Patients with pneumonia could expect significant relief coming their way with steroids, even better than what could have been achieved with the use of antibiotics alone, as per a study by researchers from the UT Southwestern Medical Center.

Health of a patient with pneumonia can be restored back with a combination of steroids and antibiotics, according to the study.

From News-medical.net:

Adding corticosteroids to traditional antimicrobial therapy might help people with pneumonia recover more quickly than with antibiotics alone, UT Southwestern Medical Center scientists have found.

Unlike the anabolic steroids used to bulk up muscle, corticosteroids are often used to treat inflammation related to infectious diseases, such as bacterial meningitis. Used against other infectious diseases, however, steroid therapy has been shown to be ineffective or even harmful.

In a study available online and in a future issue of the Journal of Infectious Diseases, researchers at UT Southwestern show that mice infected with a type of severe bacterial pneumonia and subsequently treated with steroids and antibiotics recovered faster and had far less inflammation in their lungs than mice treated with antibiotics alone.

The combination can also be effective to provide relief to patients in midst of an asthma attack (M pneumoniae infection).

Clinical trials will soon be conducted to confirm the findings, as per Dr. Robert Hardy, Study’s Senior Author & Associate Professor of Internal Medicine and Pediatrics.

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A class of antibiotics, systematic fluoroquinolones, which is used as a treatment option for bacterial infections, could possibly lead to double vision, as per a review of the safety and efficacy of a commonly-used corneal transplant procedure that was highlighted by September’s Ophthalmology, the journal of the American Academy of Ophthalmology.

Administration of fluoroquinolone in a systemic manner to treat a wide range of bacterial infections could result in diplopia or double vision in some of the patients, as per the review.

From News-Medical.net:

The researchers, led by Frederick W. Fraunfelder, M.D., found 171 cases between 1986 and 2009 of fluoroquinolone use associated with double vision through a review of reports from the Food and Drug Administration, World Health Organization, and the National Registry of Drug-Induced Ocular Side Effects. The median patient age was 51.6 years, medication doses were within recommended levels, and the interval from starting medication to onset of double vision was 9.6 days on average. Medication was discontinued in 53 patients, and diplopia resolved in all cases.

“Doctors need to be aware of this potential reaction when prescribing these antibiotics and consider stopping therapy if diplopia occurs,” Dr. Fraunfelder said. He also said that special care should be taken with patients who are older than 60, have had renal failure, or are taking steroids, and that thorough ophthalmic and neurological exams should be done to rule out other causes of double vision.

Before the review, it was considered that double vision is caused by tendinitis in the muscles around the eyes.

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In a bid to highlight the dangers of purchasing drugs online, Operation Pangea II was coordinated by INTERPOL and the World Health Organization’s International Medical Products Anti-Counterfeiting Taskforce (IMPACT). This joint operation was exercised to curb the supply of dangerous and illegal medicines.

The global initiative, lasting for a week, was marked by a series of arrests and seizure of thousands of potentially harmful medical products.

From News-Medical.Net:

During the operation, Internet monitoring revealed 751 websites engaged in illegal activity, including offering controlled or prescription only drugs, 72 of which have now been taken down. In addition, more than 16,000 packages were inspected by regulators and customs, 995 packages were seized and nearly 167,000 illicit and counterfeit pills - including antibiotics, steroids and slimming pills, confiscated.

Twenty-two individuals are currently under investigation for a range of crimes including illegally selling and supplying unlicensed or prescription-only medicines.

“As the very positive results of this global effort are made public, INTERPOL and its member countries will prove again that the Internet is not an anonymous safe haven for those who use it for criminal purposes. We hope that by raising public awareness about the dangers of illegal internet pharmacies, consumers will exercise greater care when purchasing medicines on the Internet,” added Secretary General Noble.

“Our thanks go to the police, customs and regulatory officials in the 24 participating countries as well as to our partner international organizations such as the World Health Organization’s IMPACT, the World Customs Organization and Universal Postal Union whose tireless efforts and dedication have made Operation Pangea II such a success,” Noble concluded.

The operation received significant support from the Permanent Forum on International Pharmaceutical Crime (PFIPC) the World Customs Organization, the UK’s Medicines and Health Care products Regulatory Agency (MHRA), the US Food and Drug Administration (FDA) and Immigration and Customs Enforcement (ICE), the Royal Canadian Mounted Police, and Health Canada.

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A lump in the breast region is a possible sign of breast cancer for many of us but we may not be aware of one type of breast cancer, inflammatory breast cancer that may not be characterized by any lump.

Sofia Merajver, M.D., Ph.D., co-director of the Breast Oncology Program at the University of Michigan Comprehensive Cancer Center, remarked that this complication warrants urgent diagnosis so that life of afflicted patients could be saved.

