The Experts below are selected from a list of 261 Experts worldwide ranked by ideXlab platform
Zachary M Soler - One of the best experts on this subject based on the ideXlab platform.
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impact of topical nasal Steroid Therapy on symptoms of nasal polyposis a meta analysis
Laryngoscope, 2012Co-Authors: Luke Rudmik, Rodney J Schlosser, Timothy L Smith, Zachary M SolerAbstract:OBJECTIVES/HYPOTHESIS: Topical Steroid Therapy is an important strategy in the management of chronic rhinosinusitis (CRS) with nasal polyposis. The objective of this study was to determine the impact of topical Steroid Therapy on nasal symptoms in patients with nasal polyposis. STUDY DESIGN: Systematic review with meta-analysis using standardized methodology. METHODS: Study inclusion criteria included: randomized, placebo controlled trials, nasal polyposis, and topical Steroid Therapy. Exclusion criteria included: failure to report at least one symptom-based outcome measure, concurrent use of systemic Steroids, or mixed CRS cohorts (polyp and nonpolyp patients). Quantitative analysis was performed using a random effect model. The PRISMA guidelines for meta-analysis reporting were followed. RESULTS: A total of 19 studies fulfilled eligibility. Seven studies were excluded from the meta-analysis due to significant heterogeneity in outcome reporting. A total of 12 studies were combined for quantitative analysis and demonstrated a pooled risk ratio of 1.72 (95% confidence interval, 1.41-2.09), indicating a significant improvement in nasal symptoms. All three topical Steroid preparations (fluticasone, mometasone, and budesonide) resulted in symptom improvement. All seven studies excluded from the meta-analysis qualitatively confirmed the overall findings. CONCLUSIONS: Topical nasal Steroid Therapy improves nasal symptoms in CRS patients with nasal polyposis. Future studies will need to evaluate the impact on quality of life, preferably using validated disease-specific instruments.
William H Kitchen - One of the best experts on this subject based on the ideXlab platform.
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is there a lower limit for birth weight gestational age and antenatal Steroid Therapy
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2008Co-Authors: Lex W Doyle, Michael Permezel, William H KitchenAbstract:Summary: The aim of this study was to determine if there is a lower limit for birth-weight/gestational age below which antenatal Steroid Therapy may not improve fetal survival. The association between antenatal Steroid Therapy and survival to 2 years of age was assessed in 2 cohorts of children of birth-weight below 800 g or of gestational ages below 27 weeks. Antenatal Steroid Therapy was associated with significantly higher survival rates in infants of birth-weight 500–599 g and 700–799 g, and at gestational ages of 25 and 26 weeks. There were few survivors before 25 weeks and none below 500 g birth-weight. After adjustment for extraneous prognostic variables, antenatal Steroid Therapy was associated overall with approximately a doubling of the survival rates of infants of birth-weight 500–799 g, and of gestational ages 24–26 weeks. In the absence of maternal contraindications, if the goal is to deliver a surviving infant, this study suggests that the obstetrician may assist the survival chances of the tiniest and most immature infants by treating the mother with Steroids before birth, with no apparent lower limit of birth-weight or gestational age.
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Is There a Lower Limit for Birth-weight/Gestational Age and Antenatal Steroid Therapy?
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2008Co-Authors: Lex W Doyle, Michael Permezel, William H KitchenAbstract:The aim of this study was to determine if there is a lower limit for birth-weight/gestational age below which antenatal Steroid Therapy may not improve fetal survival. The association between antenatal Steroid Therapy and survival to 2 years of age was assessed in 2 cohorts of children of birth-weight below 800 g or of gestational ages below 27 weeks. Antenatal Steroid Therapy was associated with significantly higher survival rates in infants of birth-weight 500-599 g and 700-799 g, and at gestational ages of 25 and 26 weeks. There were few survivors before 25 weeks and none below 500 g birth-weight. After adjustment for extraneous prognostic variables, antenatal Steroid Therapy was associated overall with approximately a doubling of the survival rates of infants of birth-weight 500-799 g, and of gestational ages 24-26 weeks. In the absence of maternal contraindications, if the goal is to deliver a surviving infant, this study suggests that the obstetrician may assist the survival chances of the tiniest and most immature infants by treating the mother with Steroids before birth, with no apparent lower limit of birth-weight or gestational age.
