17 Burst results for "Stevens Johnson Syndrome"
"stevens johnson syndrome" Discussed on The Carlat Psychiatry Podcast
"Jack driscoll. Wow it seems like kali janik risk soares have a lot of applications in psychiatry and medicine as a whole. Can we use this risk score to predict the future onset of disease unfortunately with the current state of psychiatric genetic research we really can't use polly genyk risk scores on our practice. According to dr benjamin the risk scores are not good enough yet to predict with any clinical certainty that someone will have one of these psychiatric disorders. The future goal isn't necessarily uc's risk scores in isolation. The goal is to combine them with other potential risk factors to try to improve our prediction of onset of a disease. But this is still very much in the research. Realm it has not improved to be clinically useful right now. These poly genyk risk scores associated with small little genetic changes are significantly worse at predicting disease likelihood in minority populations or non european ancestry. Population's genetic research like high intrigue over the past decade. Or so where there's been. The most progress has largely been in in caucasian populations individuals of european ancestry and so this is unintentionally created additional disparities. Where genetic information that we do know is just proportionately exactly relevant and useful to individuals of european ancestry in is less relevant less general eisele to individuals of other ethnicities and races and soon the risk scores are much much worse at predicting disease. Likelihood in minority populations or non european ancestry population. That's something that is very actively trying to be corrected at the current time the genetic information at me have probably more relevant individuals of european ancestry than african american or other minority ancestries. So we really need to do a better job there when it comes down to providing your patients with proper callaway. After they've received their genetic test results. There are a few different options. If you feel comfortable providing counselling on your own then go for it. The guidelines for genetic testing and genetic education from the international society of psychiatric genetics. I s he g. or a helpful and informative resource. We placed a link to the i. s. p. g. guidelines in our latest newsletter however there are alternatives if you're not fully comfortable with providing counselling to excellent resources to work alongside with our medical geneticists who are. Md's and non md genetic counselors netted counselors are experts in genetic medicine and often work alongside medical geneticists. They can facilitate genetic testing consenting genetic testing and counseling to accompany test results. And you can find one through the national society of genetic counselors you can work alongside genetic specialists to make sure patients get what they need. If you order a test and it comes back positive you could refer the patient to a medical geneticist for further counseling. Even if it comes back negative you could refer to a geneticist if you feel. The patient might benefit from more sophisticated gusting okay. So that's diagnostic testing. Let's move on to the more controversial type of testing farmer. Co genetic testing this type of testing looks at a group of genes involved in drug metabolism or involved in how our body responds to drugs in our particular sensitivities to drugs right now recommendations in psychiatry are really regions they recommend testing for one is fifty six i never tableau is is a lot of antidepressants and anti psychotics in a democracy team and then there's two see nineteen which metabolize the taliban surgery they recommend testing genes. It can tell us how fast or slow you metabolize. These medications doesn't tell us how well you're in respond to them but it tells you how fast or slow the last gina they recommend is one known as h. l. a. b. which is a gene can predispose people of asian descent to carbamazepine hypersensitivity. And barrera's if you have the risk gene is really greatly elevated and so this is definitely indicated for patients were started on art massive There's also been discussion about whether this should be done for. People who might be started on a cousin drug oscar basil pain and even lamotrigine which has also been associated with stevens johnson syndrome. However it's really not so clear that when we need to get testing for those as much as for rubber massive team okay to sum it up. Cyp two d six eight shell a. Be and cyp. Two thousand nine hundred genes are the only ones that are recommend in psychiatry. Even though we hear a lot about other ones like the m. t. h. f. r. gene and the mt gene. Yeah there's a lot of marketing for those particular genes especially for the corresponding elma floyd supplementation. We asked dr about how these genes got thrown into the mix. These are genes sort of came up a little over a decade ago during what you might all the entities gene era of psychiatric genetics. Meaning we really didn't have much information about genetic architecture psychiatric disease soon. Researchers were meeting guess about which genes might be related to donors based on some basic understanding of neurobiology and that's when these genes realized in the awareness of psychiatric genetics and heaven squirting their role in.
"stevens johnson syndrome" Discussed on JCMS: Author Interviews (Listen and earn CME credit)
"To interrupt the treatment and without needing to put the patient. Pardon his own Because all of course those things would increase the likelihood of renal cell cancer. melanoma cancers. Moving forward does that make sense and you accomplished it. Because as i was reading the manuscript. I kept going back to the table. Yeah and you'd read a subsection and then go back and say okay How do you deal with the macula. Pappy rupture stevens johnson syndrome and it was very clearly outlined and the other thing that struck me that i was appreciative. To have in front of me was the time from onset of therapy to the time of onset of the rash and it struck me that community physicians community dermatologists are probably gonna see these patients at some point in time because some of the onset was out a year from the therapy and so it's something that we is community. Physicians really need to recognize when patients. Tell us that they received or on these on these immune checkpoint inhibitors and i thought that was. That was another nice piece of the article so we learned we learned about the body surface area and identify and making sure that we were clear to any oncologists that we were talking to that. It's the nature of the pathology not the extent of the disease. That's important yes very important. That was the key message of the paper. Did yeah and it comes through very clearly and in the second thing was what you should use. I thought that was that was clearly in the table. So the do harm you. You managed that and then the other was the onset that to me because it takes out of the when you first read about these more sophisticated therapies in solid malignancies. I think hospital. I don't need to pay so much attention. The hospital guys are going to look after this right. And i think okay not so much. Well i think the other thing is this paper is there to instill confidence in all dermatologist. It's there to instill confidence even colleges who may not treat skin routinely because things are simple. Every dermatologist knows how to manage a premise or methods. That is attractive so Do not be afraid just because the patient is on immunotherapy treat..
