scholarly journals Kartagener’s syndrome: A case report

2016 ◽  
Vol 73 (9) ◽  
pp. 873-876 ◽  
Author(s):  
Djordje Tausan ◽  
Andjelka Ristic ◽  
Biljana Zvezdin
Keyword(s):  
Case Report ◽  
Lung Function ◽  
Pectus Excavatum ◽  
Inhaled Corticosteroids ◽  
Oral Prednisolone ◽  
Ciliary Movement ◽  
History Of ◽  
Lung Infections ◽  
Long Acting ◽  
Married Male

Introduction. Kartagener?s syndrome is a recessive autosomal disease which is mainly seen to affect ciliary movement. The symptoms of the syndrome are the consequence of the defective motility of the cilia found in the respiratory tract and that results with recurrent lung infections caused by mucus stasis in the bronchi. Case report. A 37-year-old married, male father of one child, presented with a history of productive cough, wheezing, dispnea, headache, temporary fever. In his 9th year of age, 1986, situs inversus, sinusitis and pectus excavatum were diagnosed. In 1994 he was operated for correction of pectus excavatum. Bronchial asthma was diagnosed in 2008 when he was 31. In the last 2 years he had episodes of breathlessness, wheezing, cough, expectoration, headache, fever and fast declining lung function. The patient was treated with combination of inhaled bronchodilatators (inhaled corticosteroids + long-acting ?-2 agonist), and occasional administration of antibiotics, oral prednisolone, mucolytics in episodes of exacerbations of disease over a period of 7?14 days. Conclusion. Treatment for patients with this syndrome has not been established yet, but it is important to control chronic lung infections and prevent declining of lung function.

scholarly journals The effectiveness of long-term aripiprazole injections to a patient with paranoid schizophrenia: a case report

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anna Maria Szota ◽  
Aleksander Araszkiewicz
Keyword(s):  
Case Report ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Paranoid Schizophrenia ◽  
Psychotic Symptoms ◽  
Suicidal Thoughts ◽  
Duration Of Hospitalization ◽  
History Of ◽  
Long Acting

AbstractParanoid schizophrenia is a chronic, psychotic disorder which can be treated with long-acting injectable (LAI) antipsychotic drugs. There are risperidone (Risperdal Consta®), olanzapine (Zypadhera®), paliperidone (Xepilon®) and aripiprazole (Abilify Maintena®) currently available.The aim of this study was to present a case history of the patient to whom monthly injections of aripiprazole effectively prevented both relapses of psychotic symptoms and hospitalizations.Case report: A 55-year-old male patient with a 13-year history of paranoid schizophrenia has been effectively treated with aripiprazole (LAI) (400mg, every 4 weeks). During the last 8 years of treatment his mental state has been stabilized, without any acute psychotic symptoms and without any anxiety, or violent behaviours. Moreover, there have been no psychotic symptoms, or suicidal thoughts, or tendencies recordered. Therefore, no hospitalization has been required. However, despite the treatment, negative symptoms such as blunted affect, cognitive dysfunction and social withdrawal have been sustained.Discussion: The available articles on aripiprazole (LAI) treatment indicate that it was effective in reducing the positive and negative symptoms of schizophrenia, as well as reducing the frequency and duration of hospitalization. However, the case report of a patient who has not had relapses of psychotic symptoms and suicidal thoughts and has not been hospitalized during 8 years of treatment with aripiprazole (LAI) has not yet been reported.Conclusions: Regular, long-term injections of aripiprazole (LAI) are very effective at preventing positive symptoms of schizophrenia development and preventing both suicidal thoughts and hospitalizations. Therefore, treatment with this drug in everyday practice should be increased.

scholarly journals Comparing LAMA with LABA and LTRA as add-on therapies in primary care asthma management

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Alan Kaplan ◽  
J. Mark FitzGerald ◽  
Roland Buhl ◽  
Christian Vogelberg ◽  
Eckard Hamelmann
Keyword(s):  
Primary Care ◽  
Lung Function ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Global Initiative For Asthma ◽  
Control Asthma ◽  
Global Initiative ◽  
Long Acting ◽  
Randomised Controlled ◽  
Meta Analyses

Abstract The Global Initiative for Asthma recommends a stepwise approach to adjust asthma treatment to the needs of individual patients; inhaled corticosteroids (ICS) remain the core pharmacological treatment. However, many patients remain poorly controlled, and evidence-based algorithms to decide on the best order and rationale for add-on therapies are lacking. We explore the challenges of asthma management in primary care and review outcomes from randomised controlled trials and meta-analyses comparing the long-acting muscarinic antagonist (LAMA) tiotropium with long-acting β2-agonists (LABAs) or leukotriene receptor antagonists (LTRAs) as add-on to ICS in patients with asthma. In adults, LAMAs and LABAs provide a greater improvement in lung function than LTRAs as add-on to ICS. In children, results were positive and comparable between therapies, but data are scarce. This information could aid decision-making in primary care, supporting the use of add-on therapy to ICS to help improve lung function, control asthma symptoms and prevent exacerbations.

scholarly journals Pro: Inhaled corticosteroids for chronic obstructive pulmonary disease

