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…
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…
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…
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…