"stevens johnson syndrome" Discussed on WNYC 93.9 FM
"We were cut out of the car by something called the jaws of life, You know, with your big, huge metal cutters. And my parents were airlifted to one hospital and I was taken by ambulance to another. I fractured my hip and I broke my right upper arm or humorous bone. I also broke my hand because at some point my hand went through the windshield. My mother broke five ribs and her sternum. And her arm as well. And my stepfather broke his leg in four places and his hip into that sounds so horrible. It was horrible. And you know, it happened exactly two days after I got out of the hospital with Stevens Johnson syndrome, and the only reason my mother took me out is because she's religious Hindu woman and she promised That she would do penance by performing a ceremony at the Hindu temple, which is 50 miles from where we lived, and on the way back from the temple. We have this car accident. It was horrible. Did that make her lose faith. No, but it made me lose faith. My mother's amazing. She all her life, got up at 5 30 in the morning and prayed and lit incense and read from the Romina. And then she cooked some of our dinner and then got ready for her shift at the hospital and then came home after a full shift and cooked and all that stuff. That women do when we have to, But you lost your faith. Yeah. I mean, I Is that a cat? I'm hearing. That's yes, That's my cat Rowdy in the background. I think he's hungry. So I did lose faith. I mean, I think I always vaguely believed in God and I went to the temple when my mother took me, but I've always been a very secular person. But, you know, actually did a moth story about this with the car accident. Losing my faith. I didn't I didn't know what to make of it. I couldn't understand a God that would make me so sick. And then allow me to get out of the hospital, only to go right back in and such a Traumatic and violent way. It was very, very, very bad car accident. I mean, if you saw the pictures of the car afterward, your stomach would turn. You'd think no one could get out of that car accident alive. And yet here we are. So let's talk more about your early background. Your mother came to the U. S to escape a difficult marriage. You were, too She left you behind with your grand parents, and so she could really get settled here and be confident. That she could take care of you and support you. By the time she brought you over, you were four. Do you remember being two years old when she went to America? Because I'm not sure I remember anything. When I was two. I always think my memory started somewhere around when I was three, but I don't really know. I don't remember the day she left. But I remember sitting at the gate of the compound where my grandparent's house wass, you know, they lived in a building in an apartment building, and it had a sort of You big gay and I remember sitting there and I remember my grandmother having to keep coming and bring me inside and saying it's getting late. What are you doing? Just sitting here by yourself. And I remember waiting for my mom to come home from the office in America. You know that she was going to this place to work. In America. That's how I pronounced America and that she would be home like everybody else, eventually from work. I don't think I understood that America was a different country that was far away. And so I do remember just that gate. I remember the way that the cement step out and sitting there because there was this bush with Berries, and I remember picking those Berries a lot. When she did bring you to the U. S. Did you recognize her? Did you feel like you knew who she was? Or did you have to get to know who she was? I was very excited to be joined with my mother. I came as a nun accompanied Minor. You know those days? You could do that. And I got two American. I remember her standing there with a friend with a male friend. I don't remember it all..
"stevens johnson syndrome" Discussed on The Curious About Cannabis Podcast
"The main researcher Orange did measure drug levels Into bloods of these patients from the A Mitigation Day. We're using but he did not publish everything and actually one of my co researchers has also him to share these data which he didn't so this is one of the objectives without grant application as well as to. Just look at it. Ourselves North for epilepsy medication but for pain medication. That's very much needed. I mean all of the clinicians I've been speaking to lately. That's where their heads are at as they say that they haven't seen the negative interactions yet But one of the doctors I talked specifically put it really well. He said he felt like those stories of those interactions are just on the horizon because we don't know enough and people are starting to feel more comfortable using CBD that people using it with other medications and everything and Concern that multiple. The doctors nurses that I've talked to pointed out. Is that if we move fast and don't understand how it's going to interact with things like pain. Medications a big one that you know we could have some very unfortunate accidents. That happen that then kind of send us backwards as far as the ability to even work with collaborates as as therapies. Yeah and there was a recent case. Study or report that was published. That's been circulating on social media lately. has gotten kind of controversial about a potential interaction with Milwaukee Cam that There was a patient. I think she was like fifty two years old. She's in her fifties and had the Stevens Johnson Syndrome reaction were her her skin just essentially started peeling off and hyper inflammatory reaction. And she died of septic shock and the authors of the report pointed out that the started very close in time to when she took a A CD product. It'd been modified. Theoretically the bioavailability would be higher. But obviously there's no way to form a direct causal link just based on on that level of data but it does precipitate an important discussion to have of how serious could these drug interactions actually be and What do clinicians need to know if they know that their patients are using CD? Yeah absolutely one of the things that I know just from. The article is debt The compound sits Let's say the CD formulation that she took Was She not fully tested? So I'm also wondering what else might have been in there but apart from that. I am not clinician so I cannot make any statements about this but I should look became more into this but I understand from one clinician that the Steven Johnson Syndrome does not happen overnight and meets at least a week off. I don't know of it's kind of an incubation I'm rose up so I will need to look into that further because if the symptoms start at the same time as cbd then and that would be true. And I'm not sure if it was really. Cbd Right Exactly Yeah. Because of the proximity was just like a couple of days like the the where she really started to notice the symptoms a couple days after sets a really good point. If Stevens Johnson Syndrome requires that extended period of time before symptoms even present themselves than that would sort of discredit that association between. But that's the quality thing is something I I wonder about a lot because You know in some of the states that have legalized cannabis and have set up testing rules in the sort of thing. We're getting better data on the quality of cannabis products. It's still not good enough in my opinion in most states but With the industry. It's really still a very wild market. You have some CD. Products that are