Archive December 2018

Everything You (and John Oliver) Need to Know About Koala Chlamydia

<h1>Everything You (and John Oliver) Need to Know About Koala Chlamydia</h1>

Everything You (and John Oliver) Need to Know About Koala Chlamydia

To honor the comedian John Oliver, the actor Russell Crowe has donated a new medical ward in Australia to treat koalas with chlamydia.

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Quote: :
To add to list:
Anti-inflammatory medications Well, there are times, especially as dogs age, that they have to take anti-inflammatory drugs.
Rimadyl is one of the more commonly prescribed, as is Prednisone . Both are used to treat arthritis or osteoarthritis and other types of inflammation. Rimadyl (carprofen) is often prescribed by vets under different names, sometimes something as simple as “vetprofen”. It’s an NSAID.
Rimadyl and Prednisone both have side effects that can hurt your dog if you keep them on it for an extended period of time.
I’ve taken Prednisone at times. I don’t like the stuff and its side effects at all, so if I don’t like it, I know my dogs won’t like it, either.
Some of my dogs have taken both at different times in their lives, but I won’t keep them on either one for more than a week or so at a time, no matter what any vet says. I trust my dogs’ doctors, but I won’t subject my dogs’ to potential liver and kidney damage if it isn’t totally necessary. That said, I will give them Tramadol in the 50mg dosage as often as I think they need it. It’s an analgesic pain reliever, and in thirty years, I’ve observed no ill effects on my dogs.

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Glucocorticoid-Induced Osteoporosis

<h1>Glucocorticoid-Induced Osteoporosis</h1>

Glucocorticoid-Induced Osteoporosis

Glucocorticoid-Induced Osteoporosis Published Dec 27, 2018 – Written by Carla Rothaus What are some of the guidelines regarding pharmacologic treatment to prevent glucocorticoid-induced fracture? Numerous randomized trials have shown that bisphosphonates (alendronate, risedronate, zoledronate, and ibandronate) increase bone mineral density in patients who receive glucocorticoids. Given their low cost and good safety profile, oral bisphosphonates are recommended as first-line agents to prevent glucocorticoid-induced fractures unless there are contraindications or unacceptable side effects. Read the latest NEJM Clinical Practice article here .
Clinical Pearls Q: When should one screen for fracture risk in patients receiving glucocorticoids? A: Screening for fracture risk should be performed soon after the initiation of glucocorticoid treatment. Vertebral fractures are the most common fractures associated with glucocorticoids; the risk of vertebral fracture increases within 3 months after initiation of treatment and peaks at 12 months.
Q: What are some of the nonpharmacologic recommendations for patients receiving glucocorticoids? A: For patients who receive glucocorticoids, routine lifestyle recommendations that are based on observational data largely from patients who have not received glucocorticoids include weight-bearing exercise, maintenance of normal weight, smoking cessation, limitation of alcohol consumption, and the assessment and management of fall risks.
Morning Report Questions Q: How are patients who should receive treatment to prevent glucocorticoid-induced fracture identified? A: Prevention of glucocorticoid-induced fractures requires identification of patients who should receive treatment. The fracture risk assessment tool (FRAX) combines many risk factors for osteoporosis (including glucocorticoid use) with the bone mineral density to provide an estimate of the 10-year risk of major osteoporotic fracture and hip fracture among patients who are at least 40 years of age. Although the risk of fracture can be calculated when the bone mineral density T score is not available, bone mineral density testing is recommended for people who receive glucocorticoids and are at least 40 years of age, since this testing improves the accuracy of FRAX estimates. Currently, tools to estimate the risk of fracture among patients who are younger than 40 years of age are lacking. When glucocorticoid use is added as a risk factor in the FRAX tool, the fracture estimates reflect the risk associated with prednisone at a dose of 2.5 to 7.5 mg per day; however, analysis of data from the U.K. General Practice Database suggests that among patients who receive more than 7.5 mg of prednisone daily, the FRAX-predicted risk of major osteoporotic fracture has to be increased by 15% and the risk of hip fracture has to be increased by 20%. However, among patients who receive very high doses of prednisone (>30 mg per day or cumulative doses to >5 g per year), this adjustment may underestimate the risk of fracture. Another limitation of the FRAX score calculation is the use of bone mineral density at the hip instead of at the lumbar spine, since glucocorticoids have the greatest negative effect on trabecular bone in the spine.
Q: What are some of the guidelines regarding pharmacologic treatment to prevent glucocorticoid-induced fracture? A: The 2017 guidelines of the American College of Rheumatology recommend pharmacologic treatment to prevent additional fractures in any patient with a previous osteoporotic fracture who is receiving glucocorticoids (prednisone dose >2.5 mg per day). Among patients who are receiving glucocorticoids and have a bone mineral density T score of −2.5 or less at either the spine or the femoral neck, pharmacologic treatment is also recommended for men who are 50 years of age or older and for postmenopausal women. Among adults who are 40 years of age or older and who do not meet the above criteria, pharmacologic treatment is recommended if the 10-year risk of major osteoporotic fracture is at least 20% or if the risk of hip fracture is at least 3% according to the FRAX tool (after increasing the risk by 15% and 20%, respectively, for a prednisone dose >7.5 mg daily).
Browse more Clinical Pearls & Morning Reports »