2019 ◽  
Vol 2 (1) ◽  
pp. 35-40
Author(s):  
Donald A. Mahler
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Mechanisms Of Action ◽  
Phase Iii ◽  
Chronic Obstructive ◽  
Exacerbation Rate ◽  
Obstructive Pulmonary Disease ◽  
Long Acting

Background: Controversy exists about the use of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD). Although ICS are not approved as monotherapy for COPD, four ICS molecules, beclomethasone, budesonide, fluticasone furoate, and fluticasone propionate, are used widely in combination with long-acting bronchodilators to treat patients with this disease. Objectives: (1) To review the mechanisms of action of ICS therapy that contribute to the clinical benefits in COPD; and (2) to describe improvements in lung function, relief of dyspnea, increase in exercise tolerance, and the reduction in exacerbations with ICS use in COPD. Methods: A critical review of phase III and IV randomized clinical trials that evaluated ICS therapy in patients with COPD. Results: ICS have two major mechanisms of action in human airways: a reduction in edema and inflammation, and a decrease in airway hyperresponsiveness. ICS monotherapy significantly increases the morning peak expiratory flow rate and forced expiratory volume in 1 second (peak and trough) as early as the first day of treatment. Discontinuation of ICS therapy leads to deterioration in lung function. Treatment with ICS, alone and in combination with a long-acting bronchodilator, reduces dyspnea related to daily activities, whereas withdrawal increases breathing difficulty. Patients with COPD exhibit a significant increase in exercise duration with ICS therapy. The combination of ICS with one or more bronchodilators significantly reduces the exacerbation rate compared with bronchodilator therapy alone. The major serious adverse effect is an increased risk of pneumonia. Conclusion: Randomized controlled trials demonstrate that ICS therapy improves both physiologic and clinical outcomes in patients with COPD. These benefits are enhanced when ICS molecules are combined with one or more long-acting bronchodilators.

scholarly journals Revisiting early intervention in adult asthma

2015 ◽  
Vol 1 (1) ◽  
pp. 00022-2015 ◽  
Author(s):  
Tari Haahtela ◽  
Olof Selroos ◽  
Paul M. O'Byrne
Keyword(s):  
Early Intervention ◽  
Lung Function ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Time Frame ◽  
Normal Lung ◽  
Lung Function Decline ◽  
Mild Disease ◽  
Short Period ◽  
Long Acting

The term “early intervention” with inhaled corticosteroids (ICS) in asthma is used in different ways, thereby causing confusion and misinterpretation of data. We propose that the term should be reserved for start of ICS therapy in patients with a diagnosis of asthma but within a short period of time after the first symptoms, not from the date of diagnosis. Prospective clinical studies suggest a time frame of 2 years for the term “early” from the onset of symptoms to starting anti-inflammatory treatment with ICS.The current literature supports early intervention with ICS for all patients with asthma including patients with mild disease, who often have normal or near-normal lung function. This approach reduces symptoms rapidly and allows patients to achieve early asthma control. Later introduction of ICS therapy may not reduce effectiveness in terms of lung function but delays asthma control and exposes patients to unnecessary morbidity. Results of nationwide intervention programmes support the early use of ICS, as it significantly minimises the disease burden.Acute asthma exacerbations are usually preceded by progressing symptoms and lung function decline over a period of 1–2 weeks. Treatment with an increased dose of ICS together with a rapid- and long-acting inhaled β2-agonist during this phase has reduced the risk of severe exacerbations.

scholarly journals Inhaled corticosteroids in COPD: friend or foe?

2018 ◽  
Vol 52 (6) ◽  
pp. 1801219 ◽  
Author(s):  
Alvar Agusti ◽  
Leonardo M. Fabbri ◽  
Dave Singh ◽  
Jørgen Vestbo ◽  
Bartolome Celli ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Lower Body ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Clinical Benefits ◽  
History Of ◽  
Bronchodilator Treatment ◽  
Long Acting ◽  
Blood Eosinophils

The efficacy, safety and positioning of inhaled corticosteroids (ICS) in the treatment of patients with chronic obstructive pulmonary disease (COPD) is much debated, since it can result in clear clinical benefits in some patients (“friend”) but can be ineffective or even associated with undesired side effects,e.g.pneumonia, in others (“foe”). After critically reviewing the evidence for and against ICS treatment in patients with COPD, we propose that: 1) ICS should not be used as a single, stand-alone therapy in COPD; 2) patients most likely to benefit from the addition of ICS to long-acting bronchodilators include those with history of multiple or severe exacerbations despite appropriate maintenance bronchodilator use, particularly if blood eosinophils are >300 cells·µL−1, and those with a history of and/or concomitant asthma; and 3) the risk of pneumonia in COPD patients using ICS is higher in those with older age, lower body mass index (BMI), greater overall fragility, receiving higher ICS doses and those with blood eosinophils <100 cells·µL−1. All these factors must be carefully considered and balanced in any individual COPD patient before adding ICS to her/his maintenance bronchodilator treatment. Further research is needed to clarify some of these issues and firmly establish these recommendations.

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