coming out of highly regulated states. That are tested. You know pretty thoroughly at least for major contaminants like pesticides and metals. And that where thing and then you have CD products that undergo no testing or fake testing. People just make certificates of analysis. That aren't real and that is definitely something that I think Anyone listening should be very cautious about Because not all of these products are the same. It's a huge gradient as far as quality goes Another thing I know that you're interested in that. I wanted to talk to you about his sleep and I know that in one of your presentations that I saw online. You talked a little bit about this. About how Sometimes there's a misconception around. How can this affect sleep? So can we talk a little bit about that? What's your experience with how Or particularly let's talk about. Thc RICH CANNABIS How it affects sleep. And what those misconceptions are that you alluded to in your presentation that I wasn't planning on saying anything about that because I know exactly what you're talking about. I was standing there and then I realized wait. Someone told me this anecdote about sleep. This is interesting dimension so I will. I will mention in a minute but about The leap so a cannabis or THC dos influence the seep It doesn't necessarily improve the sleep but I also want to Discuss I the concept of sleep. Very important to afford cannabis discussion Many people use cannabis for actually. Don't use it directly for sleep. A lot of people with sleep problems do not have a real sleep disorder. What they actually have is. They suffer from chronic pain. They suffer from anxiety their stress in any other way and they use cannabis to take away those symptoms to help them sleep better. And I would like to distinguish the indirect effect of sleep from a direct effect on sleep disorders Good Point Yeah and that is I find it so interesting that With a friend of mine Dr Will Wound check in at the sleep expertise center in the Netherlands. We actually started surveying a sleep. Patients people really go to sleep clinic because of sleep disorders and rea- just rounded up the study and are analyzing the results To see if people with particular sleep disorders also have a higher cannabis. Use and the efforts will position That is also one of the reasons why there wasn't interest in Inflammatory Bowel Disorders. Like grown sir. The season Ulster difficulties because Especially Crohn's disease. People hathaway hire a cannabis used and the average population which might be related to self-medication. Yeah so Beca to sleep because Just like with being sleep is is is not just one thing but it's a whole a complex maze of all kinds of processes that are happening and Oh that would also require difference up. We'll guest episode so and this is also one of the reasons why you should not just trust any random in vitro. Study that people read Because for example in Petrie dish experiments in animal experience experiments you see at a for example. Canaveral Noise Have an inhibiting effect on an enzyme. That produces Melatonin so. If you take secrity Minnesota together what does he do? And Yeah so. Thc As is very very known for the effect on the R E M rapid eye movements sleep that is A Beriot Elstein a particular sleep face because if you sleep you're always sleeping exactly the same you know that because if you're woken up by one or the other sometimes you wake up a you're instantly alert and you're Aaron something you you don't be alarmed Glock. Yeah and that is because you're in a different face of your sleep and the REM faces to sleep in which you have dreams when people little movements and and you may be a kick someone out of the bed. I don't know reduction in that face of sleep debt is inhibited by THC. And you are referring to a story that I told because people say oh I use. Thc To sleep better. Because I've sleep problems and what. I was saying that this woman I had lunch with. She was telling me also that she was having Cannabis for her sleep. Because if she doesn't use cannabis she gets all these streams. Guess what I think. Actually this person was Dependence on canvas forgetting a good sleep because if you stop using that then had the lead. Gosta OFF THE TRASH. Gamete boom all these dreams all of a sudden come out and that is exactly a problem. That people have who argues to using cannabis. WanNa stop using cannabis and then four weeks in a row They will have if dreams and often nightmares. Just have horror novels. He well if I have horrible seat for one night. Yeah I already very unhappy. And I think gave fewer sleep a night less eternity while imagine dead lasting for days or weeks or months so that is one of the reasons why sometimes are people who want to stop using cannabis to actually stop using cannabis if that is also on. Seraing your question. Yeah no absolutely I you know. It's it's a tricky. The tricky balance of trying to understand how cannabis is actually influencing our bodies and one of the reasons I wanted to talk about. This is because I've heard the same sort of anecdote from someone else almost to a T. The same thing health educator that I that I interviewed told me that He works with like High schoolers in college students and he said he's had people come to him. That said that I. I used to think that cannabis was helping me sleep and then I realized that it actually is causing some weird problems and when I stopped using cannabis it was tough getting through those first couple of weeks but then after that my sleep normalized and then I've now I'm sleeping better than I ever have. And it wasn't until a went through that whole process that I realized that actually the sleep I was getting when using canvas was not as good as the sleep that could get after getting through that and one reason why I like talking about this because it's one of these things that Get circulated in the canvas industry. A Lot. That canvas will help you sleep and Some of the research that I'm aware of points out that it. It may get you asleep but it doesn't necessarily help you sleep deeply for an extended period of time and part of that is because of that. Rim inhibition That you're you're not ever really getting into those like super deep sleep cycles that that normally would or you get into them. For very brief periods of time And so it just has a very different effect and I think it highlights the nuance behind. All of all of this stuff around can be using cannabis in a therapeutic context which is one reason. Why doing this podcast to talk about that. That nuance But I was. I was really happy to hear you share that story because I think it's I think people experience that but feel like their experience is not right because they hear these messages coming from the industry. About what canvas is supposed to do? And so that prevents them from sort of accepting what they actually are are experiencing and they keep trying. Keep trying to use cannabis to treat something that you know. Maybe he's not actually benefiting them. Yeah that's right Another good example of this can be. Cbn people The the sleep count and CBS. One of those interesting examples to the early entourage effect research. Akzo some of that early research that showed the CBS News They couldn't detect much activity when doing work with it alone but when with thc suddenly had different effects. Yeah Yeah Yeah. But it's been studies in in quite some just a few dozen of people fifty something people different administration for him. But that's not the healthy volunteers were sleeping during experiments..
