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Latest & greatest articles for corticosteroids
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Corticosteroids could help reduce deaths due to blood poisoning Signal - Corticosteroids could help reduce deaths due to blood poisoning Dissemination Centre Discover Portal NIHR DC Discover Corticosteroids could help reduce deaths due to blood poisoning Published on 23 March 2016 Treatment with low dose corticosteroids given over three or more days reduces the death rate from blood poisoning by 13%, saving about 43 lives per 1000 treated at one month. Blood sugar and sodium levels rose (...) slightly but there was no increased risk of gastrointestinal bleeding or additional infection. Current international guidance from 2012 only recommends using corticosteroids as an add-on therapy for people with blood poisoning whose circulation has not been restored by adequate fluid replacement and vasopressors. This review lends some weight to the case for using corticosteroids more widely for sepsis, but is not definitive. This uncertainty is due to inconsistency in results, with some trials finding
Corticosteroid injections provide only short term relief for rotator cuff disorders Signal - Corticosteroid injections provide only short term relief for rotator cuff disorders Dissemination Centre Discover Portal NIHR DC Discover Corticosteroid injections provide only short term relief for rotator cuff disorders Published on 5 October 2016 A corticosteroid steroid injection into the shoulder provides some short-term pain relief for adults with rotator cuff disorders. This review compared (...) injection of corticosteroids (‘steroids’) with injection of local anaesthetic or placebo. The average improvement in pain relief at two months was calculated as moderate using standardised techniques. The effect wore off by three months. Given the temporary benefits, it may be worth considering other treatments including physiotherapy alongside a steroid injection. Information given by an injecting physiotherapist, for example, regarding the expected duration of pain relief could also help manage
Corticosteroids improve recovery rates after Bell’s palsy Signal - Corticosteroids improve recovery rates after Bell’s palsy Dissemination Centre Discover Portal NIHR DC Discover Corticosteroids improve recovery rates after Bell’s palsy Published on 29 November 2016 Taking a corticosteroid within 72 hours of Bell’s palsy first appearing reduces the number of people with incomplete facial recovery after six months. Bell’s palsy is a sudden onset of weakness or paralysis of the muscles on one (...) side of the face. Most people recover completely within nine months, often with no treatment, but about three in 10 people are left with some weakness or unwanted facial movements. This Cochrane review found that ten people needed to be treated with corticosteroid, compared to placebo tablets, to avoid one incomplete recovery. It also showed that side effects were uncommon and mild. Corticosteroids are often already prescribed to treat Bell’s palsy in practice. This review confirms that they help
Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Signal - Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Dissemination Centre Discover Portal NIHR DC Discover Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Published on 14 February 2017 Early treatment with corticosteroids on top of standard therapy reduces the risk of serious heart problems in children under five (...) that adding corticosteroids early to standard treatment within five days of onset of symptoms reduced the risk of serious abnormalities in the heart arteries by more than two thirds. Corticosteroids were not effective when used as rescue treatment after standard treatment had failed. Increasing awareness of the presenting symptoms of children with Kawasaki disease should ensure children are referred early for treatment. Specialist clinicians may want to consider adding corticosteroids to standard
Antenatal corticosteroids reduce breathing problems in late preterm babies Signal - Antenatal corticosteroids reduce breathing problems in late preterm babies Dissemination Centre Discover Portal NIHR DC Discover Antenatal corticosteroids reduce breathing problems in late preterm babies Published on 21 February 2017 Giving corticosteroids to women at risk of preterm birth at 34 weeks of pregnancy or later reduced the risk of severe breathing problems in the baby after birth from 1.9% to 1.1 (...) , which would need monitoring. The risks and benefits need to be considered before further recommendations can be made extending the use of antenatal corticosteroids to this late preterm age. This includes exploring the long-term effects and consequences for specific groups of women such as those with diabetes or pregnant with more than one baby. Share your views on the research. Why was this study needed? In the UK, about one baby in every 13 is born prematurely, before 37 weeks of pregnancy. Preterm