From News-Medical.Net:

Inflammatory breast cancer is a very aggressive type of cancer in which the cancerous cells move rapidly throughout the breast and clog the lymph vessels in the skin, causing the breast to look swollen, red, itchy or inflamed. It’s often mistaken for a rash or infection and many women are initially treated with antibiotics or steroids.

“There are many options for treating this disease. In many cases, the treatment is going to be on and off for life. There will be times of remission, but this is a serious disease that has a high chance of recurring,” says Merajver, a professor of internal medicine at the U-M Medical School.

About inflammatory breast cancer

* Represents 3 percent to 6 percent of the 180,000 women diagnosed with breast cancer each year.

* With treatment, 20 percent to 40 percent of patients survive 10 years. This is up from 5 percent to 10 percent 20 years ago.

* Characterized by redness, warmth or an orange-skin appearance on the skin of the breast. A persistent red breast should be biopsied promptly.

* May or may not cause a lump or mass.

* Treatment includes aggressive chemotherapy, followed by surgery and radiation therapy.

It was also remarked by Merajver that U-M Inflammatory Breast Cancer Clinic will be turning into a clearinghouse to communicate information pertaining to tertiary care and advice.

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A study published on bmj.com has reported that a single dose of corticosteroid drugs together with antibiotics can be used for alleviating pain and this treatment is more effective than with antibiotics alone. However, it was not indicated that this finding holds equally good for children with sore throat.

Dr Matthew Thompson at the University of Oxford and collaborators expected the premise that corticosteroids can successfully ease sore throat symptoms because of their anti-inflammatory effects.

From MedicalNewsToday.com:

The results of eight trials were analyzed. They compared corticosteroids to placebo in adults or children. Overall, 743 patients were involved in the trial, including 369 children and 374 adults. They all had symptoms of severe sore throat.

In order to reduce partiality, variations in study feature and quality were considered.

Results showed patients given corticosteroids together with antibiotics were three times more likely to report total clearing up of pain after 24 hours than patients given placebo. After 48 hours the effect on pain was less evident. According to the authors, this indicates that a single dose of corticosteroids may be sufficient.

In addition, corticosteroids reduced the average time to pain relief by about six hours. But, the researchers specify that considerable effects were observed only in adult patients and only in those receiving oral corticosteroids. After assessing the trials, it was apparent that the use of simple painkillers made no difference.

The authors explain: “These findings suggest that, in patients with severe sore throat, pain can be reduced and resolution hastened by use of corticosteroids in conjunction with antibiotic therapy.” They write in conclusion: “These results may also help to prevent antibiotic use, particularly in the context of delayed prescribing. Future research should focus on the effect of corticosteroids independent of antibiotics.”

It was acknowledged by an associated editorial that steroids can minimize pain in the first day but the editorial cautioned about lack of information on the possible harmful effects.

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A promising target for a new class of antibiotics has been identified by researchers at the Technische Universität München (TUM). This finding is expected to provide insights on how to tackle with bacterial stems developing resistance to previously life-saving antibiotics.

The new target is expected to cast light on a metabolic step, which appears in many aggressive microorganisms such as malaria or tuberculosis pathogens.

Results of the work by involved researchers were presented in an issue of the chemistry journal Angewandte Chemie.

From Sciencedaily.com:

The cells of virtually all life forms synthesize essential natural substances belonging to the class of terpenes and steroids from the small isoprene building blocks dimethylallyl pyrophosphate (DMAPP) and isopentenyl pyrophosphate (IPP). Mammals and a large number of other organisms generate these essential metabolites via the so-called mevalonate pathway. But most human pathogens, including Plasmodium falciparum, have developed an alternate mechanism for producing these important substances. Now, this special pathway may spell doom for those bacteria. The TUM researchers have unraveled the structural basis of the terminal step in bacterial isoprene synthesis. The crucial enzyme has a most unusual structure, similar to a three-leaf clover, and may open a forceful line of attack for custom-tailored antibiotics.

The structural basis for new reaction steps critical to microorganisms but playing no relevant role in humans was described in detail by Professor Michael Groll, Dr. Jörg Eppinger and Dr. Tobias Gräwert, biochemists at the Technische Universität München, and their team of researchers.

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In order to curb the supply of dangerous and illegal medicines, Operation Pangea II was coordinated by INTERPOL and the World Health Organization’s International Medical Products Anti-Counterfeiting Taskforce (IMPACT). This was for highlighting the dangers of purchase of drugs online.

This week-long global initiative saw a series of arrests and seizure of thousands of potentially harmful medical products.

From News-Medical.Net:

During the operation, Internet monitoring revealed 751 websites engaged in illegal activity, including offering controlled or prescription only drugs, 72 of which have now been taken down. In addition, more than 16,000 packages were inspected by regulators and customs, 995 packages were seized and nearly 167,000 illicit and counterfeit pills - including antibiotics, steroids and slimming pills, confiscated.

