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Actas Dermo-sifiliograficas 2020Recurrent aphthous stomatitis is a chronic inflammatory disease of the oral mucosa. It is characterized by painful mouth ulcers that cannot be explained by an underlying... (Review)
Review
Recurrent aphthous stomatitis is a chronic inflammatory disease of the oral mucosa. It is characterized by painful mouth ulcers that cannot be explained by an underlying disease. Recurrent oral mucosal ulcers require a proper differential diagnosis to rule out other possible causes before recurrent aphthous stomatitis is diagnosed. The condition is common, with prevalence rates ranging from 5 to 60% in different series. Its pathogenesis is unknown, but multiple factors are considered to play a part. There are no standardized treatments for this condition and none of the treatments are curative. The goal of any treatment should be to alleviate pain, reduce the duration of ulcers, and prevent recurrence.
Topics: Humans; Mouth Mucosa; Oral Ulcer; Pain; Recurrence; Stomatitis, Aphthous
PubMed: 32451064
DOI: 10.1016/j.ad.2019.09.004 -
The American Journal of the Medical... Nov 2018The intestinal microbiota are important in human growth and development. Microbial composition may yield insights into the temporal development of microbial communities... (Review)
Review
The intestinal microbiota are important in human growth and development. Microbial composition may yield insights into the temporal development of microbial communities and vulnerabilities to disorders of microbial ecology such as recurrent Clostridium difficile infection. Discoveries of key microbiome features of carbohydrate and amino acid metabolism are lending new insights into possible therapies or preventative strategies for inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). In this review, we summarize the current understanding of the development of the pediatric gastrointestinal microbiome, the influence of the microbiome on the developing brain through the gut-brain axis, and the impact of dysbiosis on disease development. Dysbiosis is explored in the context of pediatric allergy and asthma, recurrent C. difficile infection, IBD, IBS, and metabolic disorders. The central premise is that the human intestinal microbiome plays a vital role in health and disease, beginning in the prenatal period and extending throughout childhood.
Topics: Adolescent; Brain; Child; Child, Preschool; Disease; Dysbiosis; Gastrointestinal Microbiome; Humans; Infant; Infant, Newborn
PubMed: 30384950
DOI: 10.1016/j.amjms.2018.08.005 -
Eye (London, England) Dec 2020Herpes simplex keratitis (HSK) is a common, potentially blinding condition characterised by recurrent infections of the cornea, seen by both general ophthalmologists and... (Review)
Review
Herpes simplex keratitis (HSK) is a common, potentially blinding condition characterised by recurrent infections of the cornea, seen by both general ophthalmologists and corneal specialists. Successful treatment of recurrences reduces disease duration, prevents progressive corneal scaring leading to vision loss and reduces risk of further recurrences. In this review we discuss the relative advantages of the diagnostic laboratory investigations including polymerase chain reaction, viral culture and fluorescence-based immunohistochemistry. We review treatment strategies in selected aspects of HSK and discuss the management options in cases not responding to treatment.
Topics: Cornea; Herpes Simplex; Humans; Keratitis, Herpetic; Polymerase Chain Reaction; Recurrence
PubMed: 32843744
DOI: 10.1038/s41433-020-01153-x -
Advances in Clinical and Experimental... Jun 2019Epidemiological data regarding venous leg ulcers, specifically low healing rates and frequent recurrences (occurring in 20-70% of the cases), seems surprising regarding... (Review)
Review
Epidemiological data regarding venous leg ulcers, specifically low healing rates and frequent recurrences (occurring in 20-70% of the cases), seems surprising regarding recent progress in the management of this complication. The aim of this review is to present the current state of knowledge on venous leg ulcer management, especially compression therapy. Treatment of venous ulcers should be comprehensive and wellorganized, based on modern standards and up-to-date, and should involve elaborated treatment strategies. A thorough diagnostic process followed by adequate treatment may result in marked improvement of the outcomes, with up to 67% healing rate at 12 weeks and up to 81% within 24 weeks. Continuation of therapeutic activities after the ulceration has been healed is reflected by a marked decrease in the recurrence rates, down to 16% whenever the patient is actively involved in the therapeutic process. Furthermore, early diagnosis and appropriate causal treatment may prevent progression of the illness.
