Stendermacias2464

CONCLUSION The present case highlights the peculiarity of the follow-up of adrenal masses in cancer patients and the primary role of 18F-FDG-PET/CT in the management of such patients.INTRODUCTION Airway obstruction is usually assessed by measuring forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF). This post hoc study investigated comparative responses of lung function measurements in adults and adolescents (full analysis set, N = 3873) following treatment with tiotropium Respimat®. METHODS Lung function outcomes were analysed from five phase III trials in adults (≥ 18 years) with symptomatic severe, moderate and mild asthma (PrimoTinA-asthma®, MezzoTinA-asthma® and GraziaTinA-asthma®, respectively), and one phase III trial in adolescents (12-17 years) with symptomatic moderate asthma (RubaTinA-asthma®). Changes from baseline versus placebo in FEV1, FVC, PEF and FEV1/FVC ratio with tiotropium 5 µg or 2.5 µg added to at least stable inhaled corticosteroids at week 24 (week 12 in GraziaTinA-asthma) were analysed. RESULTS All lung function measures improved in all studies with tiotropium 5 µg (mean change from baseline versus placebo), includinment with a drug that opens the airways (tiotropium), and comparisons were made between adults and adolescents with asthma. We also looked at people with severe asthma and those whose asthma was less severe. Tiotropium improved all the measures of lung function in both age groups and across severities. One measure improved more in adults than in adolescents. This may be because adolescents had better lung function at the start and thus less room for improvement, or because the adolescents had not had asthma for as long, and so may have had less long-term damage to their airways than adults.Trial Registration Numbers NCT00772538, NCT00776984, NCT01172808, NCT01172821, NCT01316380, NCT01257230.PURPOSE OF REVIEW Organochlorine pesticides (OCPs) have been intensely used and produced in South America. Although they were banned before the year 2000 (excepting endosulfan, which has been recently banned in several countries), OCPs remain detectable in marine environments of this continent, sometimes at risky levels for biota. This manuscript summarizes studies on OCP levels in the air, water, sediment, bivalves, fish, and marine mammals of the South American coasts and open waters over the last 20 years, tackling their spatial distribution and analyzing their associated ecotoxicological risk. RECENT FINDINGS To the best of our knowledge, this is the first study integrating all available information on current levels of OCPs in South American marine environments. The 63 researches reviewed studied punctual sites or environmental compartments. The OCP levels were higher in semi-enclosed environments such as bays and estuaries, close to large cities. In terms of individual OCPs, dichlorodiphenyltrichloroethane (DDT) and its degradation products were more abundant than other OCPs in all the environmental compartments, excepting air, for which the most abundant OCP was endosulfan. Depending on the location and the environmental matrix, hexachlorocyclohexanes (HCHs), heptachlors, mirex, and endosulfans followed DDTs. Aldrin, dieldrin and endrin, hexachlorobenzene (HCB), and chlordanes were found at very low levels in most matrices and sites, with some exceptions. Considering their potential ecotoxicological risk, most sites would be safe for biota; however, the levels of some OCPs could damage the structure and function of the communities of several coastal sites in a short or long term, mainly in southeastern Brazil and on the coast of the Argentine Pampas. Moreover, it remains to evaluate many sites potentially contaminated by OCPs.INTRODUCTION The EQ-5D-3L (3L) and EQ-5D-5L (5L) are both frequently used measures of health status. Previous studies have found the EQ-5D-5L to have superior measurement properties but no study has compared the two measures in a large general population survey using matched respondents. METHODS Using data from the GP Patient Survey, coarsened exact matching was used to match individuals completing the 3L in 2011 with those completing the 5L in 2012. Measurement properties were assessed for a general population and multimorbid population (chronic conditions ≥ 2), with ceiling effects, informativity and distribution of response compared. Changes in the direction of response, as well as the impact on utility distributions, were quantified. Vorinostat chemical structure RESULTS Matching resulted in a cohort of 1,023,218 respondents (2011 511,609; 2012 511,609) for analysis. Ceiling effects for the 5L were lower than the 3L (43.8% vs. 54.4%). The 5L had improved informativity and broader spread of responses than the 3L (5L top 50 profiles 77.4% vs. 3L 98.8%). Overall, there was an upwards shift in utility values for the 5L versus the 3L as respondents using the 5L reported ill health more frequently but with less severity. Measurement improvements and effects on utility values were more pronounced for the multimorbid population. CONCLUSION The 5L had superior measurement properties than the 3L and should be preferred in general population surveys and for use in individuals with multimorbidity. At increasing levels of morbidity, the 5L is currently associated with higher utility values than the 3L.Autoimmune blistering disease management can be challenging as treatment modalities vary greatly and no single standard of care exists. We consolidated the recommendations of international management guidelines in order to provide optimal management suggestions to physicians. A comprehensive literature search in PubMed/MEDLINE for published blistering disease management guidelines and consensus statements was conducted in November 2019. Search terms included "guideline or guidelines" or "consensus" and "pemphigoid" or "autoimmune blistering disease" or "epidermolysis bullosa acquisita". We included guidelines from established dermatologic societies and expert consensus groups. We excluded literature reviews, guidelines established by an association without dermatologists, or those specific to a single treatment. Guidelines in all languages were considered. Eleven guidelines from dermatologic associations and consensus groups meeting our inclusion criteria were selected. Several differences between recommendations, most notably when to introduce adjuvants for refractory disease, were found in bullous pemphigoid.