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Prednisone starts to take effect after about an hour and a half to 2 hours – it must be absorbed in the stomach which lakes about an hour and then must be processed by the liver to produce prednisolone which is the active form. Prednisolone works faster because it doesn’t have to go through the liver. Any form of coating on the tablets slows the absorption in the stomach so it will take longer to take effect. There will also be a bit of effect if you take the tablets with a full meal – slower than if you take it will just a glass of liquid. Prednisone achieves its peak as prednisolone in the blood in a couple of hours.
The antiinflammatory effect of pred lasts from 12 to 36 hours – everyone is a bit different.so there is no fixed time.
Withdrawal shouldn’t happen if you taper in small enough steps and again there isn’t an answer to your question – everyone is different. For some people it is just a day or two – some people feel it for a few weeks.

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Quote: : Well, there are times, especially as dogs age, that they have to take anti-inflammatory drugs.
Rimadyl is one of the more commonly prescribed, as is Prednisone . Both are used to treat arthritis or osteoarthritis and other types of inflammation. Rimadyl (carprofen) is often prescribed by vets under different names, sometimes something as simple as “vetprofen”. It’s an NSAID.
Rimadyl and Prednisone both have side effects that can hurt your dog if you keep them on it for an extended period of time.
I’ve taken Prednisone at times. I don’t like the stuff and its side effects at all, so if I don’t like it, I know my dogs won’t like it, either.
Some of my dogs have taken both at different times in their lives, but I won’t keep them on either one for more than a week or so at a time, no matter what any vet says. I trust my dogs’ doctors, but I won’t subject my dogs’ to potential liver and kidney damage if it isn’t totally necessary. That said, I will give them Tramadol in the 50mg dosage as often as I think they need it. It’s an analgesic pain reliever, and in thirty years, I’ve observed no ill effects on my dogs. I was prescribed Prednisone for poison ivy. Heavy dose; whether that worked alone or in conjunction with every internet home remedy I tried, I can’t say.
Of course, with New Year’s Eve coming, and folks shooting off fireworks, I will have to see how my new-to-me 5 month puppy handles it. Might have to dole out a Benadryl.

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O bcx.acxg.suv-trip.com.yth.gq employ electric so overjoyed topamax migraine split dosage 75-100 mg prednisone buy prednisone online no prescription generic cialis online pet meds lasix 40mg buy prednisone propecia media member effortless transplanting members.

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The presence of eosinophil aggregates correlates with increased postoperative prednisone requirement

<h1>The presence of eosinophil aggregates correlates with increased postoperative prednisone requirement</h1>

The presence of eosinophil aggregates correlates with increased postoperative prednisone requirement

Objectives/Hypothesis Failure after sinus surgery is multifactorial, but often due to recurrence of inflammatory mucosal disease. Postoperative steroid requirements for controlling mucosal inflammation may provide insight into predicting which patients require more aggressive medical therapy to prevent disease relapse.
Study Design Retrospective chart review.
Methods A review was performed of patients who underwent functional endoscopic sinus surgery (FESS) for refractory chronic rhinosinusitis (CRS). Sino‐Nasal Outcome Test‐22 scores and cumulative prednisone dose (milligrams) requirements at 1, 3, and 6 months postoperatively were reviewed. A structured histopathology report of 11 variables was accessed to correlate histopathology with postoperative steroid requirements.
Results One hundred one patients were reviewed including 42 CRS with nasal polyps and 59 CRS without nasal polyps patients. CRS patients with eosinophilia required greater cumulative steroids to control disease at 1‐, 3‐, and 6‐month postoperative intervals ( P  < .026, P  < .007, P  < .013, respectively) compared to patients without eosinophilia. Patients with tissue eosinophil aggregates required the highest cumulative steroids at 1‐, 3‐, and 6‐month postoperative intervals ( P  < .003, P  < .001, P  < .001, respectively). When removing patients with eosinophil aggregates from the eosinophilia group, no difference persisted between patients with eosinophilia and those without eosinophilia at all intervals ( P  = .664, P  = .735, P  = .800, respectively). No other histopathology variable correlated with postoperative steroid requirement.
Conclusions Tissue eosinophil aggregates appear to be the largest driving factor for increased prednisone requirements after sinus surgery to control mucosal disease than mere presence of eosinophils. This key finding may identify patients at high risk for failure after sinus surgery and guide more proactive postoperative management.
Level of Evidence 4 Laryngoscope , 2018
http://bit.ly/2s1Eqzw

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