Pri-Med News & Industry Features

Are eosinophils a good biomarker in severe asthma?

Overview: In this episode, join us as we discuss the use of blood eosinophils as a biomarker in severe asthma and whether there is prognostic value in measuring eosinophil levels.

Episode key references and resource links: 

• Bruselle GG, and Koppelman GH. N Engl J Med. 2022;386(2):157–171.
• Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention 2023. Available from: https://ginasthma.org/2023-gina-main-report/. Access date [June 2023].
• de Groot JC, et al. ERJ Open Research. 2015;1(1):00024–2015.
• Bousquet J, et al. N Engl J Med. 1990;323(15):1033–1039.
• Yancey SW, et al. J. Allergy Clin Immunol. 2017;140(6):1509–1518.
   

Guest: Dareen Siri, MD, FAAAAI, FACAAI and Matthew Mintz, MD, FACP
 

When should you refer to a specialist?

Overview: In this episode, join us as we discuss the risks of elevated eosinophil levels and exacerbations, and the role a specialist can play in the management of severe asthma.

Episode references and resource links: 

• Price DB, et al. Lancet Respir Med. 2015;3(11):849–858.
• Dougherty RH and Fahy JV. Clin Exp Allergy. 2008;39(2):193–202.
• Chung LP, et al. Respirology. 2020;25(2):161–172.
• Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention 2023. Available from: https://ginasthma.org/2023-gina-main-report/. Access date [June 2023].
• Agusti A, et al. Respir Med. 2021;187:106572.
   

Guest: Dareen Siri, MD, FAAAAI, FACAAI and Matthew Mintz, MD, FACP

Should you measure blood eosinophil levels in patients with severe asthma?

Overview: In this episode, join us as we discuss the importance of blood eosinophil testing for improving diagnosis and phenotyping in severe asthma.

Episode key references and resource links: 

• Bruselle GG, and Koppelman GH. N Engl J Med. 2022;386(2):157–171.
• Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention 2023. Available from: https://ginasthma.org/2023-gina-main-report/. Access date [June 2023].
• Heaney LG, et al. Chest. 2021;160(3):814–830.
• de Groot JC, et al. ERJ Open Research. 2015;1(1):00024–2015.
• Fitzpatrick AM, et al. J Allergy Clin Immunol Pract. 2020;8(2):452–463

Guest: Dareen Siri, MD, FAAAAI, FACAAI and Matthew Mintz, MD, FACP

The Pathophysiology of Older Adults with Type 2 Diabetes

This podcast will review the unique pathophysiology in older adults with long-term Type 2 diabetes that underlie requirements for combination insulin therapy.

Please take a few minutes to answer this questionnaire to help us evaluate the impact of this program and plan for future educational programs. Click Here

Framework for Approaching the Treatment of Older Adults with Type 2 Diabetes

This podcast reviews the specific considerations in appropriately individualizing care for older adults with T2D by reviewing health status, cognition, frailty and their living situation 

Please take a few minutes to answer this questionnaire to help us evaluate the impact of this program and plan for future educational programs. Click Here

Treatment Selection for Older Adults with Type 2 Diabetes

This podcast focuses on the exploration of treatment approaches in older patients with Type 2 diabetes who are insulin-requiring through case discussion with a focus on simplicity, minimization of hypoglycemia and importance of simplification/de-intensification utilizing an individualized approach by reviewing
psychological, medical, functional and social domains.

Please take a few minutes to answer this questionnaire to help us evaluate the impact of this program and plan for future educational programs. Click Here

Managing Recurrent UTIs: From Prevention to Treatment

The complexity behind recurrent UTI management often leaves both patients and clinicians with questions on the optimal management strategy. Should they be treated as an uncomplicated UTI? Are there special considerations or prevention measures? Are there unforeseen or unknown factors contributing to disease incidence? In this second episode, we take a deep dive into the treatment and management of recurrent UTI and explore the impact that this disease has on patients.

Disclaimers:

1. This presentation is sponsored by GSK. The speakers are GSK paid healthcare providers. The content is intended to support disease state education and is considered nonpromotional.
2. The content and views expressed therein do not necessarily reflect the views, policies, or position of Pri-Med. This program is limited to Health Care Professionals (HCPs) only. GSK complies with all state and federal laws including transparent reporting and disclosure of payments and transfers of value to HCPs.