"stevens johnson syndrome" Discussed on NewsRadio KFBK
"She just was an ice pack on my head they rush me in there and they find out I have E. coli poisoning and it's really really bad and it was it was very very bad I got to the emergency room I never forget and they rushed me right in right into the room and so I stayed there probably three days and it was two or three days I thought I was gonna die be honest with you and they get out of the house so you know the hospital may give me these drugs they get home and then I start taking these drugs it's level Quinn one of the Quinlan drugs when I took the lever Quinn what happened next almost made the the a coli C. mild as I began to break out and got something called Stevens Johnson syndrome I don't recommend you Google that if you want to be frightened I mean that was writing experience when I took this level point I mean I was done I thought it was done then so they rushed me back and she was with Russia me back in on new year's eve right after Christmas that same year so not on new year's eve I'm back in the hospital this time from eleven point I was told that if I ever took this particular any other quinolone drugs ever again in my lifetime then it would be too much my body to handle and it would do me in so now here I'm sitting here going okay if it were to happen to me and this is the drugs he administered I'm done either.
"stevens johnson syndrome" Discussed on JCMS: Author Interviews (Listen and earn CME credit)
"Plasma Ammonia on. That would be either AMAC. Kerr lied or doxycycline. And at the same time if they are very severe and appear to be rapidly progressing and it's early in the in their disease Within in the first few days than Cyclosporin can be a useful adjunct to I guess lessen the severity of their corruption and possibly lead to shorter healing time. Do you think the simply treating the pneumonic process is GONNA be sufficient. Yeah I mean I'm I'm I'm I have this picture in my mind of sick child. Severe Mucous Itis Cough fever emerge. Why wouldn't you use cyclist born straight away in addition to treating infectious illness? That you presume. Is there a differential diagnosis is there. I mean if I look at the kid in twenty twelve or thirteen. I'd say well you know I'm not so certain about this mycoplasma thing. Although Michael Plasmas you know we all thought it was a a cause of Stevens Johnson Syndrome. I might just SORTA say listen. I think this child has Steven Johnson Syndrome. I'm GonNa Start Cyclosporin today because I believe that. It's the the the treatment of choice now. Yes there while Steven Johnson. Centrum is the differential diagnosis for these patients. If you're talking about drug induced Steven Johnson Syndrome and so it is important to illicit drug history and make sure that there isn't a potential drug trigger but typically these patients look different than drug induced. SDS patients because they just don't have the amount the degree of skin involvement that you would expect with us. They're not they don't progress that way. The you'll get a history of two or three days of the mucus evolving and becoming more severe without extension onto the face. Ace which would typically stay with Steven Johnson so In terms of treating the pneumonic process. I think you mean like treating the pneumonia so so you know the kids there. You're there it's the middle of the night. The you you know the pediatricians can do a very and people can do a very nice job with treating the demonic process and the question for you is. How do I treat an ammonia? It's what's going what's going on here with the skin right. And prior to this you know thought of now Murmur Rim or rhyme or whatever. WE'RE GONNA call. It would look at child and say cheese. I think there's a pretty good chance that that Stevens Johnson Syndrome has this picture. And don't don't forget that you you know we but we also think there are infectious causes of Jess as well. It's eleven o'clock at night. Am I gonNA start somebody. Dan CYCLOSPORIN DO I. Do you think that the antibiotic therapy is sufficient to manage both the respiratory disease and this immunological. Yes so in a hospital even in the hospital setting. It's quite easy to get cyclosporin and I would recommend starting that right away. The antibiotics have not been shown to to improve or have any impact on skin On the skin reactions induced by mycoplasma pneumonia. So the primary reason to treat with an antibiotic is for the Komo News itself and also because we're giving cyclosporin which is the radically someone immunosuppressive. We don't want we don't want to leave an untreated infection So typically what we would do in our center is start the Cyclosporin and antibiotic treatment at the same time. The next question I'M GONNA ask. You is about steroids. We we order it at the same time whether or not these kids actually get this stuff in any or hours from the time you actually see it. It is the real disaster right. Well that is extrapolated from the literature on Rocky Mountain spotted. Fever were doxycycline is the required treatment And it and studies studies. That had found that there was no dental stating with short courses of doxycycline. So the reason that we brought that point point up is because cyclosporin because it's metabolized by CYP three four interacts with the macrolide antibiotics. So you could get a slightly higher cyclosporin level And so it would be not. It's not optimal. Although it's a short duration of therapy to combined a macrolide with Cyclosporin and doxycycline would be a better option in in general in general we do try to. I try to give doxycycline option the other thing Chris quickly to point about Cyclosporin is that often it's given inter Venus Venus for these patients because of their severe Cassandra's and the intravenous dose is about. I think it's about a third of the oral dose and that's just something to Put into the equation prescribing. IV cyclosporin because on the wards. They're used to giving cyclosporin things like bone marrow transplant in so doses of up to fifteen eighteen milligrams per kilogram. Might be normal or equivalent might be normal and so I have also run into situations where maybe there was not a an appropriate dose conversion. Let's let's just highlight. That does so. So if you're using so let's go through the oral dosing of cyclist. Born for this condition share it would be three to five milligrams per kilogram per day. And the intravenous dosing would be one third of that so it would be about one point five two or one to one point six six milligrams per kilogram per day. Okay and we. And that's outlined in the article for people that need to reference it we definitely put in the oral dosing. But I'm not sure that we put in the information about how to convert to intervene assed and that would be something that could be reviewed by a pharmacist as well but I know here I ran and at my own center. I ran into a situation where we had prescribed more an oral and they converted to intravenous at the same dose which would have been a much higher dose and when I talked to the pharmacist. The explanation that was given is that they're familiar with cyclosporin further indications and so they felt that that dosing might be appropriate. Okay so good warning for people to watch out for the conversion okay. So we've got typical patient. We've got we've got these folks on the kids on the war now. They're they're improving. We made the right diagnosis. And what are your discharge criteria. Do you want to see you. The response has been pretty gratifying. It's been very quick in these three cases at any that you publish so tell me what sort of things that might look for on the ward. Yes so usually the criteria the major criterion for discharge is being able to tolerate oral intake because these children have to go home and be able to. You managed a manage independently and I just as a just as an aside. I guess I should. I didn't mention that when we admit these patients agency also provide Quite quite What's the word we provide detailed instructions on mouth care or or Mucus seitis Karen General. Because that is an area. That's often missed so things were paying control things for Coating Co. Services. Okay let me let me just back back you up. Even further not even further into the middle of. That's even what what would you recommend. What your kind of standard oral care in this situation? Yes so the standard standard oral care that we recommend for these patients is either I- Mucus mouthwash. There's so many recipes for those but something that actually coats The mucosal the army Costa so that patients can begin to eat more quickly or at least people to have a little bit of Water and clean their mouth properly to So that Oh yes one example would be like the magic mouthwash. Which is I? Think one to one to win Viscous Cain to dive and Hydra Means Syrup to die of all That's the kind of I guess it's used the conversion of the old pink lady which abysmal and then the other other things can be really helpful as a Sucre fate suspension because it really just coats the whole inside of the mouth so they're not as sore they're able to drink or eat a little bit of soft food The the sue Crawford suspension is usually. I hope I I would have to look it up. I think it's one gram per ten milliliters and then they can do Swish and spit four times times a day. Tennessee Swish and spit four times a day and then for UROGENITAL MIKASA or for re throw like your Retha or Volva are we would recommend using potent topical steroid meant several times a day and with Involvement if it extends onto the glance penis we often will use a nonstick dressing like a Gel net is the commonly used one because it has to be frequently removed when the patient has do go to the bathroom. Perfect thank you. Those are the tips the probably way to detail and not at all because those those are the things that dermatologist me.
