Epidural Corticosteroid Injections: Still Credible?

Publication date: Available online 9 March 2019Source: Joint Bone SpineAuthor(s): Hervé Bard, Marc Marty, Sylvie Rozenberg, Jean-Denis Laredo
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research

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Budesonide oral suspension (BOS) is a novel topical corticosteroid, which has been shown to improve symptoms and endoscopic appearance, and reduce peak eosinophil counts in patients with eosinophilic esophagitis (EoE). This trial evaluated the effect of BOS or placebo on the severity (grade) and extent (stage) of 8 histopathologic features observed in EoE, using the validated eosinophilic esophagitis histologic scoring system (EoE HSS). Patients with EoE aged 11 to 40 years with dysphagia were randomized to receive either BOS (2.0 mg twice daily) or placebo for 12 weeks. Mean (SD) EoE HSS grade and stage total score...
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
Authors: Lou H, Wang C, Zhang L Abstract Introduction: Chronic rhinosinusitis (CRS) is a heterogeneous disease spectrum with variable phenotypes and endotypes that are not well characterized. Conventional treatment options are insufficient; recent research in precision medicine focuses on providing endotype-driven care based on underlying mechanisms. Areas covered: A comprehensive overview of CRS phenotypes and endotypes is provided. Biomarkers have been identified to predict prognosis and guide personalized pharmacotherapy, surgery, and innovative treatments. For CRS with nasal polyps (CRSwNP), type 2-targeting bi...
Source: Expert Review of Clinical Immunology - Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research
Patients who qualify for bariatric surgery are increasingly experiencing comorbid conditions which often require management through the use of immunosuppressive agents, such as corticosteroids, tumor necrosis alpha factor inhibitors, or other immunomodulators, which may increase risk of infection or wound healing complications. Perioperative management of these agents in bariatric surgery is challenging due to lack of research in that patient population. With immunosuppressive agents use on the rise, the effects of these medications must be understood, the risks posed in the perioperative period, and the benefit their sust...
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Review articles Source Type: research
AbstractBackgroundCrescent formation in immunoglobulin A nephropathy (IgAN) has been demonstrated to be a risk factor for worse outcomes. For IgAN patients with 0 –25% crescentic glomeruli (C1), whether corticosteroids (CS) can improve the prognosis remains unclear. We tried to investigate the need for using CS in IgAN patients with C1 in different proteinuria levels.MethodsA total of 120 eligible IgAN patients with C1 from two academic medical centers were retrospectively studied, and 57 (47.5%) received CS. Patients were grouped according to with or without CS. The outcomes were the rate of estimated glomerular fil...
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
Journal of Neurotrauma, Ahead of Print.
Source: Journal of Neurotrauma - Category: Neurology Authors: Source Type: research
In the palliative care of patients with non-small cell lung cancer (NSCLC), bronchial hypersecretion (bronchorrhea) may cause additional dyspnea and impaired quality of life. Bronchorrhea is defined as mostly aqueous sputum production with a volume of> 100ml / 24 hours. Various treatment options have been described in case reports and small series, including the use of tyrosine kinase inhibitors such as gefitinib and erlotinib, somatostatin analogues (octreotide), macrolide antibiotics, anti-inflammatory drugs (indomethacin, corticosteroids) and anticholinergics.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
ConclusionTimely intervention can restore hearing loss in AIED patients, but the clinician has to find a delicate balance between the hearing outcome and the potential side effects resulting from long-term use of the drugs. Treatment of steroid resistant AIED is a challenge and there are no universal guidelines for the same. AIED being an uncommon diagnosis, multicentric trials and collaboration are required to formulate diagnostic criteria and therapeutic guidelines.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
We describe a female diagnosed with non-allergic asthma. On March 24, 2016, examination of the skin-biopsy specimen revealed dense eosinophilic infiltration, and the Fip-1-like 1-platelet-derived growth factor receptor a fusion gene in peripheral blood mononuclear cells was negative. She was diagnosed with idiopathic hypereosinophilic syndrome. She was treated with intravenous methylprednisolone (MPSL), and subsequent oral MPSL. Then, she started to receive a monthly mepolizumab in June 2016, and successfully withdrew from daily use of oral MPSL. The patient has a mother diagnosed with non-allergic asthma. In February 2005...
Source: European Annals of Allergy and Clinical Immunology - Category: Allergy & Immunology Tags: Eur Ann Allergy Clin Immunol Source Type: research
CONCLUSION: BT in adults with severe asthma improved ACQ, mini-AQLQ and lung function, but resulted in an increased frequency of unscheduled doctor-visits and rescue courses of OCS and antibiotics. PMID: 31593491 [PubMed - as supplied by publisher]
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research
CONCLUSIONS: The overall rate of total infectious complications or intra-abdominal septic complications was not increased based on preoperative exposure to a particular class of biologic. Rates increased with combination immunosuppression of biologic therapy with corticosteroids and previous abdominal resection. See Video Abstract at http://links.lww.com/DCR/B24. BIOLÓGICOS Y COMPLICACIONES POSTOPERATORIAS DE 30 DÍAS DESPUÉS DE LAS OPERACIONES ABDOMINALES PARA LA ENFERMEDAD DE CROHN: ¿EXISTEN DIFERENCIAS EN LOS PERFILES DE SEGURIDAD?: ANTECEDENTES: La evidencia sobre la asociación d...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Inflammatory Bowel Disease Source Type: research
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