Tokio Wakabayashi - One of the best experts on this subject based on the ideXlab platform.
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Setting a standard for the initiation of Steroid Therapy in refractory or severe Mycoplasma pneumoniae pneumonia in adolescents and adults
Journal of Infection and Chemotherapy, 2014Co-Authors: Naoyuki Miyashita, Tokio Wakabayashi, Yasuhiro Kawai, Norikazu Inamura, Takaaki Tanaka, Hiroto Akaike, Hideto Teranishi, Takashi Nakano, Kazunobu Ouchi, Niro OkimotoAbstract:Serum interleukin (IL)-18 level was thought to be a useful as a predictor of refractory or severe Mycoplasma pneumoniae pneumonia, and Steroid administration is reported to be effective in this situation. The serum levels of IL-18 correlated significantly with those of lactate dehydrogenase (LDH). The purpose of this study was to set a standard for the initiation of Steroid Therapy in M. pneumoniae pneumonia using a simple serum marker. We analyzed 41 adolescent and adult patients with refractory or severe M. pneumoniae pneumonia who received Steroid Therapy, and compared them with 108 patients with M. pneumoniae pneumonia who responded to treatment promptly (control group). Serum LDH levels were significantly higher in the refractory and severe group than in the control group at the initiation of Steroid Therapy (723 vs 210 IU/L, respectively; p < 0.0001). From receiver operating characteristic curve analysis, we calculated serum LDH cut-off levels of 364 IU/L at initiation of Steroid Therapy and 302 IU/L at 1-3 days before the initiation of Steroid Therapy. The administration of Steroids to patients in the refractory and severe group resulted in the rapid improvement of symptoms and a decrease in serum LDH levels in all patients. Serum LDH level can be used as a useful parameter to determine the initiation of Steroid Therapy in refractory or severe M. pneumoniae pneumonia. A serum LDH level of 302-364 IU/L seems to be an appropriate criterion for the initiation of Steroid Therapy.
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appropriate Steroid Therapy for autoimmune pancreatitis based on long term outcome
Scandinavian Journal of Gastroenterology, 2008Co-Authors: Terumi Kamisawa, Atsutake Okamoto, Tokio Wakabayashi, Hiroyuki Watanabe, Norio SawabuAbstract:Objective. Because autoimmune pancreatitis (AIP) responds well to corticoSteroids, many AIP patients are given this treatment. However, there is no consensus on the indications, dose, or duration of Steroid treatment. The aim of this study was to establish the most appropriate Steroid Therapy regimen. Material and methods. We retrospectively reviewed morphological and serological improvement after Steroid Therapy and long-term outcome including relapse in 41 AIP patients who were given Steroid Therapy and were prospectively followed-up for more than 1 year. Results. All patients responded to Steroid Therapy, which was given because of bile duct stenosis secondary to sclerosing cholangitis in 34 AIP patients. Pancreatic enlargement normalized within one month; however, 13 patients had incomplete resolution of pancreatic duct narrowing, and 14 patients had incomplete resolution of bile duct stenosis. There was no correlation between the degree of morphological improvement and the initial prednisolone dose (...
Noriko Kamata - One of the best experts on this subject based on the ideXlab platform.