"stevens johnson syndrome" Discussed on JCMS: Author Interviews (Listen and earn CME credit)
"Being blind on the test was easily available for hundred and forty dollars dollars I I'd be upset about that particularly given that in two thousand nine. It appears in guidelines. Now you may not expect family physicians to read the American College rheumatology guidelines but you might with proper dissemination of information mation through the day just a letter I mean we hear so many things about obstetrical things and things that don't matter to they we don't we don't practice obstetrics as dermatologist. This is one for not dermatologist. But for rheumatologists and family doctors it could save a life for two exactly so when we looked at at who ordered the test I mean it was most commonly ordered by family physicians rheumatologists. So the right people are starting to order it but It's really important that we try that. We continue to push an advocate. Essentially for for one hundred percent compliance compliance as it has done in in countries like Like Taiwan is there any sense of the ethnicity of the physician. You think I we we don't have that data no not at this point We you know in in NBC. We're lucky in that. We have a public database And we are looking at novel ways of identifying ethnicity and ordering of this test With the writing of prescriptions. So we can track the writing of prescriptions. We can now track the ordering of tests So it's possible that we'll be able to get more data in the near future Linking the two and looking actually at improvements over time but but That's a project that I that that that that's just beginning. Let's talk permitted about Stevens Johnson Syndrome. And it's -nology and how you work like this can help modify it. Are there any other uses of work that you're aware of that listeners. Should be aware of right. So the treatment of this disease is something that is a moving target and keeps seems to be changing From year to year I guess the the Basic Tenet is that this is an immune reaction where immune cells mainly T. cells are actually damaging and killing the skin and and they're driven to do so by a cross reaction with With culprit drug. So the first thing that is important is is to recognize the disease and recognize the pattern if you have someone that presents to the emergency room with with burning eyes burning mouth south painful skin A severe adverse drug reaction should be foremost in your mind. And if that's the case it's important to be able to get a history either from the from the patient or from his family as to what drugs he has been taking. We find that these reactions usually occur within three to four or five weeks of the onset of the using a new drug and so the most most important thing is to stop that drug so we when we see these patients we often we stop all drugs that they are been until we until the dust settles and we figure out so what's actually gone on so prima facie do no harm I-IT's stop all the drugs that they're on now The second thing is we have an opportunity if we act quickly and early two may be stopped the damage that the immune system is doing to the skin and to be we have an opportunity to to actually improve outcomes in that way. How can we stop the immune system from further damaging the skin well current Evidence suggests that there are a number of things that we can do one possibilities to start the patient on a medicine that stops the activation of t cells and that medicine now is called Cyclosporin Over a long term. There's there's there have been concerns. It's about toxicity of that drug. But over short period it is a safe drug and very effective at stopping the immune activation that damages the skin. And there's now also data that may be the use of Chemicals that inhibit site a kind such as TANF inhibitors specifically. Tanner Sept- may be of benefit. When you give it early on in this disease there's been a lot of discussion about the value of something called intravenous immunoglobulin Berlin and the the validity of of the data Regarding that in the use of that is still not completely clear so I would say that's an area where they're still L. quite a lot of discussion similarly with corticosteroids. Steroids are very good at stopping the immune system but Really would be best. The only used for a very short period because if they're used for longer the increase the risk of side Effects Infections And and other toxicities. He's so I think most important recognize the pattern of of a severe drug reaction. That is pain in the eyes in the Mucosal And on the skin Recognize that that may be drug and then stop all potential culprit Dr Bags and then if If the opportunity arises use some of these newer strategies to inhibit the activation of the immune system and perhaps prevent further damage so prevention prevention prevention and early intervention right. Don't don't be afraid no-one no one is no one has died from their first dose of cyclosporine. I think this is one of these yet. We're we're we're you know. Being aggressive early pays dividends Yes. Yup Yup Tanner Sept- as well and we've had some articles in JC. The previously. About the use of Tanner Sefton and clearly more aggressive of you are the better you can always stop can always stop well. This is a very nice piece of work. Great Clinical Picture. Just thank you And significant advice to those of us that speak to family physicians that speak to pharmacy groups and I'm going the urge our colleagues to make sure that even at a at the end of their lecture even if it's on a topic Exzema if it's the appropriate cultural group it might well be worth a picture and and a comment. Yeah well thanks very much. I really appreciate your taking time out of your data to help us understand this and thanks for for doing this Not just the podcast for for the work that undoubtedly will save lives right. Well thank you.