Twenty-two individuals are currently under investigation for a range of crimes including illegally selling and supplying unlicensed or prescription-only medicines.

“As the very positive results of this global effort are made public, INTERPOL and its member countries will prove again that the Internet is not an anonymous safe haven for those who use it for criminal purposes. We hope that by raising public awareness about the dangers of illegal internet pharmacies, consumers will exercise greater care when purchasing medicines on the Internet,” added Secretary General Noble.

“Our thanks go to the police, customs and regulatory officials in the 24 participating countries as well as to our partner international organizations such as the World Health Organization’s IMPACT, the World Customs Organization and Universal Postal Union whose tireless efforts and dedication have made Operation Pangea II such a success,” Noble concluded.

This operation received significant support from the Permanent Forum on International Pharmaceutical Crime (PFIPC) the World Customs Organization, the UK’s Medicines and Health Care products Regulatory Agency (MHRA), the US Food and Drug Administration (FDA) and Immigration and Customs Enforcement (ICE), the Royal Canadian Mounted Police and Health Canada.

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According to a systematic review of literature published in an update of The Cochrane Library, topical quinolone antibiotics are better than systemic antibiotics for clearing aural discharge.

This complication, generally, occurs in the first five years of life but can persist to adulthood. It is important to note that untreated chronic suppurative otits media (CSOM) can lead to permanent hearing loss due to damage of small sound-transmitting bones in the middle ear.

From News-Medical.Net:

A systematic review of literature found that short courses of topically administered quinolone antibiotic drops such as ciprofloxacin were more effective at drying the ear than oral or injected antibiotics. The Review Authors were unable to find enough high quality data to assess the value of topical non-quinolone antibiotics that do not contain steroids, or of antiseptic treatments, when compared to systemic treatments.

“Less is known about the longer-term outcomes, or about treating complicated CSOM,” says lead author Carolyn Macfadyen a Research Associate at the International Health Research Group in the Liverpool School of Tropical Medicine, UK.

The Review Authors also noted that the evidence regarding safety of topical antibiotics is weak, and believe that clinicians should watch for any signs of ototoxicity when using topical treatment, particularly for non-quionlones such as aminoglycoside.

Macfadyen remarked that cost effectiveness of alternative treatments would be critical to guide both clinical practice and health policy.

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Offices of pediatricians are now full of people complaining about skin irritations caused by toilet seats, as per a research led by Johns Hopkins Children’s Center investigator Bernard Cohen, M.D.

Cohen, director of pediatric dermatology at Hopkins Children’s, said that toilet seat dermatitis is one of those legendary conditions described in medical textbooks but young pediatricians do not see any related issues in their daily practice.

From Sciencedaily.com:

Cohen says children can develop irritation after several uses of a wooden seat or repeated exposure to residue from harsh cleaning chemicals. He urges pediatricians to inquire about toilet seats and cleaners used both at home and at school any time they see a toddler or a young child with skin irritation around the buttocks or upper thighs.

The researchers say most cases are fairly benign and easy to treat with topical steroids, but because many pediatricians don’t suspect the cause and don’t treat it properly, the inflammation can persist and spread further, causing painful and itchy skin eruptions and unnecessary misery for both children and parents. Persistently irritated skin is vulnerable to bacteria and may lead to more serious infections requiring oral antibiotics. Indeed, missed and delayed diagnoses were a hallmark of every single case described in the review.

Dermatologist Paramoo Sugathan, M.D., of Baby Memorial Hospital, Calicut, Kerala, India, was co-investigator in the study.

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Pneumonia patients have something as a relief now.

The combination of corticosteroids to the traditional antimicrobial therapy may be regarded as an effectual form of treatment for helping pneumonia patients recover faster than with antibiotics alone, as per scientists from the UT Southwestern Medical Center.

From Sciencedaily.com:

Although antimicrobials remain the primary therapy for M pneumoniae infection, there have been several reports in recent years about physicians adding steroids to the treatment regimen of patients with severe cases, Dr. Hardy said. The problem, he said, is that those were individual case reports.

“They never had a control group, so it was impossible to tell what impact the addition of steroids had on recovery,” he said.

The new findings not only suggest that giving antibiotics with steroids can help individuals with pneumonia get better faster, but also suggest a potentially more effective therapy for someone in the midst of an asthma attack due to M pneumoniae infection. Up to 20 percent of asthma attacks in children and adults have been shown to be triggered by this bacterium.

Dr. Robert Hardy, associate professor of internal medicine and pediatrics and the study’s senior author, noted that antibiotics and steroids form a synergy together. While the antibiotics kill the bugs, steroids treat lung inflammation.

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