Short-Term Systemic Corticosteroids: Appropriate Use in Primary Care.
Short-Term Systemic Corticosteroids: Appropriate Use in Primary Care. Am Fam Physician. 2020 Jan 15;101(2):89-94 Authors: Dvorin EL, Ebell MH Abstract Short-term systemic corticosteroids, also known as steroids, are frequently prescribed for adults in the outpatient setting by primary care physicians. There is a lack of supporting evidence for most diagnoses for which steroids are prescribed, and there is evidence against steroid use for patients with acute bronchitis, acute sinusitis, carpal tunnel, and allergic rhinitis. There is insufficient evidence supporting routine use of steroids for patients with acute pharyngitis, lumbar radiculopathy, carpal tunnel, and herpes zoster. There is evidence supporting use of short-term steroids for Bell palsy and acute gout. Physicians might assume that short-term steroids are harmless and free from the widely known long-term effects of steroids; however, even short courses of systemic corticosteroids are associated with many possible adverse effects, including hyperglycemia, elevated blood pressure, mood and sleep disturbance, sepsis, fracture, and venous thromboembolism. This review considers the evidence for short-term steroid use for common conditions seen by primary care physicians. PMID: 31939645 [PubMed - in process]
The geriatric population is at high risk of severe low blood glucose (LBG) events due to diminished homeostatic mechanisms, especially on hypoglycemic medications. Moderate to severe LBG events in these patients can contribute to behavior changes such as agitation, change in level of consciousness, disruption of sleep, instability and increased risk of myocardial infarction, stroke and falls. Rapid recognition and appropriate treatment and prevention of LBG and recurrences can reduce risk for hospitalization in the geriatric population.
CONCLUSIONS.: Our results confirm the multidimensional nature of mania. Hyperactivity, increased speech, and thought disorder appear as core features of the clinical construct. The mood experience could be heterogeneous, depending on the co-occurrence of euphoric (elevated mood) and dysphoric (irritability and depressive mood) emotions of varying intensity. Results are also discussed regarding their relationship with other constitutive elements of bipolar disorder, such as mixed and depressive states. PMID: 32093802 [PubMed - in process]
Publication date: Available online 25 February 2020Source: NeuroImage: ClinicalAuthor(s): Bart van den Munckhof, Anne F. Zwart, Lauren C. Weeke, Nathalie H.P. Claessens, Joost D.J. Plate, Alexander Leemans, Hugo J. Kuijf, Heleen C. van Teeseling, Frans S.S. Leijten, Manon J.N. Benders, Kees P.J. Braun, Linda S. de Vries, Floor E. Jansen
Even patients with mild COPD exacerbations can benefit from antibiotics and systemic corticosteroids, a systematic review and meta-analysis suggests.Medscape Medical News
Publication date: Available online 25 February 2020Source: The Lancet Diabetes &EndocrinologyAuthor(s): Martin Reincke
ConclusionAcute macular neuroretinopathy can complicate intraocular TB. Tuberculosis should be kept as one of the differential diagnosis in patients with AMN. Prognosis is generally good in patients of ocular TB presenting with retinal vascular occlusions.
Publication date: Available online 25 February 2020Source: Progress in Neuro-Psychopharmacology and Biological PsychiatryAuthor(s): Su-Ying Cui, Yuan-Li Huang, Xiang-Yu Cui, Hui-Ling Zhao, Xiao Hu, Yu-Tong Liu, Yu Qin, Nurhumar Kurban, Yong-He Zhang
Authors: Nyamu DG, Guantai AN, Osanjo GO, Godman B, Aklillu E Abstract Background: Patients' profiles affect the outcome with warfarin; however, this data, and its implications, is scarce in resource-poor countries such as Kenya without access to pharmacogenetics or regular INR testing.Objectives: To characterize the profiles of patients on long-term warfarin therapy and subsequently use the findings to guide future anticoagulation management.Methods: Cross-sectional study undertaken among 180 adult patients receiving warfarin therapy in anticoagulation clinics at a leading referral hospital in Kenya. Sociodemograp...
Conclusions/Importance: This study revealed that many users are not responsibly using CBD products, many believe CBD products provide health benefits that are not yet scientifically proven, and they are not knowledgeable about legal and regulatory issues. Until CBD use is more thoroughly researched and has more comprehensive regulation, public health professionals should address alternative stress and anxiety treatment methods. PMID: 32093530 [PubMed - as supplied by publisher]
Conditions: Sleep Hygiene; Sleep Intervention: Behavioral: Sleep Hygiene tips Sponsors: Medical College of Wisconsin; Divine Savior Holy Angels High School; Children's Hospital and Health System Foundation, Wisconsin Recruiting