University Medical Center, Durham, NC 27710., [star][star] 12/6/95759

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0022-5223(99)70331-4 Byline: Andrew J. Lodge, Paul J. Chai, C.William Daggett, Ross M. Ungerleider, James Jaggers Abstract: Introduction: Cardiopulmonary bypass produces an inflammatory response that can cause significant postoperative pulmonary dysfunction and total body edema. This study evaluates the efficacy of preoperative methylprednisolone administration in limiting this injury in neonates and compares the effect of giving methylprednisolone 8 hours before an operation to the common practice of adding methylprednisolone to the cardiopulmonary bypass circuit prime. Methods: A control group of neonatal pigs (control; n = 6) received no preoperative medication. One experimental group (n = 6) received methylprednisolone sodium succinate (30 mg/kg) both 8 and 1.5 hours before the operation. A second experimental group received no preoperative treatment, but methylprednisolone (30 mg/kg) was added to the cardiopulmonary bypass circuit prime. All animals underwent cardiopulmonary bypass and 45 minutes of deep hypothermic circulatory arrest. Hemodynamic and pulmonary function data were acquired before cardiopulmonary bypass and at 30 and 60 minutes after bypass. Results: In the control group, pulmonary compliance, alveolar-arterial gradient, and pulmonary vascular resistance were significantly impaired after bypass (P < .01 for each by analysis of variance). In the group that received methylprednisolone, compliance (P = .02), alveolar-arterial gradient (P = .0003), pulmonary vascular resistance (P = .007), and extracellular fluid accumulation (P = .003) were significantly better after bypass when compared with the control group. Results for the group that received no preoperative treatment fell between the control group and the group that received methylprednisolone. Conclusions: When given 8 hours and immediately before the operation, methylprednisolone improves pulmonary compliance after bypass, alveolar-arterial gradient, and pulmonary vascular resistance compared with no treatment. The addition of methylprednisolone to the cardiopulmonary bypass circuit prime is beneficial but inferior to preoperative administration. (J Thorac Cardiovasc Surg 1999;117:515-22) Author Affiliation: Department of Surgery, Duke University Medical Center, Durham, NC. Article History: Received 6 April 1998; Revised 9 July 1998; Revised 7 October 1998; Accepted 6 November 1998 Article Note: (footnote) [star] Address for reprints: James Jaggers, MD, Division of Thoracic Surgery, Department of Surgery, Box 3474, Duke University Medical Center, Durham, NC 27710., [star][star] 12/6/95759

Byline: Oktavijan P. Minanov, John H. Artrip, Matthias Szabolcs, Pawel A. Kwiatkowski, Uri Galili, Silviu Itescu, Robert E. Michler Abstract: Objective: Pig hearts transplanted into unmedicated newborn baboons do not undergo hyperacute rejection by preformed xenoantibody and complement. These grafts are rejected at days 3 to 4 in association with the infiltration of macrophages and natural killer cells. We investigated whether an immunosuppressive regimen used widely in cardiac allotransplantation could reduce this cellular response and prolong xenograft life. Methods: Ten newborn baboons underwent heterotopic pig cardiac xenotransplantation. Five baboons were immunosuppressed with mycophenolate mofetil (100 mg/kg), methylprednisolone acetate (0.8 mg/kg), and cyclosporine A (INN: ciclosporin; 10 mg/kg). Xenograft rejection was studied by light microscopy and immunofluorescence. The induced humoral response to porcine xenoantigens was documented by enzyme-linked immunosorbent assay using synthetic [alpha]-1,3-galactosyl epitopes coupled to bovine serum albumin. Results: Graft life was extended from a mean of 3.6 [+ or -] 0.5 days (n = 5) to a mean of 6.2 [+ or -] 1.1 days (n = 5, p = 0.01). In comparison with controls, explanted grafts from medicated baboons demonstrated reduced infiltration with natural killer cells and macrophages, but increased evidence of complement-mediated rejection substantiated by increased deposition of immunoglobulin M, complement, and fibrin. In all baboons receiving transplants, levels of both immunoglobulin M and immunoglobulin G anti-galactose were significantly increased after transplantation, with immunoglobulin G levels remaining persistently elevated. Conclusions: These results indicate that cyclosporine-based triple immunosuppression marginally prolonged xenograft survival and appears to have reduced the natural killer cell and macrophage infiltrates. The immunosuppressive protocol, however, was not adequate to prevent the induced immunoglobulin M humoral response and prevent complement-mediated graft injury. (J Thorac Cardiovasc Surg 1998;115:998-1006) Article History: Received 22 April 1997; Revised 11 August 1997; Accepted 5 December 1997 Article Note: (footnote) [star] From the Cardiac Transplantation Research Laboratorya and the Departments of Surgeryb and Pathology,c College of Physicians and Surgeons, Columbia University, New York, N.Y., the Department of Microbiology and Immunology,d Medical College of Pennsylvania, Hahnemann University, Philadelphia, Pa., and Ohio State University Medical Center,e Columbus, Ohio., [star][star] Supported in part by a gift from Roche Pharmaceuticals., a Address for reprints: Robert E. Michler, MD, Karl P. Klassen Professor of Surgery, Chief, Division of Cardiothoracic Surgery, Doan Hall North, Ohio State University Medical Center, 410 West 10th Ave., Columbus, OH 43210., aa 12/1/88015

