المؤلفون: Uladzimir Adaskevich, Thomas A. Luger, Zuotao Zhao, Zeynep Tamay, Svitlana V Vozianova, Tetyana V Svyatenko, Xia Dou, Mohammad Tawara, Nikolay N. Murashkin, Leyla Namazova-Baranova, Elena Vishneva, Ashraf M. Reda, Maryna Anfilova, Hua Wang, Oleg Nitochko

المصدر: The Journal of Dermatology. 48:1139-1148

مصطلحات موضوعية: Allergy, medicine.medical_specialty, Topical Corticosteroid Therapy, Administration, Topical, Calcineurin Inhibitors, Clinical Decision-Making, Dermatology, Tacrolimus, Dermatitis, Atopic, Sensitive skin, 030207 dermatology & venereal diseases, 03 medical and health sciences, Pimecrolimus, 0302 clinical medicine, Maintenance therapy, Humans, Medicine, business.industry, General Medicine, Atopic dermatitis, medicine.disease, body regions, Calcineurin, Treatment Outcome, 030220 oncology & carcinogenesis, business, Algorithms, medicine.drug

الوصف: Atopic dermatitis is a chronic relapsing, inflammatory skin disorder associated with skin barrier dysfunction, the prevalence of which has increased dramatically in developing countries. In this article, we propose a treatment algorithm for patients with mild-to-moderate and severe atopic dermatitis flares in daily clinical practice. An international panel of 15 dermatology and allergy experts from eight countries was formed to develop a practical algorithm for the treatment of patients with atopic dermatitis, with a particular focus on topical therapies. In cases of mild-to-moderate atopic dermatitis involving sensitive skin areas, the topical calcineurin inhibitor pimecrolimus should be applied twice daily at the first signs of atopic dermatitis. For other body locations, patients should apply a topical calcineurin inhibitor, either pimecrolimus or tacrolimus, twice daily at the first signs of atopic dermatitis, such as pruritus, or twice weekly in previously affected skin areas. Emollients should be used regularly. Patients experiencing acute atopic dermatitis flares in sensitive skin areas should apply a topical corticosteroid twice daily or alternate once-daily topical corticosteroid/topical calcineurin inhibitor until symptoms improve. Following improvement, topical corticosteroid therapy should be discontinued and patients switched to a topical calcineurin inhibitor. Maintenance therapy should include the use of pimecrolimus once daily for sensitive areas and tacrolimus for other body locations. This treatment algorithm can help guide clinical decision-making in the treatment of atopic dermatitis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1eea51e3ff8e64ae181b0ab219a1920eTest
https://doi.org/10.1111/1346-8138.15921Test

المؤلفون: Takuro Hisanaga, Isao Hidaka, Isao Sakaida, Nobuaki Nakayama, Akio Ido, Naoya Kato, Yasuhiro Takikawa, Kazuaki Inoue, Masahito Shimizu, Takuya Genda, Shuji Terai, Hirohito Tsubouchi, Hajime Takikawa, Satoshi Mochida, null Intractable Hepato‐Biliary Disease

المصدر: JGH Open, Vol 5, Iss 4, Pp 428-433 (2021)
JGH Open: An Open Access Journal of Gastroenterology and Hepatology

مصطلحات موضوعية: medicine.medical_specialty, corticosteroid, medicine.drug_class, medicine.medical_treatment, Late onset, RC799-869, Liver transplantation, 03 medical and health sciences, late‐onset hepatic failure, 0302 clinical medicine, Internal medicine, medicine, In patient, Fulminant hepatitis, Hepatology, liver transplantation, business.industry, Gastroenterology, Liver failure, Original Articles, acute liver failure, Diseases of the digestive system. Gastroenterology, Corticosteroid therapy, 030220 oncology & carcinogenesis, Corticosteroid, Original Article, 030211 gastroenterology & hepatology, Bilirubin levels, business, hormones, hormone substitutes, and hormone antagonists

