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Should You Recommend Inhaled Corticosteroids for This Patient With Chronic Obstructive Pulmonary Disease?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Approximately 12 million adults in the United States receive a diagnosis of chronic obstructive pulmonary disease (COPD) each year, and it is the fourth leading cause of death. Chronic obstructive pulmonary disease refers to a group of diseases that cause airflow obstruction and a constellation of symptoms, including cough (...) bronchodilators, whereas the role of inhaled corticosteroids is less clear. Inhaled corticosteroids have substantial risks, including an increased risk for pneumonia. Here, 2 experts, both pulmonologists, reflect on the care of a woman with severe COPD, a 50-pack-year smoking history, frequent COPD exacerbations, and recurrent pneumonia. They consider the indications for inhaled corticosteroids in COPD, when inhaled corticosteroids should be withdrawn, and what other treatments are available.
COVID-19: Corticosteroids for hospitalized patients COVID-19: CORTICOSTEROIDS FOR HOSPITALIZED PATIENTS A Rapid Guidance Summary from the Penn Medicine Center for Evidence-based Practice Last updated June 8, 2020. All links rechecked June 8 unless otherwise noted. This Rapid Guidance Summary is a description of existing guidance and evidence reviews from a variety of sources that was in effect at the time of publication. It should not be used or interpreted as a clinical practice guideline (...) , but instead can be used in development of local recommendations and policies. Key questions answered in this summary • How should corticosteroid drugs be used in patients with severe COVID-19 disease? Management of patients who are taking corticosteroids for chronic conditions and treatment of patients who are pregnant is outside the scope of this report. Summary of major recommendations • Guidelines recommend against routine use of corticosteroids in patients with COVID-19 disease. • Guidelines weakly
Associations Between Maternal Antenatal Corticosteroid Treatment and Mental and Behavioral Disorders in Children. Maternal antenatal corticosteroid treatment is standard care to accelerate fetal maturation when birth before 34 weeks is imminent. Recently, expansion of the indications beyond 34 gestational weeks has been debated. However, data about long-term outcomes remain limited, especially among infants who after treatment exposure are born at term.To study if antenatal corticosteroid (...) December 31, 2017.Maternal antenatal corticosteroid treatment.Primary outcome was any childhood mental and behavioral disorder diagnosed in public specialized medical care settings.Of the 674 877 singleton children born in Finland during the study period, 670 097 were eligible for analysis. The median length of follow-up was 5.8 (interquartile-range, 3.1-8.7) years. Of the 14 868 (2.22%; 46.1% female) corticosteroid treatment-exposed children, 6730 (45.27%) were born at term and 8138 (54.74%) were born
Do Corticosteroids Benefit Patients With Influenza Pneumonia? Do Corticosteroids Benefit Patients With Influenza Pneumonia? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page To read this article in full, please review your options for gaining access at the bottom of the page. Article in Press Do Corticosteroids Benefit Patients With Influenza Pneumonia? x Michael Gottlieb , MD (EBEM Commentator) , x Thomas Seagraves , MD (EBEM (...) Commentator) , x Stephen R. Gore , MD (EBEM Commentator) Department of Emergency Medicine, Rush University Medical Center, Chicago, IL DOI: Publication History Published online: July 23, 2019 To view the full text, please login as a subscribed user or . Click to view the full text on ScienceDirect. Among patients with influenza pneumonia, corticosteroids are associated with increased mortality, longer length of stay in the ICU, and higher rates of secondary infection, although there are no data from
Comparison Between Extracorporeal Shock Wave Therapy and Local Corticosteroid Injection for Plantar Fasciitis Extracorporeal shock wave therapy (ESWT) is a nonsurgical treatment for plantar fasciitis (PF) that has had satisfactory clinical outcomes. However, local corticosteroid injection (LCI) is often regarded as first-line treatment of PF, but there have been few studies comparing the 2 methods. Therefore, we compared the effect of ESWT and LCI on patients with PF.This was a block randomized
