Perioperative “stress dose ” of corticosteroid: Pharmacological and clinical perspective

Geetanjali T Chilkoti, Anshul Singh, Medha Mohta, Ashok Kumar SaxenaJournal of Anaesthesiology Clinical Pharmacology 2019 35(2):147-152 Various exogenous steroid preparations have been in use for a wide range of indications. We, as an anesthesiologist often encounters a surgical patient receiving chronic steroid therapy. Perioperative use of steroid is associated with major complications such as full-blown adrenal crisis in the perioperative period due to the secondary adrenal insufficiency. Henceforth, comes the role of the perioperative “stress-dose” of steroids to mitigate this rare but potentially fatal complication. There have been opposing views regarding the need and the appropriate dosage of the perioperative steroids. The present review discusses the changing concept of perioperative “stress dose” of corticosteroids, its pharmacokinetics, clinical relevance, and the related controversies such as the need and the appropriate dose.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research

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Authors: Matsubayashi S, Nakatake N, Hara T Abstract Fatigue is a common symptom in patients visiting the clinic of psychosomatic medicine. A 250-μg synthetic ACTH (1-24) test (rapid ACTH test) and Beck depression inventory (BDI) were performed for 62 patients presenting with fatigue who visited the Department of Psychosomatic Medicine at Fukuoka Tokushukai Hospital. Patients were divided into 3 groups according to the serum cortisol response to the rapid ACTH test; those with a peak serum cortisol level of
Source: Endocrine Journal - Category: Endocrinology Tags: Endocr J Source Type: research
Vitamin B12 deficiency has a storied history including 2 Nobel Prizes, beginning with the discovery of an anemia by the English physician and scientist Thomas Addison in the 1840s. In the preface to his treatise on adrenal insufficiency (Addison disease), he described a  single case of what was termed “Addisonian anemia.”1 German physician Michael Biermer working in Zurich, more convincingly described what he termed “progressive pernicious anemia” in the 1870s, reporting 15 cases in great detail.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Editorials Source Type: research
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Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research
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Source: Revista Paulista de Pediatria - Category: Pediatrics Source Type: research
Abstract Immune checkpoint inhibitors have proven to be effective for various advanced neoplasia. Immune-related adverse events (irAEs) as a result of increased T cell activation are unique and potentially life-threating toxicities associated with the use of immune checkpoint inhibitors. Multiple endocrine irAEs, including primary hyperthyroidism and hypothyroidism, thyroiditis, primary adrenal insufficiency, type 1 diabetes mellitus, and hypophysitis, have been reported with the use of various immune checkpoint inhibitors. In some cases, these irAEs can lead to discontinuation of treatment. Here we propose for th...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research
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Source: Immunological Investigations - Category: Allergy & Immunology Tags: Immunol Invest Source Type: research
Haak Insight into the health-related quality of life (HRQoL) impact of adrenocortical carcinoma (ACC) is important. The disease and its treatment options potentially have an impact on HRQoL. For patients with limited survival, HRQoL research is of utmost importance. We will therefore provide an overview of HRQoL studies in patients with ACC. We found six studies that measured HRQoL in 323 patients with ACC (3 cross-sectional, 1 cohort, 2 trials), all indicating a reduced HRQoL compared to the general population. The FIRMACT trial found that HRQoL of patients with ACC was reduced compared to the general population, and...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
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Source: Tropical Doctor - Category: Tropical Medicine Authors: Tags: Trop Doct Source Type: research
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Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
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