الوصف: Background and Aim In Japan, corticosteroids have been commonly used as a part of multidisciplinary therapy for patients with acute liver failure and late‐onset hepatic failure. However, there is controversy regarding the development of infections and other complications. In this study, the influence of corticosteroids on patient outcomes after liver transplantation was investigated. Methods This study included 167 patients with acute liver failure and late‐onset hepatic failure who underwent liver transplantation between 2010 and 2015. The effects of pretransplant corticosteroid therapy on patient outcomes were evaluated using a database constructed by the subcommittee for fulminant hepatitis in the Intractable Hepato‐Biliary Diseases Study Group of Japan. Results The subacute type and the median total bilirubin levels were higher in those receiving corticosteroids than in those not receiving corticosteroids. Although infections tended to be higher in patients receiving corticosteroids, pretransplant corticosteroid administration did not affect the survival rates. The duration from corticosteroid initiation to liver transplantation was longer in patients who developed infections. The survival rates, however, did not differ between patients with and without infections. Conclusions Corticosteroids were administered to patients with poor prognoses. Otherwise, the overall outcome in those administered corticosteroids was not significantly different from that in those administered without corticosteroids. Although infectious complications tended to occur, they were generally controllable and nonfatal. Pretransplant corticosteroid therapy may be permissible, with regarding for infections and performed within the minimum duration.
Corticosteroids are commonly used for acute liver failure in Japan. However, there is controversy regarding the development of complications. We analyzed the influence of corticosteroids on patient outcomes after liver transplantation. Although, infections tended to occur in patients receiving corticosteroids, pretransplant corticosteroid didn't affect the survival rates. The duration from corticosteroid initiation to liver transplantation was longer in patients with infections. Pretransplant corticosteroid may be a permissible treatment with caution for infections and within the minimum duration.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f50cafd961f00ce28ba32fa1468b0b13Test
https://doaj.org/article/0d4366d872a644fdb3f7e6e505aa7ffcTest

المؤلفون: Neda Alijani, Kazem Ahmadikia, Emmanuel Roilides, Seyed Jamal Hashemi, Hossein Mirhendi, Sassan Rezaie, Mohammadreza Salehi, Mojtaba Mohammadi Ardehali, Muhammad Ibrahim Getso, Sadegh Khodavaisy, Mohammad Kord, Hamid Badali, Azin Tabari

المصدر: Mycoses

مصطلحات موضوعية: Adult, 0301 basic medicine, medicine.medical_specialty, Antifungal Agents, medicine.medical_treatment, Pneumonia, Viral, corticosteroid therapy, 030106 microbiology, viral pneumonia, Review Article, Dermatology, Aspergillosis, mucormycosis, Diabetes Complications, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Adrenal Cortex Hormones, COVID‐19, Amphotericin B, Diabetes mellitus, Internal medicine, Influenza, Human, medicine, Humans, Review Articles, Dexamethasone, business.industry, Mucormycosis, COVID-19, Immunosuppression, General Medicine, Triazoles, medicine.disease, Infectious Diseases, Viral pneumonia, Liposomes, Female, influenza, Complication, business, medicine.drug

الوصف: Acute respiratory distress syndrome is a common complication of severe viral pneumonia, such as influenza and COVID‐19, that requires critical care including ventilatory support, use of corticosteroids and other adjunctive therapies to arrest the attendant massive airways inflammation. Although recommended for the treatment of viral pneumonia, steroid therapy appears to be a double‐edged sword, predisposing patients to secondary bacterial and invasive fungal infections (IFIs) whereby impacting morbidity and mortality. Mucormycosis is a fungal emergency with a highly aggressive tendency for contiguous spread, associated with a poor prognosis if not promptly diagnosed and managed. Classically, uncontrolled diabetes mellitus (DM) and other immunosuppressive conditions including corticosteroid therapy are known risk factors for mucormycosis. Upon the background lung pathology, immune dysfunction and corticosteroid therapy, patients with severe viral pneumonia are likely to develop IFIs like aspergillosis and mucormycosis. Notably, the combination of steroid therapy and DM can augment immunosuppression and hyperglycaemia, increasing the risk of mucormycosis in a susceptible individual. Here, we report a case of sinonasal mucormycosis in a 44‐year‐old woman with hyperglycaemia secondary to poorly controlled diabetes following dexamethasone therapy on a background of influenza pneumonia and review 15 available literatures on reported cases of influenza and COVID‐19 associated mucormycosis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9677cf2d840b6b162d2bf658c9b68dd4Test
https://doi.org/10.1111/myc.13256Test

