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Latest & greatest articles for corticosteroids
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Corticosteroids as Adjunctive Therapy in the Treatment of Influenza: An Updated Cochrane Systematic Review and Meta-analysis Corticosteroids may be beneficial in sepsis, but uncertainty remains over their effects in severe influenza. This systematic review updates the current evidence regarding corticosteroids in the treatment of influenza and examines the effect of dose on outcome.Electronic databases (MEDLINE, EMBASE, CINAHL, LILACS, CENTRAL, and Web of Science) and trial registries were (...) searched to October 2018 for randomized controlled trials, quasi-experimental designs, and observational cohort studies reporting corticosteroid versus no corticosteroid treatment in individuals with influenza.Two researchers independently assessed studies for inclusion. Risk of bias was assessed using the Cochrane Risk of Bias tool (randomized controlled trials) or Newcastle-Ottawa Scale (observational studies). Where appropriate, we estimated the effect of corticosteroids by random-effects meta
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
Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis Corticosteroid injection is frequently used for plantar heel pain (plantar fasciitis), although there is limited high-quality evidence to support this treatment. Therefore, this study reviewed randomised trials to estimate the effectiveness of corticosteroid injection for plantar heel pain.A systematic review and meta-analysis of randomised trials that compared corticosteroid injection to any comparator (...) . Primary outcomes were pain and function, categorised as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks).A total of 47 trials (2989 participants) were included. For reducing pain in the short term, corticosteroid injection was more effective than autologous blood injection (SMD -0.56; 95% CI, - 0.86 to - 0.26) and foot orthoses (SMD -0.91; 95% CI, - 1.69 to - 0.13). There were no significant findings in the medium term. In the longer term, corticosteroid injection was less
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
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
Inhaled corticosteroids in children with persistent asthma: effects of different drugs and delivery devices on growth. Inhaled corticosteroids (ICS) are the most effective treatment for children with persistent asthma. Although treatment with ICS is generally considered to be safe in children, the potential adverse effects of these drugs on growth remains a matter of concern for parents and physicians.To assess the impact of different inhaled corticosteroid drugs and delivery devices (...) conducted in September 2014, and updated in November 2015, September 2018, and April 2019.We selected parallel-group randomized controlled trials of at least three months' duration. To be included, trials had to compare linear growth between different inhaled corticosteroid molecules at equivalent doses, delivered by the same type of device, or between different devices used to deliver the same inhaled corticosteroid molecule at the same dose, in children up to 18 years of age with persistent asthma.At
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
Are corticosteroid injections needed after needling and lavage of calcific tendinitis? Randomised, double-blind, non-inferiority trial Steroid injections are common after an ultrasound-guided puncture and lavage (UGPL) of calcific tendonitis of the rotator cuff. However, steroids may prevent calcification resorption and negatively affect tendon healing. Our study was designed to determine whether saline solution was non-inferior to steroids in the prevention of acute pain reactions in the week
Effects of repeat prenatal corticosteroids given to women at risk of preterm birth: An individual participant data meta-analysis Infants born preterm compared with infants born at term are at an increased risk of dying and of serious morbidities in early life, and those who survive have higher rates of neurological impairments. It remains unclear whether exposure to repeat courses of prenatal corticosteroids can reduce these risks. This individual participant data (IPD) meta-analysis (MA (...) ) assessed whether repeat prenatal corticosteroid treatment given to women at ongoing risk of preterm birth in order to benefit their infants is modified by participant or treatment factors.Trials were eligible for inclusion if they randomised women considered at risk of preterm birth who had already received an initial, single course of prenatal corticosteroid seven or more days previously and in which corticosteroids were compared with either placebo or no placebo. The primary outcomes for the infants
Tralokinumab did not demonstrate oral corticosteroid-sparing effects in severe asthma Long-term oral corticosteroid (OCS) use in patients with severe asthma is associated with significant adverse effects.This 40-week, randomised, double-blind trial evaluated the OCS-sparing potential of tralokinumab in patients with severe, uncontrolled asthma requiring maintenance OCS treatment plus inhaled corticosteroids/long-acting β2-agonists. Overall, 140 patients were randomised to tralokinumab 300 mg
Corticosteroids as adjunctive therapy in the treatment of influenza. Specific treatments for influenza are limited to neuraminidase inhibitors and adamantanes. Corticosteroids show evidence of benefit in sepsis and related conditions, most likely due to their anti-inflammatory and immunomodulatory properties. Although commonly prescribed for severe influenza, there is uncertainty over their potential benefits or harms. This is an update of a review first published in 2016.To systematically (...) assess the effectiveness and potential adverse effects of corticosteroids as adjunctive therapy in the treatment of influenza, taking into account differences in timing and doses of corticosteroids.We searched CENTRAL (2018, Issue 9), which includes the Cochrane Acute Respiratory infections Group's Specialised Register, MEDLINE (1946 to October week 1, 2018), Embase (1980 to 3 October 2018), CINAHL (1981 to 3 October 2018), LILACS (1982 to 3 October 2018), Web of Science (1985 to 3 October 2018
Systemic corticosteroids for the management of cancer-related breathlessness (dyspnoea) in adults. Dyspnoea is a common symptom in advanced cancer, with a prevalence of up to 70% among patients at end of life. The cause of dyspnoea is often multifactorial, and may cause considerable psychological distress and suffering. Dyspnoea is often undertreated and good symptom control is less frequently achieved in people with dyspnoea than in people with other symptoms of advanced cancer, such as pain (...) and nausea. The exact mechanism of action of corticosteroids in managing dyspnoea is unclear, yet corticosteroids are commonly used in palliative care for a variety of non-specific indications, including pain, nausea, anorexia, fatigue and low mood, despite being associated with a wide range of adverse effects. In view of their widespread use, it is important to seek evidence of the effects of corticosteroids for the management of cancer-related dyspnoea.To assess the effects of systemic corticosteroids