Posts Tagged ‘glucocorticoids’

Eye of the Beholder

Posted by Carla Rothaus • May 6th, 2016

Dermatomyositis, polymyositis, and necrotizing autoimmune myopathy all cause proximal muscle weakness. Proximal weakness is often progressive, with patients reporting difficulty in raising their arms above their head, climbing stairs, or standing from a seated position. Clinically, dermatomyositis is distinguished from polymyositis and necrotizing autoimmune myopathy by its distinctive dermal findings. A 47-year-old man presented to an… Read More…

Betamethasone for Women at Risk for Preterm Delivery

Posted by MaryAnn Wilbur, M.D. M.P.H. • April 6th, 2016

A term delivery occurs on or after 37 weeks gestation.  Any delivery prior is considered “preterm” and those   between 34 weeks, 0 days and 36 weeks, 6 days are often referred to as “late preterm.”  The standard of care has been to recommend antenatal glucocorticoids (typically, betamethasone 12.5mg IM q24 hours x 2 doses) to… Read More…

Springing a Leak

Posted by Carla Rothaus • October 2nd, 2015

In a new Clinical Problem-Solving article, a 52-year-old man presented to the emergency department with general weakness and swelling in his legs. Symmetric swelling had begun 4 weeks earlier and had progressed to the point that it was difficult for him to wear shoes. The nephrotic syndrome is most commonly caused by membranous nephropathy, focal segmental glomerulosclerosis,… Read More…

A Pregnant Woman with Headache

Posted by Carla Rothaus • September 18th, 2015

In a new Case Record of the Massachusetts General Hospital, a 38-year-old pregnant woman presented with headache and visual symptoms. MRI of the brain revealed multiple small infarcts, with no thrombosis. Anemia and eosinophilia were present, as was abnormal endocardial material on echocardiography. Diagnostic tests were performed. Geophagia is practiced in Guatemala and even encouraged during… Read More…

Brain Abscess

Posted by Sara Fazio • August 1st, 2014

Despite advances in diagnostic techniques and treatment, brain abscess remains a challenging clinical problem with substantial case fatality rates. Delays in diagnosis and treatment can result in a poor outcome. A new review summarizes current approaches to effective treatment. Despite advances in imaging techniques, laboratory diagnostics, surgical interventions, and antimicrobial treatment, brain abscess remains a challenging… Read More…

Mild Asthma

Posted by Sara Fazio • August 9th, 2013

Mild, persistent asthma is common but underdiagnosed and often undertreated. Regular controller treatment with lowdose inhaled glucocorticoids and rescue treatment with short-acting beta2-agonists as needed is recommended initially. Treatment is adjusted on the basis of the response within 3 to 4 months. The latest article in our Clinical Practice series comes from Dr. Elisabeth H…. Read More…

Racemic Adrenaline in Acute Bronchiolitis

Posted by Sara Fazio • June 14th, 2013

In this study of infants with bronchiolitis, there was no difference in the length of hospital stay between those treated with inhaled adrenaline and those treated with inhaled saline. Infants treated on demand had a shorter length of stay than those treated on a fixed schedule. Acute bronchiolitis in infants frequently results in hospitalization, but there… Read More…

Injuries

Posted by Sara Fazio • May 3rd, 2013

Injuries, whether intentional or unintentional, account for a substantial burden on the health care system. The latest article in our new Global Health series describes the magnitude of the problem worldwide, enumerates ongoing efforts to prevent injuries, and summarizes systems that need to be in place to care for the injured. In 2010, there were 5.1… Read More…

Belimumab for SLE

Posted by Sara Fazio • April 19th, 2013

In the latest review article in our Clinical Therapeutics series, a 20-year-old woman with SLE presents with disease flares and receives belimumab, a monoclonal antibody that binds to B-cell activating factor, inhibiting B-cell stimulation. Belimumab is considered for patients who do not have a response or have adverse effects with first-line therapies. Clinical Pearls • What… Read More…

Reduced Cortisol Breakdown in Critical Illness

Posted by Daniela Lamas • April 17th, 2013

The 65-year old woman’s stomach started to hurt about a week ago. She thought nothing much of it at first, but the pain intensified and she started spiking fevers, feeling weak and dizzy. When she couldn’t get out of bed, her husband called for an ambulance. By the time she arrives at the hospital, her blood pressure… Read More…