Rationale and design of the steroids to reduce systemic inflammation after infant heart surgery (stress) trial

Publication date: Available online 9 December 2019Source: American Heart JournalAuthor(s): Kevin D. Hill, H. Scott Baldwin, David P. Bichel, Ryan J. Butts, Reid C. Chamberlain, Alicia M. Ellis, Eric M. Graham, Jesse Hickerson, Christoph P. Hornik, Jeffrey P. Jacobs, Marshall L. Jacobs, Robert DB Jaquiss, Prince J. Kannankeril, Sean M. O'Brien, Rachel Torok, Joseph W. Turek, Jennifer S. Li, For the STRESS Network InvestigatorsFor decades, physicians have administered corticosteroids in the perioperative period to infants undergoing heart surgery with cardiopulmonary bypass (CPB) to reduce the post-operative systemic inflammatory response to CPB. Some question this practice because steroid efficacy has not been conclusively demonstrated and because some studies indicate that steroids could have harmful effects. STRESS is a randomized, placebo-controlled, double blind, multi-center trial designed to evaluate safety and efficacy of perioperative steroids in infants (age
Source: American Heart Journal - Category: Cardiology Source Type: research

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Conclusions: Compared with patients without bronchiectasis and COPD, BCOS patients with recent SABAs, past ICSs, and past anti-arrhythmia drugs use; a low or medium SABAs ICSs, and OSs dose; and a low SAMAs dose had a higher risk of HDS. LAMAs were not associated with HDS.
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusions: TDL impose high medical economic burden. The estimated economic costs had been developed mainly by inpatient services and medication prescriptionsThis study was supported by a grant of the Ministry of Health and Welfare, Republic of Korea (Grant No. HC16C-2254-010017).
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Tuberculosis Source Type: research
SOCOS group Abstract The International Staging System (ISS) -calculated from serum albumin and beta-2 microglobulin (β2m)- is an established prognostic marker in multiple myeloma (MM), which has also been suggested to account for survival among general senior population. Our objective was to examine long-term survival of older women free of MM according to baseline ISS. The study included 230 community-dwelling healthy older women without known MM from the EPIDOS cohort (mean ± SD, 80.4 ± 3.4 years). Serum albumin and β2m were measured at baseline, and used to calculate the ISS a ...
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
Abstract We investigated the incidence of type II diabetes mellitus (T2DM) among people with COPD and whether exposure to inhaled corticosteroid (ICS) and exacerbation status was associated with T2DM. This descriptive cohort study used primary care data from the Clinical Practice Research Datalink (CPRD). The patient cohort included people with a diagnosis of COPD and previous smoking history registered at a CPRD practice between January 2010 and December 2016. We determined incidence rates by age, gender and deprivation. Using a nested case-control design-where cases and controls are drawn from the cohort populat...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: NPJ Prim Care Respir Med Source Type: research
We report the case of a 50-year-old male of UCTD presented with dark brown urine, swelling and edema of the upper limbs, and decreased urine output. Diagnosis: The patient was diagnosed with rhabdomyolysis-induced AKI secondary to UCTD. Interventions: The patient was successfully treated with intravenous methylprednisolone with other supportive treatment. Outcomes: After 3 days of initiating treatment of medicinal charcoal tablets, sodium bicarbonate and intravenous fluids upon admission, the patient's serum creatinine changed mildly from 145.0 μmol/L to 156.0 μmol/L, but the urinary output increased from 10...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
AbstractChronic obstructive pulmonary disease (COPD) can be a disabling disease, and the impact on older adults is particularly evident in the nursing home setting. Chronic obstructive pulmonary disease is present in about 20% of nursing home residents, most often in women, and accounts for significant healthcare utilization including acute care visits for exacerbations and pneumonia, as well as worsening heart disease and diabetes mellitus. The emphasis on hospital readmissions is particularly important in nursing homes where institutions have quality measures that have financial implications. Optimizing drug therapies in...
Source: Drugs and Aging - Category: Geriatrics Source Type: research
The objective of this study was to evaluate possible predictive factors for exacerbation and re-exacerbation. Methods: In order to predict exacerbation until the next visit based on the knowledge of exacerbation since the last visit, a multistate model described by Therneau and Grambsch was performed. Results: Data of 1,247 patients (60.4% males, 46.6% current smokers) were analyzed, 268 (21.5%) did not fulfill spirometric diagnostic criteria for COPD. Data of 748 patients (63% males, 44.1% current smokers) were available for model analysis. In order to predict exacerbation an extended Cox Model was performed. Me...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Multidiscip Respir Med Source Type: research
The objective of this study was to evaluate possible predictive factors for exacerbation and re-exacerbation.MethodsIn order to predict exacerbation until the next visit based on the knowledge of exacerbation since the last visit, a multistate model described by Therneau and Grambsch was performed.ResultsData of 1,247 patients (60.4% males, 46.6% current smokers) were analyzed, 268 (21.5%) did not fulfill spirometric diagnostic criteria for COPD. Data of 748 patients (63% males, 44.1% current smokers) were available for model analysis. In order to predict exacerbation an extended Cox Model was performed. Mean FEV1/FVC-rati...
Source: Multidisciplinary Respiratory Medicine - Category: Respiratory Medicine Source Type: research
​I recently met with a group from our children's hospital to standardize the hospital management of bronchiolitis according to the latest American Academy of Pediatrics guidelines. (Pediatrics 2014;134[5]:e1474; http://bit.ly/2QIGbMX.) Unfortunately, these guidelines seem to cause confusion for experienced and inexperienced emergency physicians alike.This confusion comes from the guidelines raising unaddressed issues and new questions, most importantly not tackling important aspects of frontline clinical practice. These guidelines were developed with the best evidence currently available, and their application mostly cau...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
(Natural News) Corticosteroids in asthma inhalers could make women fat and increase the risk of metabolic syndrome, a recent study found. Corticosteroids are widely-used anti-inflammatory agents that come in many forms — such as inhalers, nasal sprays, tablets, injections and cream — and are prescribed to ease symptoms of asthma and other respiratory diseases. Metabolic...
Source: NaturalNews.com - Category: Consumer Health News Source Type: news
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