المؤلفون: Taieb Jomni, Abdelwaheb Nakhli, Syrine Bellakhal, Zeineb Teyeb, Imen Abdelaali, M Ayari

المصدر: Clinical Case Reports, Vol 9, Iss 3, Pp 1759-1762 (2021)
Clinical Case Reports

مصطلحات موضوعية: Intestinal pseudo-obstruction, Systemic disease, medicine.medical_specialty, lcsh:Medicine, Case Report, Case Reports, systemic disease, 030204 cardiovascular system & hematology, urologic and male genital diseases, dysmotility, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, medicine, skin and connective tissue diseases, intestinal pseudo‐obstruction, lcsh:R5-920, Systemic lupus erythematosus, Systemic lupus, business.industry, lcsh:R, General Medicine, lupus, medicine.disease, Dermatology, Corticosteroid therapy, 030220 oncology & carcinogenesis, Presentation (obstetrics), business, lcsh:Medicine (General)

الوصف: Systemic diseases should be always considered when managing unexplained intestinal pseudo‐obstruction. Intestinal pseudo‐obstruction related to systemic lupus erythematosus is often responsive to corticosteroid therapy when promptly treated.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1b471539d73202b3ba1c3489f1883be1Test
https://doaj.org/article/3dfe50fa9adf4799bdd24dc6515f4efaTest

المؤلفون: Zhu Cui, Leonidas Palaiodimos, Andrei Assa, William N. Southern, Erica Chung, Margaret E McCort, Zachary Merritt, Shitij Arora, Bibi Ayesha, Hashim Mustehsan, Anand Kumthekar, Yelena Averbukh, Sichen Liu, Sarah W. Baron

المصدر: Journal of Hospital Medicine. 16:E1-E7

مصطلحات موضوعية: Male, medicine.medical_specialty, Reduced risk, Coronavirus disease 2019 (COVID-19), Leadership and Management, Assessment and Diagnosis, 03 medical and health sciences, 0302 clinical medicine, Adrenal Cortex Hormones, Internal medicine, Humans, Medicine, In patient, 030212 general & internal medicine, Care Planning, Aged, Retrospective Studies, 030304 developmental biology, 0303 health sciences, biology, SARS-CoV-2, business.industry, Health Policy, C-reactive protein, COVID-19, Retrospective cohort study, General Medicine, Odds ratio, Middle Aged, COVID-19 Drug Treatment, C-Reactive Protein, Corticosteroid therapy, biology.protein, Biomarker (medicine), Female, Fundamentals and skills, business, Biomarkers

الوصف: BACKGROUND: Corticosteroids may be beneficial in a subset of patients with coronavirus disease 2019 (COVID-19), but predictors of therapeutic response remain unknown. C-reactive protein (CRP) is a routinely measured biomarker, and reduction in its levels after initiation of therapy may predict inpatient mortality. METHODS: In this retrospective cohort study, the charts of patients who were admitted to Montefiore Medical Center between March 10, 2020, and May 2, 2020 for the management of COVID-19 were examined. Of all patients who met inclusion criteria, patients who received corticosteroid treatment were categorized as CRP responders (≥50% CRP level reduction) and CRP nonresponders (

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::62f24ed19069ce542201ec8a01257f03Test
https://doi.org/10.12788/jhm.3560Test

المؤلفون: Maryam Mahdavi, Reihaneh Aryan, Vahid Mashayekhi, Yalda Nahidi, Mehrdad Teimoorian

المصدر: Clinical Case Reports, Vol 9, Iss 1, Pp 133-136 (2021)
Clinical Case Reports

مصطلحات موضوعية: medicine.medical_specialty, Medicine (General), recurrence, medicine.drug_class, medicine.medical_treatment, Case Report, Case Reports, 030204 cardiovascular system & hematology, disseminated, 03 medical and health sciences, cutaneous leishmaniasis, 0302 clinical medicine, R5-920, Cutaneous leishmaniasis, parasitic diseases, medicine, In patient, immunosuppression, business.industry, Immunosuppression, General Medicine, medicine.disease, systemic corticosteroids, Dermatology, Corticosteroid therapy, 030220 oncology & carcinogenesis, Corticosteroid, Medicine, Presentation (obstetrics), business

