Steroid responsive meningitis canine

Bile acids, in particular chenodeoxycholic acid (CDCA) and cholic acid (CA), can regulate the expression of genes involved in their synthesis, thereby, creating a feed-back loop. The elucidation of this regulatory pathway came about as a consequence of the isolation of a class of receptors called the farnesoid X receptors, FXRs . The FXRs belong to the superfamily of nuclear receptors that includes the steroid/thyroid hormone receptor family as well as the liver X receptors (LXRs) , retinoid X receptors (RXRs), and the peroxisome proliferator-activated receptors (PPARs) .

Potentiated by CYP3A4 inhibitors (eg, ketoconazole, macrolides), cyclosporine, estrogens. Antagonized by CYP3A4 inducers (eg, barbiturates, phenytoin, carbamazepine, rifampin), cholestyramine. May potentiate cyclosporine (seizure risk). May antagonize oral anticoagulants (monitor), isoniazid. Increased risk of arrhythmias with digitalis. May need to adjust dose of antidiabetic agents. Monitor for hypokalemia with potassium-depleting drugs (eg, amphotericin B, diuretics). Concomitant neuromuscular blocking agents; increased risk of myopathy. Withdraw anticholinesterase agents at least 24hrs before initiating corticosteroid therapy. Aminoglutethimide may lead to loss of corticosteroid-induced adrenal suppression. Increased GI effects with aspirin, other NSAIDs. Caution with aspirin in hypoprothrombinemia. May suppress reactions to skin tests.

In order to prescribe ASIT, allergens to which a dog is hypersensitive need to be identified through allergy testing. Both intradermal and serum tests detect allergens. A positive allergy test indicates the presence of excessive amounts of IgE, and a positive result may be associated with clinical allergy or subclinical hypersensitivity. The significance of a positive result can only be ascertained once all other causes for the dermatitis have been ruled out. Also, a positive result should be for an allergen present in high quantities at the time of year that the individual patient has exacerbations of skin disease. Thus, the dermatologist will review patient history prior to selection of allergens for immunotherapy.

This study isn’t going to change what I currently do as I think it supports my intuition that as yet we still don’t have a good diagnostic system for infant and childhood wheeze. A theory which would support both the Panickar and Foster work is that there are different cohorts of children between the age of 1-5 who present with similar symptomatology but for different pathophysiological reasons. The spectrum of bronchiolitis to viral wheeze to asthma is not precise enough to guide the most effective management. As recent discussion around dexamethasone and prednisolone has shown, if we can’t define the group we are treating how can we adequately assess the response to treatment?

Steroid responsive meningitis canine

steroid responsive meningitis canine

This study isn’t going to change what I currently do as I think it supports my intuition that as yet we still don’t have a good diagnostic system for infant and childhood wheeze. A theory which would support both the Panickar and Foster work is that there are different cohorts of children between the age of 1-5 who present with similar symptomatology but for different pathophysiological reasons. The spectrum of bronchiolitis to viral wheeze to asthma is not precise enough to guide the most effective management. As recent discussion around dexamethasone and prednisolone has shown, if we can’t define the group we are treating how can we adequately assess the response to treatment?

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