Byline: Robert J. McKenna, Matthew Brenner, Richard J. Fischel, Arthur F. Gelb Abstract: Both unilateral and bilateral lung volume reduction procedures are being advocated for treatment of severe, generalized emphysema. We analyzed the results of 166 consecutive patients who underwent unilateral (n = 87) or bilateral (n = 79) thoracoscopic stapled lung volume reductions to help define the role for these procedures. There was no statistically significant difference in the operative mortality (3.5% vs 2.5%), mean length of stay (11.4 [+ or -] 1 vs 10.9 [+ or -] 1 days), or morbidity for the unilateral and bilateral groups, respectively (p not significant for all variables). Oxygen dependence was eliminated in 18 (36%) of 50 patients who had unilateral procedures and 30 (68%) of 44 of those who had bilateral procedures (p < 0.01). Prednisone was eliminated for 38 (54%) of 51 unilateral-procedure patients, compared with 30 (85%) of 35 bilateral-procedure patients (p = 0.02). Overall, bilateral procedures produced a mean improvement in the forced expiratory volume in 1 second (FEV.sub.1) of 57%, compared with 31% for unilateral reduction procedures (p < 0.01). Our bilateral staple procedure produced a 72.8% mean increase in the FEV.sub.1 for patients who had upper lobe emphysema. Especially compromised patients (age [greater than or equal to]75, with preoperative room air Po.sub.2 [less than or equal to]50 mm Hg or FEV.sub.1 [less than or equal to]500 ml) had the same morbidity and operative mortality with unilateral or bilateral procedures, but they had a higher 1-year mortality (17% vs 5%), primarily because of respiratory failure after the unilateral operation (p < .001). Although unilateral staple lung volume reduction may produce an excellent result in a given patient, the bilateral procedure appears to be the procedure of choice, because it provides better overall results at no increased morbidity or mortality compared with the unilateral procedure. The results of bilateral staple lung volume reduction by thoracoscopy appear to be comparable to those of median sternotomy. (J THORAC CARDIOVASC SURG 1996;112:1331-9) Article History: Received 11 March 1996; Revised 29 May 1996; Revised 11 July 1996; Accepted 15 July 1996 Article Note: (footnote) [star] From the Lung Center, Chapman Medical Center, Orange, Calif.,a the Pulmonary Department,b Lakewood Regional Medical Center, Lakewood, Calif., and UCI Medical Center,c UCLA Pulmonary Division,d and UCLA Department of Thoracic Surgery,e Los Angeles, Calif., [star][star] Supported in part by DOE grant DE-f603-91 ER61227 NIH grant R01192 and the Heart and Lung Surgery Foundation., a Read at the Seventy-sixth Annual Meeting of The American Association for Thoracic Surgery, San Diego, Calif., April 28-May 1, 1996., aa Address for reprints: Robert J. McKenna, Jr., MD, 1245 Wilshire Blvd., Suite 606, Los Angeles, CA 90017., acents 0022-5223/96 $5.00 + 0, acentsacents 12/6/76507