الوصف: Clinicians should always consider rare, atypical, and opportunistic infections in patients undergoing long‐term systemic corticosteroid therapy. Diagnosis needs further evaluations and special consideration.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::05e8827a6ef630e9af557b3875d94a42Test
https://doaj.org/article/714ae47c84fa4a1ab2e365eaadcdd787Test

المؤلفون: Yasuhiko Endo, Yumie Yamanaka, Shota Fujimoto, Kazuyoshi Kuwano, Hanae Miyagawa, Yoshitaka Seki, Akira Kinoshita, Naoaki Watanabe, Chiaki Hosoda, Yusuke Kurita, Keisuke Saito

المصدر: Clinical Case Reports, Vol 7, Iss 3, Pp 477-481 (2019)
Clinical Case Reports

مصطلحات موضوعية: medicine.medical_specialty, organizing pneumonia, pulmonary alveolar proteinosis, corticosteroid therapy, lcsh:Medicine, Case Report, Case Reports, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Hematologic disorders, chronic myeloid leukemia, Internal medicine, medicine, In patient, lcsh:R5-920, business.industry, lcsh:R, General Medicine, medicine.disease, Steroid therapy, Corticosteroid therapy, 030220 oncology & carcinogenesis, Atypical chronic myeloid leukemia, Organizing pneumonia, lcsh:Medicine (General), Pulmonary alveolar proteinosis, business

الوصف: Key Clinical Message Organizing pneumonia (OP) and pulmonary alveolar proteinosis (PAP) are rare complications in patients with hematologic disorders. We herein report a case of PAP that developed during steroid treatment for OP in a patient with atypical chronic myeloid leukemia. Physicians should pay close attention to these complications in patients with hematologic malignancies.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::81d4441d39f694118a5cd6ee482adeb8Test
https://doi.org/10.1002/ccr3.2014Test

المؤلفون: Daniel H. Kim, Devyani Lal, Lisa A. Marks, Angela M. Donaldson, Garret Choby

المصدر: Otolaryngology–Head and Neck Surgery. 163:1097-1108

مصطلحات موضوعية: Adult, Pediatrics, medicine.medical_specialty, Side effect, medicine.drug_class, medicine.medical_treatment, Iatrogenic Disease, 03 medical and health sciences, 0302 clinical medicine, Adrenal Cortex Hormones, medicine, Humans, 030223 otorhinolaryngology, Adverse effect, Administration, Intranasal, United States Food and Drug Administration, business.industry, Nasal Sprays, United States, Safety profile, 030228 respiratory system, Otorhinolaryngology, Corticosteroid therapy, Meta-analysis, Corticosteroid, Surgery, Nasal administration, business, Topical steroid

الوصف: To address concerns related to the safety profile of both Food and Drug Administration (FDA)-approved and non-FDA-approved intranasal corticosteroid (INCS) use in the adult population.Systematic review of MEDLINE, PubMed, and EMBASE databases using a comprehensive search strategy including all INCS formulations and adverse events. The study design was developed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additional sources were identified from study references of relevant articles.A structured literature search was conducted. Each study was graded for level of evidence using the Oxford Centre for Evidence-Based Medicine. Extracted data included population size, study design, drug (dosage, route, and frequency), presence of hypothalamus pituitary axis suppression, ocular symptoms, and treatment-related adverse events.A total of 60 studies met inclusion criteria. The studies included use of INCS as metered nasal sprays, drops, injections, aerosols, and irrigations. There were no persistent abnormalities in cortisol level or intraocular pressure change. Meta-analysis of epistaxis showed a significantly increased risk in the FDA-approved treatment group in comparison with control (risk ratio 1.56; 95% confidence interval, 1.13-2.14;Overall, it appears that the use of both FDA and published non-FDA application of INCS are safe in the adult population. Meta-analysis demonstrated an increased risk of epistaxis in patients using INCS compared with placebo. Otherwise, there was no significant difference between in adults in the treatment group and placebo group. As an important caveat, the interpretation of safety of nonstandard INCS is restricted to delivery methods and dosages published in the literature.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9db8470e7fcaefcf9482f3a2bb892010Test
https://doi.org/10.1177/0194599820931455Test

