299 research outputs found
Nonsteroidal therapy of sarcoidosis
No full textNone of the medications used in clinical practice to treat sarcoidosis have been approved by the regulatory authorities. Understanding how to use disease-modifying antisarcoid drugs, however, is essential for physicians treating patients with sarcoidosis. This review summarizes the recent studies of medications used for sarcoidosis with a focus on nonsteroidal therapies. Studies from 2006 to 2013 were considered for review to update clinicians on the most relevant literature published over the last few years.
Several recently published pieces of evidence have helped expand our ability to more appropriately sequence second-line and third-line therapies for sarcoidosis. For instance, methotrexate and azathioprine may be useful and well tolerated medications as second-line treatment. Mycophenolate mofetil might have a role in neurosarcoidosis. TNF-α blockers and other biologics seem to be well tolerated medications for the most severely affected patients.
Corticosteroids remain the first-line therapy for sarcoidosis as many patients never require treatment or only necessitate a short treatment duration. Second-line and third-line therapies described in this article should be used in patients with progressive or refractory disease or when life-threatening complications are evident at the time of presentation
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Editorial: Interstitial Lung Disease in the Context of Systemic Disease: Pathophysiology, Treatment and Outcomes
No full textPersonalized medicine approach in mycobacterial disease
No full textAbstractMycobacterial diseases are a group of illnesses that cause a considerable number of deaths throughout the world, regardless of years of public health control efforts. Personalized medicine is a new but rapidly advancing field of healthcare. Personalized medicine in the field of mycobacteriology may be applied in the different levels of management such as prevention, diagnosis, treatment and prognosis. A genetic predisposition and a protein dysfunction study are recommended to tailor an individual approach in mycobacterial diseases
Towards personalized medicine in mycobacterial diseases; from bench to bedside
No full textObjectiveMycobacterial disease is still an important cause of morbidity and mortality in the world. Personalized medicine is a rapidly advancing field of medicine. It uses all available omics in order to make accurate decisions about prevention, diagnosis, and treatment of disease. Personalized medicine may be helpful to design more efficient strategies for prevention of mycobacterial diseases and for offering better treatment options.MethodsA literature search was conducted using search keywords “personalized medicine”, “individualized”, “nontuberculous mycobacteria”, “mycobacterium tuberculosis”, “tuberculosis”, “genetic susceptibility”, “genomics”, “side effects”, “treatment”, “prevention” and “diagnosis” from studies that have been published by July 2014. PubMed, Cinahl, Scopus, Embase and the Cochrane Library were searched.ResultsThe advances in personalized medicine for diagnosis, treatment and prognosis of mycobacterial diseases were addressed. A need assessment for individuating the mycobacterial diseases was performed. Finally, the proposed approach to personalized medicine in mycobacterial diseases was discussed.ConclusionsMoving toward personalized medicine in mycobacterial diseases has already started, but needs further works to make it applicable for patient care. It will help us to improve diagnostic and treatment strategies and possibly to deliver a better quality of healthcare to patients
Health and Economy in COVID-19 Era: A Plan for Reconstituting Long-Term Economic Security
No full text© Copyright © 2020 Allen and Mirsaeidi. COVID-19 is a rapidly evolving pandemic, which represents a multifaceted global threat. Given the economic consequences, most researchers agree that social distancing measures are an effective strategy relative to the cost. Previous studies indicate that community size as well as viral population risk groups should be considered in forming an effective targeted social distancing strategy. The resultant delay in the occurrence of infections in order to support vaccine development has been shown to be an effective policy. However, a return to normalcy from the current situation would require policy intervention that transforms the American economy along with continued targeted social distancing and the use of medical science as a tool to facilitate gradual personal interactions of low-risk individuals. We believe that the adoption of rapid IgG testing would be best suitable for widespread population-level screening as part of a comprehensive plan for incrementally rebuilding the in-person workforce. As such, this crisis represents an opportunity for the United States to increase automation of the manufacturing sector, shrink supply chains, and create higher-level jobs in order to reduce the dependency on other countries for critical supplies. This economic transition to better utilize technology along with reconstruction of the workforce could improve the standard of living for many Americans as well as better prepare the US for future pandemics
Pneumococcal vaccine and patients with pulmonary diseases
No full textChronic pulmonary diseases are chronic diseases that affect the airways and lung parenchyma. Examples of common chronic pulmonary diseases include asthma, bronchiectasis, chronic obstructive lung disease, lung fibrosis, sarcoidosis, pulmonary hypertension, and cor pulmonale. Pulmonary infection is considered a significant cause of mortality in patients with chronic pulmonary diseases. Streptococcus pneumoniae is the leading isolated bacteria from adult patients with community-acquired pneumonia, the most common pulmonary infection. Vaccination against S. pneumoniae can reduce the risk of mortality, especially from more serious infections in both immunocompetent and immunocompromised patients. Patients with chronic pulmonary diseases who take steroids or immunomodulating therapy (eg, methotrexate, anti-tumor necrosis factor inhibitors), or who have concurrent sickle cell disease or other hemoglobinopathies, primary immunodeficiency disorders, human immunodeficiency virus infection/acquired immunodeficiency syndrome, nephrotic syndrome, and hematologic or solid malignancies should be vaccinated with both 13-valent pneumococcal conjugate vaccine and the pneumococcal polysaccharide vaccine 23-valent
Cardiovascular complications and mortality determinants in near drowning victims: A 5-year retrospective analysis
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Impact of seasonal variation in meteorological conditions on dry eye severity
No full textHarrison Dermer,1 Anat Galor,2,3 Abigail S Hackam,3 Mehdi Mirsaeidi,2–4 Naresh Kumar5 1Miller School of Medicine, University of Miami, Miami, FL, USA; 2Eye Care (Ophthalmology), Miami Veterans Affairs (VA) Medical Center, Miami, FL, USA; 3Ophthalmology Department, Bascom Palmer Eye Institute, Miami, FL, USA; 4Divison of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Miami, Miami, FL, USA; 5Public Health Sciences, Environmental Health Division, University of Miami, Miami, FL, USA Purpose: To compare dry eye (DE) diagnosis patterns by season in Miami vis-a-vis the US and examine differences in DE symptoms and signs by season in Miami.Patients and methods: US veteran affairs (VA) patient visits with ICD-9 codes for DE (375.15) and routine medical examination (V70.0) from 2010 to 2013 were retrospectively analyzed to evaluate the seasonal pattern of DE diagnosis. A total of 365 patients with normal ocular anatomy were prospectively recruited from the Miami VA eye clinic from 2014 to 2016 for the assessment of symptoms and signs.Results: While DE visit prevalence in Miami was about 10% lower than that of the rest of the country (22.5% vs 33.7%), Miami had roughly four times higher variability in DE visit prevalence throughout the year than the US. Peak values for DE symptoms in the Miami cohort aligned with peak DE prevalence seen in the retrospective sample, occurring in spring and fall. A similar, but less dramatic, pattern was noted with DE signs. The seasonal pattern in DE symptoms remained even after controlling for confounders including demographics and medication use.Conclusion: DE symptoms, and to a lesser degree signs, varied by month, with the highest severity of symptoms occurring in spring and fall, which corresponded with peak allergy season and weather fluctuations, respectively. These findings have important implications for season-specific diagnosis, treatment, and management of DE. Keywords: seasonality, DE signs and symptoms, weather, pollen, United States, epidemiolog
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