Byline: Gary E. Hill, Anselmo Alonso, John R. Spurzem, Alfred H. Stammers, Richard A. Robbins Abstract: Cardiopulmonary bypass induces an inflammatory state characterized by tumor necrosis factor-[alpha] release. Integrin CD11b is a neutrophil surface adhesive glycoprotein integrin that is rapidly and permanently unregulated by tumor necrosis factor-[alpha] exposure. The CD11b integrin is known to be the primary neutrophil integrin responsible for neutrophil lung and myocardial entrapment after cardiopulmonary bypass and subsequent reperfusion injury. Twenty-four adults admitted to the hospital for myocardial revascularization were equally randomized to one of three groups: group A (control), group B (methylprednisolone before cardiopulmonary bypass), and group C (low-dose aprotinin protocol). Blood was collected at three times: (1) baseline, (2) 50 minutes of cardiopulmonary bypass duration, and (3) 30 minutes after cardiopulmonary bypass termination. Neutrophil CD11b integrin expression was measured by fluorescence-activated cell sorter analysis and plasma tumor necrosis factor-[alpha]levels measured by enzyme-linked immunosorbent assay. Group A demonstrated significant (p < 0.05) increases in CD11b expression at times 2 and 3 when results were compared with those of the same group baseline and with those of groups B and C at similar times. No significant changes were noted between groups B and C at any time. Group A demonstrated a significant (p < 0.05) increase in levels of tumor necrosis factor-[alpha] at time 3 when results were compared with those of the same group baseline and of groups B and C at the same time. No significant changes were noted between groups B and C at any time. These results demonstrate low-dose aprotinin has a similar antiinflammatory effect to that of methylprednisolone in blunting cardiopulmonary bypass-induced systemic tumor necrosis factor-[alpha] release and neutrophil integrin CD11b upregulation. (J THORAC CARDIOVASC SURG 1995;110:1658-62) Author Affiliation: Omaha, Neb Article History: Received 28 February 1995; Accepted 6 April 1995 Article Note: (footnote) [star] From the Departments of Internal Medicine,b Anesthesiology, a Surgery, c and Perfusion Sciences Education, d University of Nebraska Medical Center, Omaha, Neb., [star][star] Address for reprints: Gary E. Hill, MD, FCCM, Department of Anesthesiology and Internal Medicine, University of Nebraska Medical Center, 600 S. 42 St., Box 984455, Omaha, NE 68198-4455., a 0022-5223/95 $5.00 + 0, aa 12/1/65323

Byline: Pierre R. Delaere, Zi Ying Liu, Robert Hermans, Raf Sciot, Louw Feenstra Abstract: The feasibility of tracheal allotransplantation with a fascial vascular carrier was examined in three groups with varied dose sequences of immunosuppression. A control group (group 1) received no medication. The three experimental groups were given daily cyclosporine intramuscular doses of 5 mg/kg (group 2), 5 mg/kg plus 3 mg/kg methylprednisolone (Solu-Medrol) (group 3), and 10 mg/kg (group 4) for 6 weeks or until death. Grafts were assessed by silicone dye infusion of the artery of the fascial flap to examine their microcirculation and by quantitative histologic study. Group 1 evidenced complete rejection after a heterotopic revascularization period of 14 days. The allografts of the experimental groups remained viable after 14 days of revascularization and could be transplanted orthotopically after this period. After transplantation, the viability of group 2 tracheas was unpredictable with changes ranging from mild to complete rejection. Group 3 evidenced well-preserved transplant viability with infection-induced necrosis at the anastomoses caused by the corticosteroid component. All group 4 animals survived the follow-up period with normal allograft viability. Cyclosporine in a dosage of 10 mg/kg per day can effectively suppress the immune response after transplantation of vascularized tracheal allografts. This experimental model will allow future studies to examine airway wall immunogenicity. (J T horac C ardiovasc S urg 1995;110: 728-37) Author Affiliation: Leuven, Belgium Article History: Received 26 October 1994; Accepted 12 January 1995 Article Note: (footnote) [star] From the Department of Oto-Rhino-Laryngology Head and NeckSurgery,a the Department of Pathology,c and the Department of Radiology,b the University Hospitals ofLeuven, Leuven, Belgium., [star][star] Supported by a grant from the N.F.W.O. (No. S 2/5-ID. F 214).Cyclosporine was a generous contribution of Sandoz Pharmaceuticals, E.Hannover, N.J., a Address for reprints: Pierre R. Delaere, MD, Department of Oto-Rhino-Laryngology, University Hospital St. Rafael, K.U. Leuven, Kapueijnenvoer 33, B-3000 Leuven, Belgium., aa 12/1/63338

