Posts Tagged ‘glucocorticoids’

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… 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… 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… 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… Read More…

Inhaled Glucocorticoids in Children and Adult Height

Posted by Sara Fazio • September 7th, 2012

In a randomized, controlled trial, the use of inhaled budesonide in childhood was associated with a decrease of 1.2 cm in attained adult height, as compared with placebo. Inhaled glucocorticoids are the recommended therapy for persistent asthma in children. In prepubertal children, however, the use of inhaled glucocorticoids has been shown to reduce growth velocity,… Read More…

Cushing’s Syndrome

Posted by Sara Fazio • December 30th, 2011

In the latest Case Record of the Massachusetts General Hospital, a 52-year-old man was admitted to this hospital because of weakness, leg swelling, and hypokalemia. During the hospital course, multiple infections were diagnosed and imaging studies revealed enlarged adrenal glands. A diagnostic procedure was performed. Once excess cortisol is suspected, laboratory testing is advisable for… Read More…

Inhaler Wars: Tiotropium versus Salmeterol for Chronic Obstructive Pulmonary Disease

Posted by Ishani Ganguli • March 23rd, 2011

COPD sufferers know the symptoms all too well: the phlegmy cough, gasping wheezy breaths, and chest tightness that signal an exacerbation. Guidelines recommend inhaled long-acting bronchodilators—either an anticholinergic or a β2-agonist—to mitigate symptoms and reduce the frequency of these exacerbations in patients with moderate to severe disease. Which one is more effective? Without large head-to-head… Read More…

ANCA-Associated Vasculitis

Posted by Graham McMahon • July 16th, 2010

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, including Wegener’s granulomatosis and microscopic polyangiitis, is a multisystem autoimmune syndrome characterized by vasculitis predominantly affecting microscopic vessels and circulating autoantibodies to neutrophil cytoplasmic antigens. Jones et al. report that in a randomized trial, standard glucocorticoid regimen plus rituximab was not superior to standard intravenous cyclophosphamide as induction therapy in… Read More…