 

References:

1. Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. J Urol. 2019;202(2):282-289. doi: 10.1097/JU.00000000000002963. 
2. Foxman B, Brown P. Epidemiology of urinary tract infections: transmission and risk factors, incidence, and costs. Infect Dis Clin North Am. 2003;17(2):227-241. doi: 10.1016/s0891-5520(03)00005-9
3. Foxman B, Gillespie B, Koopman J, et al. Risk factors for second urinary tract infection among college women. Am J Epidemiol 2000; 151:1194.
4. Ikäheimo R, Siitonen A, Heiskanen T, et al. Recurrence of urinary tract infection in a primary care setting: analysis of a 1-year follow-up of 179 women. Clin Infect Dis 1996; 22:91.
5. Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52:e103.
6. Markowitz MA, Wood LN, Raz S, Miller LG, Haake DA, Kim JH. Lack of uniformity among United States recommendations for diagnosis and management of acute, uncomplicated cystitis. Int Urogynecol J. 2019;30(7):1187-1194. doi:10.1007/s00192-018-3750-z.
7. Labcorp Report – Antibiotic Resistance in Bladder Infections (2019). https://www.labcorp.com/organizations/data/insights[1]analysis#InsightAnalytics-Antibiotic. Accessed December 1, 2022.
8. Langford BJ, Brown KA, Diong C, et al. The Benefits and Harms of Antibiotic Prophylaxis for Urinary Tract Infection in Older Adults. Clin Infect Dis. 2021;73(3):e782-e791. doi:10.1093/cid/ciab116
9. Harding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ. 2022;376:e068229. Published 2022 Mar 9. doi:10.1136/bmj-2021-0068229

Patient-Centered Approach to Treating UTIs: Seeking Consensus Through Controversies

Uncomplicated UTIs (Urinary Tract Infections) can have a detrimental impact on emotional wellbeing. Patients may feel ignored by their clinicians, who face a diverse set of challenges when managing uncomplicated UTIs, all of which are important to address when keeping the plan patient-centered. In this podcast, we will discuss patient-clinician communication barriers and the importance of patient[1]centered outcomes in managing uncomplicated UTIs.

Disclaimers:

1. This presentation is sponsored by GSK. The speakers are GSK paid healthcare providers. The content is intended to support disease state education and is considered nonpromotional.
2. The content and views expressed therein do not necessarily reflect the views, policies, or position of Pri-Med. This program is limited to Health Care Professionals (HCPs) only. GSK complies with all state and federal laws including transparent reporting and disclosure of payments and transfers of value to HCPs.

 

References:

1. Hilt EE, McKinley K, Pearce MM, et al. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J Clin Microbiol. 2014;52(3):871-876. doi:10.1128/JCM.02876-13
2. Lindsay LE, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis 68, no. 10 (May 2, 2019): e83–110. https://doi.org/10.1093/cid/ciy1121
3. Advani SD, Polage CR, Fakih MG. Deconstructing the urinalysis: A novel approach to diagnostic and antimicrobial stewardship. Antimicrob Steward Healthc Epidemiol. 2021;1(1):e6. doi: 10.1017/ash.2021.167. Epub 2021 Jun 28. PMID: 34604864; PMCID: PMC8486290
4. FDA Drug Safety Communication. FDA. 2016. Accessed October 10, 2022 https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety[1]communication-fda-advises-restricting-fluoroquinolone-antibiotic-use-certain
5. Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. J Urol. 2019;202(2):282-289. doi: 10.1097/JU.00000000000002963
6. Thompson J, Marijam A, Mitrani-Gold FS, Wright J, Joshi AV. Activity impairment and health-related emotional wellbeing associated with an uncomplicated urinary tract infection among US females. Oral presentation at: IDWeek 2021; September 29-October 3, 2021; Virtual Conference. Session: UTIs; presentation 196

7.Colgan R, Keating K, Dougouih M. Survey of symptom burden in women with uncomplicated urinary tract infections. Clin Drug Investig. 2004;24(1):55-60. doi: 10.2165/00044011-200424010-00007

8. Thompson J, Marijam A, Mitrani-Gold FS, Wright J, Joshi AV. A survey study of healthcare resource use, and direct and indirect costs, among females with an uncomplicated urinary tract infection in the United States. Poster presented at: IDWeek 2021; September 29-October 3, 2021. Poster 1227
9. Grigoryan L, Mulgirigama A, Powell M, Schmiemann G. The emotional impact of urinary tract infections in women: a qualitative analysis. BMC Womens Health. 2022;22(1):182. doi: 10.1186/s12905-022-01757-3
10. Scott VC, Thum LW, Sadun T, et al. Fear and frustration among women with recurrent urinary tract infections: findings from patient focus groups. J Urol. 2021;206(3):688-695. doi: 10.1097/JU.0000000000001843
11. Lecky DM, Howdle J, Butler CC, McNulty CA. Optimising management of UTIs in primary care: a qualitative study of patient and GP perspectives to inform the development of an evidence-based, shared decision-making resource. Br J Gen Pract. 2020;70(694):e330-e338. doi: 10.3399/bjgp20X708173
12. Chwa A, Kavanagh K, Linnebur SA, Fixen DR. Evaluation of methenamine for urinary tract infection prevention in older adults: a review of the evidence. Ther Adv Drug Saf. 2019;10:2042098619876749. Published 2019 Sep 23. doi:10.1177/2042098619876749
13. Harding C, Mossop H, Homer T, etal. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ 2022;376:e068229. doi: 10.1136/bmj-2021-0068229
14. Wade C, et al. Methenamine Prophylaxis for Recurrent Urinary Tract Infections in a Tertiary Referral Center. Urol Pract 2021;8(8):699-704
15. Hoffmann TC. Methenamine hippurate for recurrent urinary tract infections. BMJ 2022; 376
16. De Paepe H, Hoebeke P, Renson C, et al. Pelvic-floor therapy in girls with recurrent urinary tract infections and dysfunctional voiding. Br J Urol. 1998;81 Suppl 3:109-113. doi:10.1046/j.1464-410x.1998.00021.x
17. Hooton TM, Vecchio M, Iroz A et al. Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections. JAMA Intern Med 2018; 178: 1509
18. Gupta K, Hooton TM, Naber KG, et al.; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103-e120. doi: 10.1093/cid/ciq257

