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Sarcoidosis
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Remicade and renal sarcoidosis case Requested dosing: Remicade (infliximab) 500 mg IV every 4 weeks Indication: Renal sarcoidosis Patient was previously treated with Remicade for sarcoidosis and had experienced some relief. After two weeks this benefit subsided and the patient has since then not improved. The initial dosing frequency of the Remicade was Q6W. The patient has a relative contraindication to corticosteroids due to diabetes. While Remicade is not FDA approved for sarcoidosis, there is an off-label indication for its use in this condition. TNF is thought to contribute to granuloma formation and therefore use of TNF-alpha inhibitors are a reasonable treatment strategy. Review of Remicade dosing options in sarcoidosis: The
R.S. has been using the recommended treatment for his condition, which inlcude inhaled short-acting Beta-2 agonist and Theophylline, a bronchodilator, to control his respiratory disease.
middle of paper ... ... omomas aeroginosa. Meanwhile, a study made by Palmer found that inhaled antibiotics used as adjunct to systemic antibiotic therapy has proven to improve the clinical outcome of patients with MDR VAP (6). The study also showed a direct relationship between antibiotic resistance with the se of systematic antibiotics.
Every one in two thousand people are diagnosed with hereditary spherocytosis. This rare blood disorder is of the Northern European ancestry. The prevalence of hereditary spherocytosis in people of other ethnic backgrounds is unknown (Government). This disease should be detected in early childhood, but in some rare cases it can go undetected for years or never be detected at all. Hereditary spherocytosis not only affects the red blood cells but the spleen as well. It only takes one abnormal gene for a child to have the disease for the rest of his or her life. The disease is a reoccurring cycle, and this rare blood disorder is rare to the minds that do not have the disease, and to the minds that have not studied the disease. Although there is no definite cure a splenectomy will help maintain the disease. The million dollar question is “What is hereditary spherocytosis and is there a cure?”
L. H. a 22-year-old female who came into the clinic as a new patient complaining of lower back pain. Vital signs include: height 62 inches, weight 108 lbs., and 16 respirations. The patient stated that her back pain has gone on for quite sometime now (about 2 years total). She works as a nursing assistant in a nursing home in Wahoo. The physician stated that he wanted to taper her off tramadol (she takes 150 mg a day). He also wants to taper her off Effexor as well. The doctor noticed that the painful region was in the patient’s upper left side of her back. He recommended to the patient that L1 to L2 and L2 to L3 facets would benefit from steroid injections. The patient and her mother wanted to make sure they met their
Nelson BSN, RN, Roxanne. "Controversay Surrounds Gardasil." AJN, American Journal of Nursing 108.7 (2008): 17. Print.
The claimant is a 25-year-old female who was injured in an industrial-related incident on 01/23/16. She presented with a work-related low back pain associated with a right lower extremity radiculopathy. The request is for Methyprednisolone. However, .there was no mention that the claimant had inflammation. Further, this medication was not part of her medication regimen nor part of the treatment plan. Also, as per cited guidelines, oral corticosteroids are “not recommended for chronic pain.
Polycystic Kidney Disease, also known as PKD, is a common inherited gene disorder that causes the growth of cysts in the tissues of both the kidneys. The kidneys are a major organ in the excretory system; they remove wastes from the blood and form of urine. They filter the blood, keeping it clean of all wastes and have a number of other functions as well. Due to the growth of cysts on the kidneys it makes it hard to carry out these functions and the will eventually cause the kidneys to fail. This paper will discuss what PKD is, the many symptoms and treatments of PKD, and recent developments in research of this disease.
The patient is a 40-year-old male with chronic lower back pain and radicular symptomatology in the left lower extremity and then the right. The patient underwent epidural steroid injection therapy on 08/18/2016. The patient underwent a right L5-S1 and an S1 transforaminal ESI under fluoroscopic guidance. The patient states that he did fairly well after injection therapy up until 12/2016 when his symptoms began to come back though not nearly as intense as they were before. Previously, he was having the radicular complaints on a continuous basis. Currently, he states that he has the same type of symptoms but they are not present all the time. He also notes that his symptoms may have also gotten worse as a result of a recent urologic surgery that he underwent which required him to be lying on his back with his legs elevated for several hours until the procedure was completed. He currently denies any new changes with regards to his bowel or bladder function or increased pain with Valsalva-type maneuver. No recent fever or infection. No weight loss. No new constitutional symptoms.