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pancreatic endocrine and exocrine function and salivary gland function in autoimmune pancreatitis before and after Steroid Therapy
Pancreas, 2003Co-Authors: Terumi Kamisawa, Noriko Kamata, Atsutake Okamoto, Naoto Egawa, K Tsuruta, Shigeko Inokuma, Teruo Nakamura, Masakatsu MatsukawaAbstract:INTRODUCTION: Autoimmune pancreatitis (AIP) is a distinct clinical entity in which an autoimmune mechanism may be involved in pathogenesis. AIM: To investigate salivary gland function in addition to pancreatic endocrine and exocrine function in patients with AIP, and to determine changes occurring after Steroid Therapy. METHODOLOGY: Fasting serum glucose levels, oral glucose tolerance tests or glycosylated hemoglobin values were examined in 19 patients with AIP. N-benzoyl-L-tyrosyl-p-aminobenzoic acid excretion test, sialochemistry and parotid gland scintigraphy were performed in 8 patients. RESULTS: Eight patients had evidence of DM. Steroid Therapy subsequently improved insulin secretion and glycemic control in 3 of 5 patients treated. Pancreatic exocrine function was reduced in 88% of patients. Impaired pancreatic exocrine function improved after Steroid Therapy in 3 of 6 patients treated. The 3 patients also showed treatment-related improvement in endocrine function. Concentration of beta2-microglobulin in saliva was significantly raised in patients with AIP compared with controls (P < 0.05). Ratio of cumulative peak count to injected radionuclide and washout ratio in parotid scintigraphy in patients with AIP was significantly lower than those of controls (P < 0.01). Salivary gland dysfunction improved after Steroid Therapy in all 5 patients treated. CONCLUSIONS: Pancreatic endocrine and exocrine and salivary gland function were frequently impaired in patients with AIP, and Steroid Therapy was occasionally effective for these dysfunctions.
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Outpatient treatment of moderately severe active ulcerative colitis with pulsed Steroid Therapy and conventional Steroid Therapy.
Digestive Diseases and Sciences, 2003Co-Authors: Nobuhide Oshitani, Noriko Kamata, Ryuta Ooiso, Daichi Kawashima, Makoto Inagawa, Mitsue Sogawa, Masaki Iimuro, Yoshio Jinno, Kenji Watanabe, Kazuhide HiguchiAbstract:Pulsed Steroid Therapy may induce rapid remission in patients with moderately severe ulcerative colitis in outpatient clinics. A total of 19 patients with moderately severe active ulcerative colitis who refused hospitalization were treated between October 1999 and September 2001 in the outpatient clinic. Patients were treated with either conventional oral Steroid Therapy or intravenous pulsed Steroid Therapy followed by conventional oral Steroid Therapy. Eight patients received conventional Steroid Therapy and 11 patients received pulsed Steroid Therapy followed by conventional Steroid Therapy. The efficacies of the two types of Steroid Therapy were equal, but patients with active colitis responded more quickly to pulsed Steroid Therapy than to conventional Steroid Therapy. No serious adverse effects were observed. Moderately severe colitis can be safely treated with either conventional or pulsed Steroid Therapy in the outpatient clinic, but pulsed Steroid Therapy may induce clinical remission more quickly than conventional Steroid Therapy.
Luke Rudmik - One of the best experts on this subject based on the ideXlab platform.
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impact of topical nasal Steroid Therapy on symptoms of nasal polyposis a meta analysis
Laryngoscope, 2012Co-Authors: Luke Rudmik, Rodney J Schlosser, Timothy L Smith, Zachary M SolerAbstract:OBJECTIVES/HYPOTHESIS: Topical Steroid Therapy is an important strategy in the management of chronic rhinosinusitis (CRS) with nasal polyposis. The objective of this study was to determine the impact of topical Steroid Therapy on nasal symptoms in patients with nasal polyposis. STUDY DESIGN: Systematic review with meta-analysis using standardized methodology. METHODS: Study inclusion criteria included: randomized, placebo controlled trials, nasal polyposis, and topical Steroid Therapy. Exclusion criteria included: failure to report at least one symptom-based outcome measure, concurrent use of systemic Steroids, or mixed CRS cohorts (polyp and nonpolyp patients). Quantitative analysis was performed using a random effect model. The PRISMA guidelines for meta-analysis reporting were followed. RESULTS: A total of 19 studies fulfilled eligibility. Seven studies were excluded from the meta-analysis due to significant heterogeneity in outcome reporting. A total of 12 studies were combined for quantitative analysis and demonstrated a pooled risk ratio of 1.72 (95% confidence interval, 1.41-2.09), indicating a significant improvement in nasal symptoms. All three topical Steroid preparations (fluticasone, mometasone, and budesonide) resulted in symptom improvement. All seven studies excluded from the meta-analysis qualitatively confirmed the overall findings. CONCLUSIONS: Topical nasal Steroid Therapy improves nasal symptoms in CRS patients with nasal polyposis. Future studies will need to evaluate the impact on quality of life, preferably using validated disease-specific instruments.