A dose of corticosteroids benefits most women anticipating a preterm delivery Signal - A dose of corticosteroids benefits most women anticipating a preterm delivery Dissemination Centre Discover Portal NIHR DC Discover A dose of corticosteroids benefits most women anticipating a preterm delivery Published on 16 May 2017 Giving corticosteroids to most women who are anticipating labour before completing 37 weeks of pregnancy helps reduce immediate health problems in the baby compared with placebo (...) or no intervention. Deaths around the time of birth were reduced by 28% and babies were a third (34%) less likely to develop respiratory distress syndrome. A corticosteroid dose is already used for women who go into labour or if waters break before 37 weeks or where delivery is planned for other reasons. The drug accelerates the development of the baby’s lungs and reduces breathing difficulties at birth. This recommendation followed decades of research. This review supports current practice of using a dose
Moisturisers improve eczema symptoms and lessen the need for corticosteroids Signal - Moisturisers improve eczema symptoms and lessen the need for corticosteroids Dissemination Centre Discover Portal NIHR DC Discover Moisturisers improve eczema symptoms and lessen the need for corticosteroids Published on 27 June 2017 Moisturisers help reduce eczema symptoms compared to no treatment, but to a minor extent. They do lengthen the time between each flare, and reduce the number of flares (...) . Importantly they reduce the amount of corticosteroid creams required. Moisturisers seem well tolerated, though there is little data on patient satisfaction. This Cochrane review of 77 trials does not provide information on which moisturiser might be preferred for different parts of the body or different disease severity. Nevertheless, since moisturisers reduce flares and form part of combined treatment with other active treatments, it makes sense to encourage their continued use. Given the lack of a one
Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations Dissemination Centre Discover Portal NIHR DC Discover Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations Published on 15 January 2019 doi: Taking low-dose theophylline tablets in addition to inhaled corticosteroids did not significantly reduce (...) . NICE guidance recommends the use of this drug only when inhaled bronchodilators are not possible Some small studies have suggested that lower doses of theophylline can increase the anti-inflammatory effect of inhaled corticosteroids and might thereby reduce the risk of exacerbations. This larger scale study helps address this uncertainty. What did this study do? This UK-based trial randomised 1,567 participants to receive either low-dose theophylline or placebo over a year in addition
Consequences of long-term oral corticosteroid therapy and its side-effects in severe asthma in adults: a focused review of the impact data in the literature 30190274 2018 10 26 1399-3003 52 4 2018 Oct The European respiratory journal Eur. Respir. J. Consequences of long-term oral corticosteroid therapy and its side-effects in severe asthma in adults: a focused review of the impact data in the literature. 1800703 10.1183/13993003.00703-2018 This review provides an overview of the role of long (...) -term treatment of severe asthma with oral corticosteroids (OCS) and its associated side-effects in adults. It is based on a systematic literature search conducted in MEDLINE, Embase and the Cochrane Library to identify relevant studies. After a short overview of severe asthma and its treatment we present studies showing a dose-response relationship in asthmatic patients treated with OCS and then consider by organ systems the undesired effects demonstrated in clinical and epidemiological studies
Corticosteroids for septic arthritis in children. BACKGROUND: Septic arthritis is an acute infection of the joints characterised by erosive disruption of the articular space. It is the most common non-degenerative articular disease in developing countries. The most vulnerable population for septic arthritis includes infants and preschoolers, especially boys. Septic arthritis disproportionately affects populations of low socioeconomic status. Systemic corticosteroids and antibiotic therapy may (...) be beneficial for treatment of septic arthritis. Even if the joint infection is eradicated by antibiotic treatment, the inflammatory process may produce residual joint damage and sequelae. OBJECTIVES: To determine the benefits and harms of corticosteroids as adjunctive therapy in children with a diagnosis of septic arthritis. SEARCH METHODS: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library, Latin American Caribbean Health Sciences Literature