"stevens johnson syndrome" Discussed on KGO 810
"Go undergo treatments, and as a result of there being rifts every consumer should be as informed as possible. And that's just a general thought for that Lister. Is you need to be at a very active customer as far as her present condition. I all I could see chess not knowing what's going on exactly with you. But haven't seen Steven Johnson syndrome, myself and patience, which by the way, the deadly problem could be a problem. I would ask you to take care of the things that you have some control of at this moment. And that would be what you eat, you know, whether or not you exercise whether or not you get some sunshine. We haven't talked about bad bad habits. Hold on John. Let's let you finish up with some recommendations for Barbara. When we come back. We'll take final calls. The coast website is now conveniently optimized for mobile devices. If you're a coast insider, you can listen to live and pass shows right on your phone. Just visit coast to coast AM dot com on your iphone or Android browser..
"stevens johnson syndrome" Discussed on KNST AM 790
"Unfortunately. The the the business of heart surgery has grown so big. That. They resorted to. Performing surgery that are planning simple unnecessary and also into scaring the patient. We actually call call these the Widowmaker. You heard that term, absolutely. Every medical school student loans that term too that's part of our formal education to t- to talk patients into having surgery for chronic disease. It's we we take we take them. We get the man in the room. We take the life side. We have the pictures of her husband's heart, and we point to that leash. What we call that, ma'am? We call that a Widowmaker somebody turned out. A widow mate I wish we would have been born with a backup part though. Wouldn't that have been nice? Why don't we just take care of the one? We have. Yeah. Let's go to Barbara and Tacoma, Washington. Hey, barb. Go ahead. Hi. Hi there. I just wanted to tell you how great it is. I love the shown. Thank you. Thank you. Yeah. I wanted to ask the doctor. I have I've been sick since I was seventeen. I got Steven Johnson syndrome from guy Lantin and almost killed me. What what is that bar? Just for those of us who don't know what that is. What is that in Johnson syndrome is a reaction? Dynamic today. Manton is a seizure medication. Taking a baby for two weeks. And I got lesion all over my body inside out and the only place they they give me my last rights when I was seventeen I we in high school. Yes. And I had my feet, and and then I. Buckets because I they were so it's so bad. Fingernails toenails selloff. They were in my ear as they were down my throat. And they were waiting for one to just get into one of my lungs, and I would have died. Thank the Lord. They didn't. None of them went in my life because I'm still here. That's right. They said I would not be able to have any babies. I had one daughter very healthy grandson now. So. But anyway, I wanted to ask the doctor I've been sick ever since. And that very sick after I had my daughter triggered viral miles. And that's gotten worse ever sin. How many years have you been sick marver? I've been sick. All together. Now twenty seven years God almost every day. Oh every day. I've been sick. Yes. John. What does she do? Well, first of all, I think everybody must realize that treatments have adverse effects of the dishes deposited affect you. Just hope at the end of the day. You can say to yourself of the doctor. I did the patient more good than harm. It's it's a risky business to go undergo treatments. And as a result of there being rifts every consumer should be as informed as possible. And that's just a journal for that. Lister is you need to be in a very active customer as far as her present condition. I go all I could suggest not knowing what's going on exactly with you. But haven't seen Steven Johnson syndrome, myself and patience, which by the way, the deadly problem could be desert problem. I I would ask you to take care of the things that you have some control of at this moment. And that would be what you eat, you know, whether or not you exercise whether or not you get some sunshine. We haven't talked about badly bad habits. Hold on John. Let's let you finish up with some recommendations for Barbara. When we come back. We'll.
"stevens johnson syndrome" Discussed on KFI AM 640
"Got a story. Of the other type of double ganger. Looking at her let her tell the story, and then we'll give you the numbers to the time. We have remaining is only thirty minutes or so, but the story has been great. So thank you for hanging on as long as you have to get on the air to tell them to Erin sakers who will continue next on coast to coast AM. This is. Hey. News on the hour on the half. And when it breaks. I'm Mary Kay Gaffney. Live from the KFI twenty four hour newsroom. Officials up and down California say the rain may have taken a break, but saturated hillsides could still collapse giving way to mud and debris slides. The Riverside County. Fire department says crews have been doing damage assessments the storm Thursday caused flooding and rope problems all over the place. A mudslide north of San Francisco barreled over cars up rooted trees, and sent a home sliding down a hill into another house in sausalito, a woman was trapped for two hours, while crews dug her out the family of a girl who almost died from a prescription has sued the school district. This. Doctors say Ashley Silverman could have died from a rare toxic skin disease called Stevens Johnson syndrome after taking a prescription drug called Lombardo. The fourteen year old got it from a psychiatrist the school district reportedly recommended to treat her mood. Swings. Her lips were all blistered her neck everywhere. Head to toe. David Silverman says it was tough to watch his daughter deteriorate sitting there, totally helpless. He says it will take up to a year for Ashley to heal. But she is expected to make a full recovery. The clinic he's suing isn't commenting in north.