Inhaled corticosteroids: A rapid review of the evidence for treatment or prevention of COVID-19 Inhaled corticosteroids: A rapid review of the evidence for treatment or prevention of COVID-19 - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. Navigate this website Inhaled corticosteroids: A rapid review of the evidence for treatment or prevention of COVID-19 June 22, 2020 Laura C Armitage and Rachel Brettell On behalf (...) of the Oxford COVID-19 Evidence Service Team Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences University of Oxford Correspondence to: VERDICT This review aimed to synthesise the current literature on the role of inhaled corticosteroids in moderating the disease course or severity of COVID-19 disease. Inhaled ciclesonide has been shown to suppress SARS-CoV-2 replication in cultured cells and it is suggested that it exhibits direct acting anti-viral activity in addition
The Effects of Perioperative Corticosteroids on Dysphagia Following Surgical Procedures Involving the Anterior Cervical Spine: A Prospective, Randomized, Controlled, Double-Blinded Clinical Trial Dysphagia is one of the most common complications of surgical procedures in the anterior cervical spine, and can persist up to 2 years postoperatively. Corticosteroids are relatively safe and inexpensive for treating various inflammatory conditions. Perioperative corticosteroid administration (...) for anterior cervical spine procedures may effectively minimize postoperative dysphagia, potentially leading to better outcomes, decreased readmission rates, and improved patient satisfaction. The purpose of this study was to determine the efficacy of perioperative corticosteroids in decreasing the severity and duration of dysphagia following single-level and multilevel anterior cervical spine procedures.Seventy-four patients undergoing elective anterior cervical surgical procedures for degenerative
Inhaled Corticosteroids for Cystic Fibrosis: A Review of Clinical Effectiveness Inhaled Corticosteroids for Cystic Fibrosis: A Review of Clinical Effectiveness | CADTH.ca Find the information you need Inhaled Corticosteroids for Cystic Fibrosis: A Review of Clinical Effectiveness Inhaled Corticosteroids for Cystic Fibrosis: A Review of Clinical Effectiveness Last updated: March 12, 2019 Project Number: RC1082-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal (...) Result type: Report Question What is the clinical effectiveness of inhaled corticosteroids for the management of patients with cystic fibrosis? Key Message Evidence of limited quality from one systematic review reporting study-level findings and one randomized controlled trial suggested that routine use of inhaled corticosteroids in children and adult cystic fibrosis patients is not significantly more effective than placebo or non-steroid medication in improving lung function as indicated by forced
Intranasal Corticosteroids for the Management of Chronic Rhinosinusitis or Nasal Polyposis in Cystic Fibrosis: A Review of Clinical Effectiveness Intranasal Corticosteroids for the Management of Chronic Rhinosinusitis or Nasal Polyposis in Cystic Fibrosis: A Review of Clinical Effectiveness | CADTH.ca Find the information you need Intranasal Corticosteroids for the Management of Chronic Rhinosinusitis or Nasal Polyposis in Cystic Fibrosis: A Review of Clinical Effectiveness Intranasal (...) Corticosteroids for the Management of Chronic Rhinosinusitis or Nasal Polyposis in Cystic Fibrosis: A Review of Clinical Effectiveness Last updated: March 18, 2019 Project Number: RC1083-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of intranasal corticosteroids for the management of chronic rhinosinusitis or nasal polyposis in patients with cystic fibrosis? Key Message One systematic review with one included
Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 74, Issue 1, Pages e1–e3 Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? x Thomas Seagraves , MD (EBEM Commentator) , x Michael Gottlieb , MD (EBEM Commentator (...) ) Department of Emergency Medicine, Rush University Medical Center, Chicago, IL DOI: | Publication History Published online: June 21, 2018 Expand all Collapse all Article Outline Take-Home Message For adult patients with severe community-acquired pneumonia, corticosteroids reduce morbidity and mortality. For pediatric patients and adults with nonsevere community-acquired pneumonia, corticosteroids appear to reduce morbidity, but not mortality. Methods Data Sources The authors searched the Cochrane Acute
Effect of Corticosteroid-Sparing Treatment With Mycophenolate Mofetil vs Methotrexate on Inflammation in Patients With Uveitis: A Randomized Clinical Trial. Methotrexate and mycophenolate mofetil are commonly used immunomodulatory therapies for achieving corticosteroid-sparing control of noninfectious uveitis, but there is uncertainty about which drug is more effective.To compare the effect of methotrexate and mycophenolate for achieving corticosteroid-sparing control of noninfectious (...) intermediate uveitis, posterior uveitis, and panuveitis.The First-line Antimetabolites as Steroid-sparing Treatment (FAST) uveitis trial screened 265 adults with noninfectious uveitis requiring corticosteroid-sparing immunosuppressive therapy from 9 referral eye centers in India, the United States, Australia, Saudi Arabia, and Mexico between August 22, 2013, and August 16, 2017. Follow-up ended on August 20, 2018.Patients were randomized to receive oral methotrexate, 25 mg weekly (n = 107), or oral