Saline irrigation and corticosteroid spray are effective first choice treatments for chronic sinusitis Signal - Saline irrigation and corticosteroid spray are effective first choice treatments for chronic sinusitis Dissemination Centre Discover Portal NIHR DC Discover Saline irrigation and corticosteroid spray are effective first choice treatments for chronic sinusitis Published on 22 December 2015 The authors of this systematic review found that high-volume saline irrigation and corticosteroid (...) nasal sprays were effective at reducing symptoms of sinusitis. They recommend a combination of these two therapies as the first line treatment of choice, in accordance with guidelines from the Royal College of Surgeons and ENT UK. In addition they found that, in those with nasal polyps, corticosteroids sprays reduced the polyp size, and during acute exacerbations a two to three week course of oral corticosteroids, doxycycline or a leukotriene antagonist was the most effective strategy. For those
Corticosteroids Provide Better Postoperative Endodontic Pain Relief Compared to Placebo (CAT#3350) UTCAT3350, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Corticosteroids Provide Better Postoperative Endodontic Pain Relief Compared to Placebo Clinical Question In patients receiving non-surgical endodontic therapy, do corticosteroids provide better postoperative endodontic pain relief compared to placebo? Clinical (...) Bottom Line Corticosteroids provide better postoperative endodontic pain relief compared to placebo. Different types and dosages of corticosteroids have different levels of analgesic efficacy. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Shamszadeh/2018 1088 patients in 18 Randomized clinical trials Systematic Review and Meta-Analysis Key results Patients who received corticosteroids had greater
The Effect of Local Versus Intravenous Corticosteroids on the Likelihood of Dysphagia and Dysphonia Following Anterior Cervical Discectomy and Fusion: A Single-Blinded, Prospective, Randomized Controlled Trial 30180054 2018 09 04 1535-1386 100 17 2018 Sep 05 The Journal of bone and joint surgery. American volume J Bone Joint Surg Am The Effect of Local Versus Intravenous Corticosteroids on the Likelihood of Dysphagia and Dysphonia Following Anterior Cervical Discectomy and Fusion: A Single
The clinical and cost-effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome (INSTINCTS trial): an open-label, parallel group, randomised controlled trial. BACKGROUND: To our knowledge, the comparative effectiveness of commonly used conservative treatments for carpal tunnel syndrome has not been evaluated previously in primary care. We aimed to compare the clinical and cost-effectiveness of night splints with a corticosteroid injection with regards to reducing (...) with the European Clinical Trials Database, number 2013-001435-48, and ClinicalTrial.gov, number NCT02038452 . FINDINGS: Between April 17, 2014, and Dec 31, 2016, 234 participants were randomly assigned (118 to the night splint group and 116 to the corticosteroid injection group), of whom 212 (91%) completed the BCTQ at 6 weeks. The BCTQ score was significantly better at 6 weeks in the corticosteroid injection group (mean 2·02 [SD 0·81]) than the night splint group (2·29 [0·75]; adjusted mean difference -0·32
Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD: A Randomized Clinical Trial. Importance: Chronic obstructive pulmonary disease (COPD) is a major global health issue and theophylline is used extensively. Preclinical investigations have demonstrated that low plasma concentrations (1-5 mg/L) of theophylline enhance antiinflammatory effects of corticosteroids in COPD. Objective: To investigate the effectiveness of adding low-dose theophylline (...) to inhaled corticosteroids in COPD. Design, Setting, and Participants: The TWICS (theophylline with inhaled corticosteroids) trial was a pragmatic, double-blind, placebo-controlled, randomized clinical trial that enrolled patients with COPD between February 6, 2014, and August 31, 2016. Final follow-up ended on August 31, 2017. Participants had a ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) of less than 0.7 with at least 2 exacerbations (treated
New evidence available on corticosteroids added to antibiotics in severe pneumonia Signal - New evidence available on corticosteroids added to antibiotics in severe pneumonia Dissemination Centre Discover Portal NIHR DC Discover New evidence available on corticosteroids added to antibiotics in severe pneumonia Published on 9 November 2015 For adults admitted to hospital with severe pneumonia, this review found that adding corticosteroids to the usual antibiotic treatment may be beneficial (...) . The evidence was less supportive of using corticosteroids in people with less severe pneumonia. Results showed modest benefits in allowing patients to reach a clinically stable recovery and leave hospital an average of one day earlier. Reduced need for artificial breathing support was the main benefit for people with non-severe pneumonia. The review showed that using corticosteroids increased levels of blood sugar. This and other potential adverse events were not well investigated, as people at risk