Is an Uncomplicated UTI Really Uncomplicated?

The controversy surrounding whether to collect urine cultures and which empiric treatment to prescribe in patients with uncomplicated UTI has left many clinicians unsure of the right approach. In this the first episode of a podcast series, we’ll discuss the definition of clinical cure and dive into the evidence behind grey areas in the diagnosis and management of uncomplicated UTI.

Disclaimers:

1. This presentation is sponsored by GSK. The speakers are GSK paid healthcare providers. The content is intended to support disease state education and is considered nonpromotional.
2. The content and views expressed therein do not necessarily reflect the views, policies, or position of Pri-Med. This program is limited to Health Care Professionals (HCPs) only. GSK complies with all state and federal laws including transparent reporting and disclosure of payments and transfers of value to HCPs.

 

References:

1. Gupta K, Hooton TM, Naber KG, et al.; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103- e120. doi: 10.1093/cid/ciq2572.
2. Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. J Urol. 2019;202(2):282-289. doi: 10.1097/JU.00000000000002963
3. Houlbar M, Meng L. SHC Clinical Pathway: Inpatient Management of Urinary Tract Infections – Adult Patients. Stanford Antimicrobial Safety and Sustainability Program. November 2017. https://med.stanford.edu/content/dam/sm/bugsanddrugs/documents/c linicalpathways/SHC-UTI-Inpatient-Guideline.pdf. Accessed November 30, 2022.
4. Hooton TM, Gupta K. Acute simple cystitis in women. UpToDate. Updated March 15, 2021. Accessed November 9, 2022. https://www.uptodate.com/contents/acute-simple-cystitis-in-women
5. Colgan R, Williams M. Diagnosis and treatment of acute uncomplicated cystitis. Am Fam Physician. 2011;84(7):771-776.
6. Shafrin J, Marijam A, Joshi AV, et al. Impact of suboptimal or inappropriate treatment on healthcare resource use and cost among patients with uncomplicated urinary tract infection: an analysis of integrated delivery network electronic health records. Antimicrob Resist Infect Control. 2022;11(1):133. Published 2022 Nov 4. doi:10.1186/s13756-022-01170-3
7. Daneman N, Chateau D, Dahl M, et al. Fluoroquinolone use for uncomplicated urinary tract infections in women: a retrospective cohort study. Clin Microbiol Infect. 2020;26(5):613-618. doi:10.1016/j.cmi.2019.10.016
8. Bratsman A, Mathias K, Laubscher R, Grigoryan L, Rose S. Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning. Pharmacoepidemiol Drug Saf. 2020;29(6):701-707. doi:10.1002/pds.5018
9. FDA Drug Safety Communication. FDA. 2019. Accessed October 10, 2022 https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns[1]about-increased-risk-ruptures-or-tears-aorta-blood-vessel[1]fluoroquinolone-antibiotics
10. Nicolle LE; AMMI Canada Guidelines Committee*. Complicated urinary tract infection in adults. Can J Infect Dis Med Microbiol. 2005;16(6):349- 360. doi:10.1155/2005/385768

Meet The Patient: Decoding IBS-D in Your Practice

Diagnosing and treating IBS-D can be challenging. On IBS-D(ecoded), host Susan Brazil gets the latest facts about IBS-D, and real life patients share their experiences living with IBS-D. In Episode 1, patient Molly from Atlanta discusses her symptoms and frustrations since being first diagnosed with IBS-D ten years ago. Expert physician Dr. Gregory Sayuk introduces treatment options..

US-VBZ-220064 09/22

This content is developed exclusively by or on behalf of the industry sponsor through a third party and is not reviewed by Pri-Med. The content and opinions expressed are those of the sponsor or presenters and may not reflect the views of Pri-Med.