Internal medicine journal
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Internal medicine journal · May 2010
ReviewCorticosteroid insensitivity in severe asthma: significance, mechanisms and aetiology.
Chronic severe asthma remains a challenging clinical problem despite the availability of modern treatments. Relative corticosteroid insensitivity is present in severe asthma and may contribute to continuing disease severity. Advances in the understanding of molecular mechanisms underlying corticosteroid insensitivity may yield new therapeutic targets. Furthermore, aetiological factors for corticosteroid insensitivity have been identified and these may be amenable to modification.
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Internal medicine journal · Apr 2010
Comparative StudyAutoimmune hepatitis in a demographically isolated area of Australia.
Previous studies describing autoimmune hepatitis (AIH) come from liver transplant centres in which a skewed distribution of cases may give a misleading picture of the incidence of AIH and its natural history. This series describes AIH in a stable and demographically discrete population of patients in the Australian Capital Territory (ACT) and the surrounding region. ⋯ In this Australian community-based study, type 1 AIH was primarily a disease of later life, responded to conventional immunosuppressive therapy and generally has a good prognosis. Further study of the use of azathioprine is warranted to determine the optimal dose.
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Conventional teaching on the mechanisms and treatment of spontaneous pneumothorax is either obviously wrong or based on a misunderstanding of the natural history of the condition. Spontaneous pneumothorax is a generally benign, self-limiting condition where conservative management should be considered. If intervention is needed, medical thoracoscopy might be the procedure of choice.