"stevens johnson syndrome" Discussed on KFI AM 640
"For vanity project for a monument to stupidity. Newsome says the courts will have the last word not President Trump Trump announced a national emergency at the border yesterday saying it's necessary to stop drug and human trafficking. Laura. Trump says she's glad more than one dollar will be spent on building a wall at the southern border. We know that needs to Pelosi only said that she was willing to give a dollar still looking at one point four billion dollars within the Bill for funding. The wall. House speaker Pelosi and Senate Democratic leader Chuck Schumer called it an unlawful declaration over a crisis. That does not exist apparent has sued the school district for recommending a psychiatrist who he says almost killed his daughter the doctor prescribed the pill that resulted in Stevens Johnson syndrome. It's a toxic disease that basically makes a person's skin bubble and melt off. Do this. The fourteen year old was in the hospital for weeks and recorded her progress. The girl's father says it could take up to a year for her to fully recover. Monica. Rix, KFI news. Neighbors have flooded a street in lake Elsinore with help statia combo was picking through the mud along the banks of creek. They used to be dry almost a babbling brook could be somewhat calming. If you didn't know how destructive it was Jews hunting for anything that looked like it belongs to our neighbor up of lock and lost their brother six months ago and one of the sheds contain many of his personal belongings. So we were just trying to find what we could to be able to give it back to them. Glenn Huggins lives just up the street. He came down to survey the damage, it's bad.
"stevens johnson syndrome" Discussed on KFI AM 640
"She of the host says she was attacked while cleaning the men's room. I do want to speak out because many make me feel like I was nothing compared to the guests groups calling for panic button safety barriers and the right to have guests who are abusers kicked out. Mary owner. VR has not responded to requests for comment in Irvine Corbin. Carson KFI news. The father of a girl who almost died from a prescription drug has sued the LA school district. David Silverman says the district recommended a psychiatrist to treat his daughters mood swings. Silverman said that doctor gave the girl drug with little warning of its severe side effects the girl developed a rare toxic skin disease called Stevens Johnson syndrome that made her skin bubble and landed her in the hospital for weeks. Silverman says he thought he'd lose her. She was unconscious. A lot of the time they were pumping ivy's into her twenty four seven everyone there saved her life. Silverman says he also plans to sue the psychiatrist and clinic where the doctor works. Both the clinic and school district are not commenting police in Illinois say the five people killed in a shooting manufacturing plant where all employees es Aurora police chief Kristen Zemun says forty five year old Gary Martin was shot and killed during the incident yesterday. Preliminary investigation into. Cates that the deceased victims were located in the same general area of the Henry Pratt facility. While this investigation is ongoing. We believe that. There was only one assailant six police officers were also hurt Zemun said all of the officers will be okay. Martin had six prior arrests, including traffic.
"stevens johnson syndrome" Discussed on KFI AM 640
"Himself as a Catholic priest. Vatican spokesman Alessandro gives Saudi read from the official church decree sorta sedation in the sacrament of confessions and since against the sixth commandment with minors and adults. Bresso impose him the penalty of dismissal from the clerical state. The eight year old MC Eric resigned last summer because of sexual misconduct allegations. This is the most severe punishment. The church can impose on clergy members apparent has sued the school district for recommending a psychiatrist who almost killed his daughter the doctor prescribed the pill that resulted in Stevens Johnson syndrome. It's a toxic disease that basically makes a person's skin bubble and melt off who. To do this. The fourteen year old was in the hospital for weeks and recorded her progress. You can go really scary. Ready here. Help me so much. The girl's father says it could take up to a year for her to fully recover. Monica. Rix KFI, news pilots should have a clearer approach to an airport in the inland empire soon Redlands airport association. President Ted goblin says birds became a problem after the state built a citrus reservoir fewer than two thousand feet away from a runway anytime you have a body of water and the body of water is an unknown flyway for wildlife birds. They like to set down on the water and rest look for fish, or whatever goblin says, the guidance from Cal trans is not to build a reservoir within ten thousand feet of runway, San Bernardino. Value municipal water district will be tossing seven point five million floating. Plastic Rumbold's into the reservoir over the next year. Those rob Wade's are supposed to trick the birds and keep them away if you win an award. But no one watched you accept it. Did it really happen? The academy has reversed its controversial decision to hand out. Four Oscars during the award shows commercial breaks top academy leaders, including president John Bailey. And CEO, Don Hudson have pledged to air every awards category on the live show. The academy initially stood firm for days despite backlash from filmmakers across the four categories and their peers, but open letters from a list talent calling the move insulting on top of heavy criticism and judgment from the unions representing those categories proved too much to handle the Oscars will now run over three hours as a result. And it's all happening live February twenty four th at the Dobie theater in Hollywood. Mary Kay Gaffney. KFI.
"stevens johnson syndrome" Discussed on KFI AM 640
"How he was being brutalized by people in the church when in fact, he was not coming out to try to disprove God or or or anything like that. Well, so it is with open lines. And we'll see where you take us coming up. We'll give you the numbers again in just a moment. And then the good news about where you can see George Noory in his next live performance on coast to coast AM. This is. News on the hour. On the half. And when it breaks. I'm Mary Kay Gaffney. Live from the KFI twenty four hour newsroom. Officials up and down California say the rain may have taken a break, but saturated hillsides could still collapse giving way to mud and debris slides. The Riverside County. Fire department says crews have been doing damage assessments the storm Thursday caused flooding and row problems all over the place a mudslide north of San Francisco barreled over cars up rooted trees, and sent her home sliding down a hill into another house in Toledo. A woman was trapped for two hours while crews dug her out the family of a girl who almost died from a prescription has sued the school district. Doctors say Ashley Silverman could have died from a rare toxic skin disease called Stevens Johnson syndrome after taking a prescription drug called Lamictal. The fourteen year old got it from a psychiatrist the school district reportedly recommended to treat her mood. Swings. Her lips were all blizzard her neck everywhere. Head to toe. David Silverman says it was tough to watch his daughter deteriorate. I mean, you sitting there totally helpless. He says it will take up to a year for Ashley to heal. But she is expected to make a full recovery. The clinic he's suing isn't commenting in north.