Topics: Compression Bandages; Disease Progression; Humans; Recurrence; Stockings, Compression; Varicose Ulcer; Wound Healing
PubMed: 30085435
DOI: 10.17219/acem/78768 -
Arquivos Brasileiros de Cardiologia 2020
Topics: Chronic Disease; Electrocardiography; Humans; Recurrence; Takotsubo Cardiomyopathy
PubMed: 32267318
DOI: 10.36660/abc.20200080 -
La Revue Du Praticien Jan 2021"Pericarditis Acute pericarditis is a common disease, most often idiopathic or viral. This is usually a mild condition but recurrences are frequent. The predominant... (Review)
Review
"Pericarditis Acute pericarditis is a common disease, most often idiopathic or viral. This is usually a mild condition but recurrences are frequent. The predominant pathophysiological hypothesis is that of underlying dysimmune disorders, involving an inflammatory response of the innate immune system typical of "autoinflammatory diseases", mainly mediated by interleukin-1 [IL-1] with activation of inflammasome; and an adaptive immune system response, typical of «autoimmune diseases», primarily mediated by autoantibodies and autoreactive T cells. The clinical picture associates fever, chest pain, changes in the electrocardiogram and possible pericardial effusion. Treatment is based on the combination of aspirin/nonsteroidal anti-inflammatory drugs and colchicine for several weeks. In refractory pericarditis, low dose corticosteroid therapy and / or immunosuppressive agents have been proposed with limited efficacy. Growing evidency suggest a place for IL-1 receptor antagonists in the treatment of recurrent pericarditis. Many studies have shown the effectiveness of anakinra with a good safety profile. Other IL-1 receptor antagonists have shown promising results (canakinumab, rilonacept). Further evaluation in larger prospective clinical trials is needed to confirm the long-term efficacy and safety of anti-IL1."
Topics: Aspirin; Colchicine; Humans; Interleukin 1 Receptor Antagonist Protein; Pericarditis; Prospective Studies; Recurrence
PubMed: 34160952
DOI: No ID Found -
Current Cardiology Reports Jan 2022We reviewed the contemporary literature and clinical trials to discuss the applications of the interleukin-1 (IL-1) inhibitor rilonacept to treat pericarditis, with... (Review)
Review
PURPOSE OF REVIEW
We reviewed the contemporary literature and clinical trials to discuss the applications of the interleukin-1 (IL-1) inhibitor rilonacept to treat pericarditis, with regards to pathophysiology, pharmacology, efficacy, and safety.
RECENT FINDINGS
Rilonacept is an emerging novel agent for treating recurrent pericarditis, with phase II and III clinical trials recently published. Rilonacept rapidly resolved pericarditis pain and inflammation, markedly reduced recurrent pericarditis episodes, and had few adverse events indicating a high safety profile. Recurrent pericarditis is associated with significant morbidity and unmet need for novel therapies. Inflammasomes and the IL-1 pathways were found to be critical in its pathophysiology, leading to IL-1 inhibitors being developed. The high efficacy and safety of rilonacept for recurrent pericarditis means it could potentially be considered as a second-line therapy ahead of or as an alternative to corticosteroids, and highlight the great promise of targeted immunomodulatory therapy in this field.
Topics: Humans; Inflammasomes; Interleukin-1; Pericarditis; Recombinant Fusion Proteins; Recurrence
PubMed: 34993745
DOI: 10.1007/s11886-021-01621-0 -
Indian Pediatrics Feb 2015Recurrent Kawasaki disease is rare.
BACKGROUND
Recurrent Kawasaki disease is rare.
CASE CHARACTERISTICS
An eight-month old infant had classic Kawasaki disease with transient coronary artery dilatation.
OBSERVATIONS
Recurrence of incomplete Kawasaki disease after two years of initial diagnosis.
OUTCOME
The index episode of Kawasaki disease was resistant to single infusion of immunoglobulin, while repeat episode responded within 24 hours of institution of therapy.
MESSAGE
Early recognition of recurrent Kawasaki disease requires a high index of suspicion.
Topics: Child, Preschool; Foot; Humans; Infant; Male; Mucocutaneous Lymph Node Syndrome; Recurrence; Skin; Treatment Outcome
PubMed: 25691189
DOI: No ID Found -
BMJ Case Reports Aug 2020Thoracic endometriosis syndrome (TES) is a rare entity caused by thoracic implantation of endometrial tissue, manifesting as catamenial pneumothorax, pleural effusion...
Thoracic endometriosis syndrome (TES) is a rare entity caused by thoracic implantation of endometrial tissue, manifesting as catamenial pneumothorax, pleural effusion and haemoptysis in young female individuals. Its management and long-term prevention of recurrences, can be challenging. We present the case of a young woman who presented with recurrent pneumothorax, haemopneumothorax and pleural effusion. The diagnosis of TES was confirmed based on cytological findings of pleural fluid. She underwent treatment with mechanical pleurodesis twice but continued to have recurrences. Hormonal treatment failed to produce a satisfactory resolution. She underwent chemical pleurodesis, which successfully induced remission of her TES. A review of the literature suggests that chemical pleurodesis produces better results compared with mechanical pleurodesis and that hormonal treatment with gonadotropin-releasing hormone agonists is effective at preventing recurrences.
Topics: Adult; Biopsy; Endometriosis; Female; Humans; Intubation; Recurrence; Thoracentesis; Thoracic Diseases; Thoracic Surgery, Video-Assisted
PubMed: 32816934
DOI: 10.1136/bcr-2020-235965 -
International Journal of Molecular... Mar 2016Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of... (Review)
Review
Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.
Topics: Child; Communicable Diseases; Diagnosis, Differential; Fever; Hereditary Autoinflammatory Diseases; Humans; Recurrence
PubMed: 27023528
DOI: 10.3390/ijms17040448