المؤلفون: Shosei Ro, Torahiko Jinta, Clara So, Manabu Murakami, Ryosuke Imai

المصدر: Respirology Case Reports, Vol 8, Iss 6, Pp n/a-n/a (2020)
Respirology Case Reports

مصطلحات موضوعية: Pulmonary and Respiratory Medicine, ARDS, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, corticosteroid therapy, Disease, Acute respiratory distress, mechanical ventilation, 03 medical and health sciences, 0302 clinical medicine, COVID‐19, medicine, Case Series, Mechanical ventilation, lcsh:RC705-779, business.industry, Clinical course, lcsh:Diseases of the respiratory system, medicine.disease, 030228 respiratory system, Corticosteroid therapy, Methylprednisolone, 030220 oncology & carcinogenesis, Anesthesia, business, medicine.drug

الوصف: We report a case series of seven mechanically ventilated patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease (COVID‐19) who received early treatment with high‐dose, short‐term systemic corticosteroids to prevent cytokine overproduction. Of the seven patients, four were male and median age was 69 years. They were intubated within seven days after admission when their respiratory status rapidly worsened. At that time, we administered 1000 or 500 mg/day for three days of methylprednisolone intravenously, followed by 1 mg/kg and tapered off. The median duration for the total administration of corticosteroids was 13 days. This high‐dose, short‐term corticosteroid therapy enabled extubation of the patients within seven days. Many questions on the clinical management of COVID‐19 remain unanswered, and data on corticosteroid therapy as a choice of treatment are mixed. We present the clinical course of our cases, review the previous evidence, and discuss management.
Many questions on the clinical management of coronavirus disease (COVID‐19) remain unanswered, and data on corticosteroid therapy as a choice of treatment are mixed. We present the clinical course of seven patients, review the previous evidence, and discuss management.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::53ef6a67b06389aa5ff8112193f4cf5cTest
https://doaj.org/article/7eba86f0619f464d974d1d4dae0f5480Test

المؤلفون: Reina Hara, Haruhiko Hirata, Yoshimi Noda, Yuichi Adachi, Akinori Uchiyama, Moe Koide, Yoshito Takeda, Saori Amiya, Takayuki Shiroyama, Takayuki Niitsu, Atsushi Kumanogoh, Kotaro Miyake, Yasuhiko Suga, Kiyoharu Fukushima, Takatoshi Enomoto

المصدر: Respirology Case Reports, Vol 9, Iss 7, Pp n/a-n/a (2021)
Respirology Case Reports

مصطلحات موضوعية: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Secondary infection, corticosteroid therapy, Congenital cytomegalovirus infection, Case Report, Autopsy, Case Reports, cytomegalovirus pneumonia, Diseases of the respiratory system, 03 medical and health sciences, 0302 clinical medicine, COVID‐19, medicine, Intensive care medicine, Co‐infection, Mechanical ventilation, RC705-779, Critically ill, business.industry, lymphopenia, medicine.disease, Pneumonia, 030228 respiratory system, Respiratory failure, 030220 oncology & carcinogenesis, business

الوصف: Coronavirus disease 2019 (COVID‐19) can cause severe lymphopenia and respiratory failure requiring prolonged invasive mechanical ventilation (MV). COVID‐19 patients with severe lymphopenia or respiratory failure are at risk of developing secondary infections. Here, we present the needle autopsy findings of a critically ill patient with COVID‐19 who required reintubation and prolonged MV, and eventually died of secondary cytomegalovirus (CMV) pneumonia. This case highlights the potential risk of long‐term steroid use and the need for routine monitoring for CMV infection in critically ill patients with COVID‐19.
Here, we present the needle autopsy findings of a critically ill patient with coronavirus disease 2019 (COVID‐19) who required reintubation and prolonged mechanical ventilation, and eventually died of secondary cytomegalovirus (CMV) pneumonia. This case highlights the potential risk of long‐term steroid use and the need for routine monitoring for CMV in critically ill patients with COVID‐19.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4ad01c4c12d7e4fbdc2ce6e8998cb3d0Test
https://doi.org/10.1002/rcr2.801Test