"stevens johnson syndrome" Discussed on KFI AM 640
"They have released without charges the two guys they had been questioning about the reported assault of empire actor jussie smollet homeless people around LA city hall claimed they've been kept in the dark about typhus concerns. Many say they don't know how disease spreads were trying to survive every day, you know, without the knowledge of the rodents, and that sort of thing. Health officials say rodents attract fleas, which can later spread typhus to humans people who camp around city hall, say rats are common. The family of a girl who almost died from a prescription has sued L unified live around this doctor say Ashley Silverman could have died from a rare toxic skin disease called Stevens Johnson syndrome after taking. Prescription drug called Lamictal the fourteen year old got it from a psychiatrist the school district reportedly recommended to treat her mood. Swings. Her lips were all blizzard her neck everywhere. Head to toe. David Silverman says it was tough to watch his daughter deteriorate. I mean, you sitting there totally helpless. He says it will take up to a year for Ashley to heal. But she is expected to make a full recovery. The clinic he's suing isn't commenting in north Hollywood. Monica Rix, KFI news Mugler's have been targeting rare plants in California wildlife officials say people are foraging through national parks and breaking into nurseries looking for succulents, Katie Telford manages at plant nursery in Highland Park. She says succulents are popular all over the world right now. But the plants can only be grown in warm climates. There's a lot of rare succulents like that just grow here. So they're not rare here, but that makes them rare and other places. So the demand is really just for whatever is not available social say smugglers, mostly trading, the plans to Asia, the supreme court has agreed to hear the Trump administration's appeal of a ruling to keep. Citizenship question off, the twenty twenty cents is Aaron Katersky reports. A judge a lower court agreed with the thirty four states and nonprofits who sued the commerce to Barbara over the question. The judge found the questions inclusion arbitrary and capricious the supreme court agreed to take up the Trump administration's appeal before the case wound its way through the usual. Lower courts reflecting a deadline in June to get the census questionnaire printed hearing is expected to be held in April. The state's lawsuits say the citizenship question could keep illegal immigrants from taking part in the population count, and that could cost federal funds crash.
"stevens johnson syndrome" Discussed on KFI AM 640
"His Gary Martin. Here's a forty five year old, man. And we believe he was employee an employee of the company at this time. We aren't sure of the motive of this act of violence. She says five officers were also shot to were airlifted to trauma centers in Chicago. A sixth officer is being treated for a knee injury. The news is brought to you by reborncabinets. President Trump says he needs to use executive powers to secure the US Mexico border. You don't have a border. You don't have a country. The president's national emergency declaration would let him divert money to build a wall. Trump says he expects to be sued over this decision. They will sue us in the ninth circuit. Even though it shouldn't be there, and we will possibly get a bad ruling. And then we'll get another bad ruling, and then will end up in the supreme court. He says he expects to win their house speaker Nancy Pelosi and Senate minority leader Chuck Schumer say the declaration is unlawful, and they will take action in congress and the courts, and in the public the family of a girl who almost died from prescription has sued the school district to go through this doctor say Ashley Silverman could have died from a rare toxic skin disease called Stevens Johnson syndrome after taking a prescription drug called Lamictal. The fourteen year old got it from a psychiatrist the school district reportedly recommended to treat her mood. Swings. Her lips were all blizzard her neck everywhere. Head to toe. David Silverman says it was tough to watch his daughter deteriorate. I mean, you're sitting there totally helpless. He says it will take to a year for Ashley to heal. But she is expected to make a full recovery. The clinic he's suing isn't commenting in north Hollywood. Monica Rix, KFI news. Officials in LA are planning more cleanups and landscaping to slow the typhus risk around city hall. The key issue is getting rid of rats and fleas council, president herb Wesson throughout some ideas. If we did have an army of cash, they came over here to attack the rats that doesn't might eliminate the rats. But that doesn't mean we would eliminate the flea problem. Exactly said a tation crews plan to increase trash pickups around homeless encampments and add street cleaning around the Civic Center at city hall. Andrew mollenbeck KFI news homeless people around LA city hall claim they've been kept in the dark about typhus concerns. Many of them say they don't know how the disease spreads were charred survive.
"stevens johnson syndrome" Discussed on KFI AM 640
"Died from prescription meds, the fourteen year old girl went to a clinic in north hills, which often works with the school district as I kinda trysts air prescribed the drug called lack to mole to treat. Her mood. Swings. It's typically used to treat seizures epilepsy and bipolar disorder in adults doctors say side effects from this medication almost killed her. She developed a severe skin reaction called Stevens Johnson syndrome that basically made her skin bubble and melt off the team spent weeks in a burn unit ICU at children's hospital L A in a statement the school district called the case alarming and officials say they're looking into it. Monica Rix, KFI news rally clippers player Corey mcgettigan has been accused of rape by the woman who says Virginia's Lieutenant governor raped her in a press release. The woman's lawyer mentioned raped by a basketball player without naming him. Media outlets learned of their twenty year old mcginty's accusation from some women's friends who say she told them about it McGee and the Lieutenant governor of Virginia or Bolton wrongdoing tires have been slashed on the cars of dozens of people who park their rods and Boyle heights. Kinda sad and depressing and mad knowing that your car's been slashed. And now you have to pay extra two hundred three hundred dollars off your pockets. Some cars were parked on the street. Others were in public parking lots than people whose tires were slashed say they missed work yesterday because they had no good transportation options. One person has been arrested civic leaders in LA have ceremoniously broken ground on a project, which will transform a parking lot into a landmark development Bowland philanthropist. Eli broad says the idea for the building the grand started with the belief that every great city needs a vibrant center. Grand avenue is becoming the arch cultural and civic district for regional fourteen million people the grand is being built across the street from the Disney concert hall, both buildings were designed by famed architect. Frank Gehry and dog owners are looking to their pets to sniff out bad dates a survey of two thousand dog owners shows three out of four believe how they're pup reacts to a love interest plays a key role in whether to keep dating the dog walking up wag survey. Also shows fifty percent say if their dog doesn't like who they're dating it's a deal breaker for the date about one in four say, they have dated someone even though their dog reacted negatively and say they'd never make that mistake again. Amy king KFI news.