Browsing by Subject "Therapy"
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- ItemOpen AccessEfficacy of budesonide/formoterol maintenance and reliever therapy compared with higher-dose budesonide as step-up from low-dose inhaled corticosteroid treatment(2017) Jenkins, Christine R; Eriksson, Göran; Bateman, Eric D; Reddel, Helen K; Sears, Malcolm R; Lindberg, Magnus; O’Byrne, Paul MAsthma management may involve a step up in treatment when symptoms are not well controlled. We examined whether budesonide/formoterol maintenance and reliever therapy (MRT) is as effective as higher, fixed-dose budesonide plus as-needed terbutaline in patients requiring step-up from Step 2 treatment (low-dose inhaled corticosteroids), stratified by baseline reliever use.
- ItemOpen AccessHyaline membrane disease: a study of lung function and treatment(1967) Harrison, V CAt present, both the aetiology of hyaline membrane disease and a means of preventing it remain unknown. Recent studies indicate that a significant number of infants die of respiratory failure but there is no general agreement concerning the changes of pulmonary function which lead to this stage. Two approaches have been used in the treatment of respiratory decompensation. First it has been proposed that blood gas and acid base abnormalities which result from respiratory failure can be prevented by oxygen and intravenous alkali and secondly an attempt has been made to correct abnormal lung function itself by means of artificial ventilation. These methods are directed at different aspects of the problem and their efficacy is as yet not established. The application of artificial ventilation in particular must depend on the nature of any ventilation, diffusion or perfusion defect.
- ItemOpen AccessThe immunological response to syphilis differs by HIV status; a prospective observational cohort study(2017) Kenyon, Chris; Osbak, Kara Krista; Crucitti, Tania; Kestens, LucBACKGROUND: It is not known if there is a difference in the immune response to syphilis between HIV-infected and uninfected individuals. METHODS: We prospectively recruited all patients with a new diagnosis of syphilis and tested their plasma for IFNα, IFNγ, IL-1β, IL-12p40, IL-12p70, IP-10, MCP-1, MIP-1α, MIP-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10 and IL-17A at baseline pre-treatment and 6 months following therapy. RESULTS: A total of 79 HIV-infected [44 primary/secondary syphilis (PSS) and 35 latent syphilis (LS)] and 12 HIV-uninfected (10 PSS and 2 LS) cases of syphilis and 30 HIV-infected controls were included in the study. At the baseline visit, compared to the control group, concentrations of IL-10 were significantly elevated in the HIV-infected and uninfected groups. The level of IL-10 was significantly higher in the HIV-infected compared to the HIV-uninfected PSS group (25.3 pg/mL (IQR, 4.56-41.76) vs 2.73 pg/mL (IQR, 1.55-9.02), P = 0.0192). In the HIV-infected PSS group (but not the HIV-infected LS or HIV-uninfected PSS groups) the IP-10, MIP-1b, IL-6 and IL-8 were raised compared to the controls. IL-10 levels decreased but did not return to control baseline values by 6 months in HIV infected PSS and LS and HIV uninfected PSS. CONCLUSION: PSS and LS in HIV-infected individuals is characterized by an increase in inflammatory and anti-inflammatory cytokines such as IL-10. The increase of IL-10 is greater in HIV-infected than uninfected individuals. Further work is required to ascertain if this is part of an immunological profile that correlates with adverse outcomes such as serofast syphilis and neurosyphilis, in HIV-infected individuals.
- ItemOpen AccessThe international WAO/EAACI guideline for the management of hereditary angioedema – the 2017 revision and update(BioMed Central, 2018-02-27) Maurer, Marcus; Magerl, Markus; Ansotegui, Ignacio; Aygören-Pürsün, Emel; Betschel, Stephen; Bork, Konrad; Bowen, Tom; Boysen, Henrik B; Farkas, Henriette; Grumach, Anete S; Hide, Michihiro; Katelaris, Constance; Lockey, Richard; Longhurst, Hilary; Lumry, William R.; Martinez-Saguer, Inmaculada; Moldovan, Dumitru; Nast, Alexander; Pawankar, Ruby; Potter, Paul; Riedl, Marc; Ritchie, Bruce; Rosenwasser, Lanny; Sánchez-Borges, Mario; Zhi, Yuxiang; Zuraw, Bruce; Craig, TimothyHereditary Angioedema (HAE) is a rare and disabling disease. Early diagnosis and appropriate therapy are essential. This update and revision of the global guideline for HAE provides up-to-date consensus recommendations for the management of HAE. In the development of this update and revision of the guideline, an international expert panel reviewed the existing evidence and developed 20 recommendations that were discussed, finalized and consented during the guideline consensus conference in June 2016 in Vienna. The final version of this update and revision of the guideline incorporates the contributions of a board of expert reviewers and the endorsing societies. The goal of this guideline update and revision is to provide clinicians and their patients with guidance that will assist them in making rational decisions in the management of HAE with deficient C1-inhibitor (type 1) and HAE with dysfunctional C1-inhibitor (type 2). The key clinical questions covered by these recommendations are: 1) How should HAE-1/2 be defined and classified?, 2) How should HAE-1/2 be diagnosed?, 3) Should HAE-1/2 patients receive prophylactic and/or on-demand treatment and what treatment options should be used?, 4) Should HAE-1/2 management be different for special HAE-1/2 patient groups such as pregnant/lactating women or children?, and 5) Should HAE-1/2 management incorporate self-administration of therapies and patient support measures? This article is co-published with permission in Allergy and the World Allergy Organization Journal.