Inhaled steroids: more harm than good in COPD?
Reuters, 10/14/2009
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In people who suffer from COPD, a progressive lung disease that makes it hard to breathe, adding an inhaled steroid to a so–called "long–acting beta–2 agonist" may do more harm than good, new research hints.
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Bone mineral density and fractures in older men with chronic obstructive pulmonary disease or asthma
Osteoporosis International, 10/13/2009
ascertained Results- 714 (13%) men reported COPD or asthma, of which 103 were prescribed an oral steroid and 177 an inhaled steroid
- Men prescribed corticosteroids for COPD or asthma had the lowest BMD and 2-fold increased risk of vertebral osteoporosis compared to
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Neutrophilic airway inflammation is a main feature of induced sputum in nonatopic asthmatic children
Allergy, 10/14/2009
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present IS with a cell pattern that is predominantly neutrophilic while eosinophilia is the hallmark of airway inflammation in the majority of atopic wheezing children not treated with inhaled steroids.
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Bronchoscopic View of Pulmonary Blastomycosis
Journal of Bronchology, 10/16/2009
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Saeed AI et al. – The authors describe bronchoscopic finding of blastomycosis involving the upper and lower respiratory tract. Inhaled steroids may have suppressed cellular immunity, allowing fungus to grow in the submucosa with histology significant for extensive eosinophilic infiltration
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Inhalational Anesthesia: Basic Pharmacology, End Organ Effects, and Applications in the Treatment of Status Asthmaticus
Journal of Intensive Care Medicine, 10/26/2009
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Tobias JD – The potent inhalational anesthetic agents are used on a daily basis to provide intraoperative anesthesia. The article reviews the history of inhalational ... anesthesia, the physical structure of the inhalational anesthetic agents, their end–organ effects, reports of their use for the treatment of refractory status asthmaticus in the intensive care unit (ICU) patient, and special considerations for their administration in this setting including
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Steroid Therapy of Septic Shock
Critical Care Clinics, 11/06/2009
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Sprung CL et al. – This article reviews the subject of steroid treatment of patients with septic shock and weighs the advantages and disadvantages of steroid treatment. It reviews and contrasts several low– and high–dose steroid studies, and makes
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The ADMIT series - Issues in Inhalation Therapy. 4) How to choose inhaler devices for the treatment of COPD
Primary Care Respiratory Journal, 11/05/2009
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Although efficacy and safety are the primary factors determining the choice of an inhaler device, randomised controlled trials (RCTs) directly comparing the efficacy and safety of different ... a device for the delivery of inhaled drugs in ‘real life’ patients with COPD, other factors should be considered. These include availability and affordability of the inhaled drugs and inhaler devices, the uniformity of inhaler devices when several drugs are to be inhaled, the ability of patients to ... clinician’s task is to provide comprehensive instructions for correct handling of the device and to review regularly the patient’s inhalation technique.
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Supplemental perioperative steroids for surgical patients with adrenal insufficiency
Cochrane Reviews, 10/19/2009
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Yong SL et al. – This review examined the need for additional steroids during surgery, on top of the normal physiological dose requirement. The authors found insufficient evidence from randomized controlled ... use additional steroids at the time of surgery.
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Peritoneal Dialysis Patients with High Effluent Fibrin Degradation Products
Advances in Peritoneal Dialysis, 10/19/2009
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In peritoneal dialysis patients with a high eFDP level, steroid therapy effectively led to a decline in eFDPs. We suggest that peritoneal dialysis patients with an eFDP level above 40 microg/mL should receive steroid therapy. Such steroid therapy may prevent EPS development, but a therapeutic effect ... has persisted for a prolonged period followed by a further increase. Thus, steroids should be administered in the earliest phase of elevation in the eFDP level. Further work is needed to determine the optimal dose of steroid.
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Sustained remission after steroids and leukocytapheresis induced response in steroid-dependent ulcerative colitis: Results at 1 year
Digestive and Liver Diseases, 10/16/2009
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Cabriada JL et al. – Initial remission can be maintained at 1 year in half of the patients without the need for additional steroids. Complete remission and
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