...t the actual infection but instead focus on the side effects and conditions that stem from medication and the disease itself. Some of the problems that can be treated are peripheral neuropathy, myalgia, hypertension, and muscle wasting (Dudgeon, et al., 2006; Galantino & Kietrys, n.d.). As the disease progresses it may cause problems with balance and slow down oxygen use in the body (Galantino & Kietrys, n.d.).
In the use of Cinqair hypersensitivity to drug/class/components, status asthmaticus, acute asthma, acute bronchospasm, caution in long term corticosteroid usage. I would need to make sure that the patient do not have any drug interactions with this medication. People take so many different medications these days to control so many different things. There are no drug interactions known currently. This is a very new medication so that doesn’t mean that there will not be drug interactions that come to the light as usage becomes more popular. We need to advise our patients that there are possible side effects to taking this medication. Cinqair can cause serious side effects including breathing problems paleness, flushing, skin rash (hives)itching, swelling of your face, lips, mouth, or tongue, symptoms of low blood pressure (fainting, dizziness, light headedness, confusion, fast heart beat) nausea or abdominal discomfort. The most common side effects in clinical trials for Cinqair included anaphylaxis, cancer, and muscle pain (P. N. 2013, June 03). Drugs can have what is known as black box warning labels and Cinqair is one that does care this label. Black box warning anaphylaxis occurred in 0.3% of patients in placebo-controlled studies. We need to observe our patients for a suitable period after
From the results of the numerous tests carried out according to the patient history of frothy urine with a significant oedema over a maximum period of 5 days, the patient was diagnosed with Nephrotic Syndrome. This is condition that occurs due to leakage in the kidney filtration part leading to a large amount of protein leaking from the blood into the urine. This is mainly due to fluid retention known as oedema which is as a result of low protein level in the blood. It occurs due to abnormal functioning or a part of the kidney is affected (glomeruli). This syndrome can be caused by numerous diseases coming together to cause or form one particular disease; these causes range from minimal change disease, membranous nephropathy, focal segmental glomerulosclerosis (FSGS) and other conditions, disorders of the glomeruli. The membranous nephropathy also known as the membranous nephritis or membranous glomerulonephritis, only causes diseases in adults and very uncommon in children. Leakage occurs from this due to the thickening of the membranous in the glomeruli which is the filter of the glomeruli. Focal segmental glomerulosclerosis is a causative due to the formation of small scars (sclerosis) on some of the kidney glomeruli. Another form of cause of nephrotic is minimal change which is due to lack of virtual change detected in the glomeruli when examined under the microscope. This causes the syndrome in 9 out of a total of 10 children under the age of 5 years.
Urinary Tract Infection, also known as UTI, occurs in two common locations, the bladder and kidneys. The kidneys are important organs that aid in filtering out waste products from blood and maintaining water distribution throughout the body. The waste products are filtered out via bladder, which is the reason of the bladder being the second site for the infection. A normal human being has two kidneys, one on left and right side, a bean shaped organ, and is located at the back of the abdomen. “Each kidney is about 11.5 cm long, 5-7.5 cm broad, 5 cm thick, and weight about 150 grams” (HealthInfoNet, Paragraph 2). Furthermore, a bacterium named Escherichia coli lives in both the kidneys and the GI tract. E. coli is part of the human body and produces
Continuous treatment with high dose Inhaled corticosteroids (ICS) and long acting beta-agonist for at least 3 months prior to screening
According to the National Kidney Foundation, 1 in 3 Americans are at risk for kidney disease. However, Asian Americans have a higher risk for kidney disease than Caucasians. Although it’s not entirely clear why Asian’s experience kidney disease at a higher rate diabetes seems to be a risk factor along with high blood pressure, diet, and access to health care. The job of the kidneys is to clean your blood, keep the balance of salt and minerals, and help control blood pressure, when kidneys fail to do these jobs it results in kidney disease. According to the U.S. Department of Health and Human Services, the risk of diabetes is 18% higher among Asian Americans than white Americans and about 1/3 of people with diabetes develop kidney disease. The
The patient has been experiencing fever for the past 3 months but takes medication, which reduces the fever.