Corticosteroid Therapy in Neonates Undergoing Cardiopulmonary Bypass: Randomized Controlled Trial The efficacy of intraoperative corticosteroids to improve outcomes following congenital cardiac operations remains controversial.The purpose of this study was to determine whether intraoperative methylprednisolone improves post-operative recovery in neonates undergoing cardiac surgery.Neonates undergoing cardiac surgery with cardiopulmonary bypass at 2 centers were enrolled in a double-blind
Effectiveness of a Bundled Intervention Including Adjunctive Corticosteroids on Outcomes of Hospitalized Patients With Community-Acquired Pneumonia: A Stepped-Wedge Randomized Clinical Trial Community-acquired pneumonia remains a leading cause of hospitalization, mortality, and health care costs worldwide. Randomized clinical trials support the use of adjunctive corticosteroids, early progressive mobilization, antibiotic switching rules, and dietary interventions in improving outcomes. However (...) including adjunctive corticosteroids demonstrated no evidence of effectiveness and resulted in a higher incidence of gastrointestinal bleeding. Efficacy of individual interventions demonstrated in clinical trials may not necessarily translate into effectiveness when implemented in combination and may even result in net harm.ClinicalTrials.gov identifier: NCT02835040.
Effectiveness of Foot Orthoses Versus Corticosteroid Injection for Plantar Heel Pain: The SOOTHE Randomized Clinical Trial Plantar heel pain is a common foot complaint that causes significant disability and poorer health-related quality of life. Foot orthoses and corticosteroid injection are effective treatments for plantar heel pain; however, it is unclear whether one is more effective than the other.The aim of this trial was to compare the effectiveness of foot orthoses and corticosteroid (...) injection for plantar heel pain.In this parallel-group, assessor-blinded, randomized clinical trial, participants received prefabricated, arch-contouring foot orthoses or a single ultrasound-guided corticosteroid injection. The primary outcome measure was the foot pain subscale of the Foot Health Status Questionnaire at 4 and 12 weeks.One hundred three participants aged 21 to 72 years (63 female) with plantar heel pain were recruited from the community and received an intervention. For the primary
Inhaled corticosteroids for cystic fibrosis. The reduction of lung inflammation is one of the goals of cystic fibrosis therapy. Inhaled corticosteroids are often used in this respect to treat children and adults with cystic fibrosis. The rationale for this is their potential to reduce lung damage arising from inflammation, as well as their effect on symptomatic wheezing. It is important to establish the current level of evidence for the risks and benefits of inhaled corticosteroids, especially (...) in the light of their known adverse effects on growth. This is an update of a previously published review; however, due to the lack of research in this area, we do not envisage undertaking any further updates.To assess the effectiveness of taking regular inhaled corticosteroids compared to not taking them in children and adults with cystic fibrosis.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register, comprising references identified from comprehensive electronic database
Cost-effectiveness of Antenatal Corticosteroid Therapy vs No Therapy in Women at Risk of Late Preterm Delivery: A Secondary Analysis of a Randomized Clinical Trial Administration of corticosteroids to women at high risk for delivery in the late preterm period (34-36 weeks' gestation) improves short-term neonatal outcomes. The cost implications of this intervention are not known.To compare the cost-effectiveness of treatment with antenatal corticosteroids with no treatment for women at risk (...) for late preterm delivery.This secondary analysis of the Antenatal Late Preterm Steroids trial, a multicenter randomized clinical trial of antenatal corticosteroids vs placebo in women at risk for late preterm delivery conducted from October 30, 2010, to February 27, 2015. took a third-party payer perspective. Maternal costs were based on Medicaid rates and included those of betamethasone, as well as the outpatient visits or inpatient stay required to administer betamethasone. All direct medical costs