Byline: William M. DeCampli, Helen Luikart, Sharon Hunt, Edward B. Stinson Abstract: The clinical status and quality of life of 40 patients who lived or are still alive more than 10 years after transplantation at our institution were reviewed with the use of our transplant database, prospective patient examinations, cardiac catheterization, and exercise testing. Patient-perceived health status was determined with use of the Nottingham Health Profile and General Well Being examinations. Factors associated with longevity were determined by a Cox proportional hazards model. Twenty-six patients are alive and 14 have died. The mean age at transplant was 32.4 [+ or -] 12 years and the current age (or age at death) is 46.1 [+ or -] 12.8 years. Actuarial freedom from rejection was similar to that of patients surviving less than 10 years (p = 0.8), but freedom from all types of infection was less (p = 0.005). Immunosuppressive drugs include cyclosporine (11/26 patients), azathioprine (24/26), and prednisone (26/26, mean dose 12.7 mg/day). Catheterization hemodynamic data show well-preserved graft function at a mean follow-up of 11.7 [+ or -] 3.3 years. Graft coronary artery disease prevalence is 51.0% [+ or -] 8%. Exercise test results are as follows: duration 8.7 [+ or -] 3.5 minutes (range 2 to 16 minutes), maximum heart rate/expected rate 77.3% [+ or -] 11% (50% to 92%), maximum systolic blood pressure 171 [+ or -] 23 mm Hg (140 to 208 mm Hg), and metabolic equivalents 9.2 [+ or -] 2.3 units (5.5 to 12.9 units), or about 84% of predicted. Mean score on the General Well Being examination was 75.3 [+ or -] 21.6 (normal). Nottingham Health Profile scores were nearly normal, except for in the 50- to 64-year-old age group in categories of mobility, pain, sleep quality, and energy level. Causes of death were coronary artery disease in 7 of 14, infection in 4 of 14, lymphoma in 1 of 14, and nonlymphoid cancer in 2 of 14. In the Cox regression, variables most associated with survival t > 2.0, multivariate p = 0.0005) were age at transplantation (t = 3.26), preoperative duration of illness (t = 3.57), postoperative cytomegalovirus infection (t = 2.16), and ejection fraction at 12 months after operation (t = -2.62). We conclude that cardiac transplantation can provide patients with end-stage cardiac failure an acceptable general medical condition, functional status, and perceived quality of life well into the second decade after operation. (J T HORAC C ARDIOVASC S URG 1995;109:1103-15) Author Affiliation: Stanford, Calif. Article Note: (footnote) [star] From the Department of Cardiothoracic Surgery, Stanford University Medical Center, Stanford, Calif., [star][star] Read at the Twentieth Annual Meeting of The Western Thoracic Surgical Association, Olympic Valley, Calif., June 22-25, 1994., a Address for reprints: William M. DeCampli, MD, PhD, Division of Cardiothoracic Surgery, Children's Hospital Oakland, 747-52nd St., Oakland, CA 94609., aa 0022-5223/95 $3.00 + 0 12/6/62945

A multifaceted condition, blepharoconjunctivitis involves both the eyelids and ocular tissues, with symptoms including eyelid irritation and redness, conjunctival inflammation, and ocular surface irritation. Because these symptoms are often the [...]

'There is debate concerning the safety and efficacy of antenatal steroids in preterm labour with suspected intrauterine infection (chorioamnionitis). We performed a systematic literature review and meta-analysis aimed at evaluating [...]

According to recent research from the United States, "Introduction and objective: Hunner's ulcer subtype interstitial cystitis (IC) is characterized by the presence of circumscribed inflammatory ulcerations in the bladder wall [...]

A course of prenatal corticosteroids can reduce mortality by about half in neonates born before 24 weeks, a meta-analysis showed. Previous studies have established that prenatal corticosteroids, used to hasten [...]

Anaheim, CA -- Similar to patients with other chronic pain conditions, men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have evidence of a hypothalamic-pituitary-adrenal (HPA)-axis abnormality. In addition, high stress, [...]

They may relieve pain in the short-term, but local corticosteroid injections are associated with a significantly increased rate of injury in Thoroughbred racehorses, according to research from Australia. University of [...]

EXPERT ANALYSIS FROM THE WINTER RHEUMATOLOGY SYMPOSIUM SNOWMASS, COLO. -- The common strategy of managing inflammatory arthritis during pregnancy by stopping all prepregnancy medications and prescribing prednisone is counterproductive, Dr. [...]