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Asthma Epidemiology, Etiology, Pathophysiology and Management in the Current Scenario
Published in Suvardhan Kanchi, Rajasekhar Chokkareddy, Mashallah Rezakazemi, Smart Nanodevices for Point-of-Care Applications, 2022
Manu Sharma, Aishwarya Rathore, Sheelu Sharma, Kakarla Raghava Reddy, Veera Sadhu, Raghavendra V. Kulkarni
Corticosteroids are another class of drugs widely used in asthma management orally or by inhalation. The use of corticosteroids in the treatment of acute persistent asthma has been recommended by Global Initiative for Asthma and National Asthma Education and Prevention Program. It treats asthma by enhancing the beta-adrenergic response in the body and relieves the patient from bronchospasm. Moreover, the drug also inhibits the release of leukotriene LTC4, LTB4 and LTD4, which in turn inhibits the inflammatory response and the function of secretagogue which decreases the mucus production and downregulation of eosinophils and mast cell activation. Prednisolone is an oral corticosteroid whereas beclomethasone (Qvar, Qnasl), mometasone (Asmanex), fluticasone (Arnuity Ellipta), flunisolide (Aerospan HFA), budesonide (Rhinocort), ciclesonide (Omnaris, Alvesco, Zetonna) and triamcinolone are widely used as inhalation corticosteroids. Corticosteroids are used for only a short period of time as long-term usage of the drug results in severe lethal side effects which include osteoporosis, increase in blood sugar, adrenal suppression, weight gain, psychosis, hypertension, etc. [22,23].
Eczema
Published in Dag K. Brune, Christer Edling, Occupational Hazards in the Health Professions, 2020
Treatment of hand eczema must be based on an accurate diagnosis and assessment of the etiological factors. Irrespective of the cause, a patient with hand dermatitis should minimize irritant exposure. Exposure to relevant allergens should be avoided. Topical corticosteroids suppress the eczematous inflammation effectively in most patients. Refatting the skin with safe emollients is important in the treatment of all hand eczemas. If the eczema does not heal in spite of adequate treatment and sick leave, a change of work may be necessary. Hand eczema has, however, to be accepted as a likely consequence of wet hospital work. Immediate recognition, investigation, and treatment are important in order to reduce the need of changing the work. In the prevention of hand eczema, occupational counseling according to the given recommendations is important. A preventive program for hand eczema should include simple guidelines on adequate and safe prophylaxis and self-treatment measures for mild eczema. Exposure to rubber gloves should be minimized by using vinyl gloves whenever possible. Perfumes should not be included in emollients offered at the workplace.
Treatment of Rheumatoid Arthritis
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Stuart Weisman, Arthur Kavanaugh
Prior to the introduction of the most recent therapies, numerous medications were available for the treatment of rheumatoid arthritis; however, the efficacy and tolerability of these medications were variable. The options included NSAIDs, corticosteroids, and DMARDs. NSAIDs are useful for symptomatic treatment; however, they do not have disease-modifying properties. They continue to be widely used since they are effective for relief of pain and stiffness. The overall role of corticosteroids in the treatment of rheumatoid arthritis remains controversial. Corticosteroids are used to promptly relieve the symptoms of inflammation and decrease disease activity. Corticosteroids may also protect against progressive radiological damage in the short term.7 Significant debate persists regarding the ability of this group of medications to prevent long-term damage. Corticosteroids have also never been shown to provide long-term improvement in functional outcome. Because of the side effects and toxicity of corticosteroids, they are often used only until other medications become effective.
The effectiveness of heel raises in managing Haglund deformity pain in figure skaters – a pilot study
Published in Footwear Science, 2023
The pain level reported by the participants was relatively low (less than 3/10) but would represent the first initial pain felt. Given that the skaters in this study spend about 20 hours per week training, this level of pain is anticipated to increase over the duration of the training sessions. If the heel raise were found to be effective in reducing the initial pain, or delaying the onset of initial pain, a future study with a longer skating time could be considered. However, the results of this pilot study found that heel raises did not significantly reduce HD pain. This implied that when performing tasks of greater complexity, there may also not be any significant reduction in pain level. Chronic pain in the foot can result in poor skating performance. A more effective way than heel raises to reduce HD pain needs to be explored before subjecting participants to further trials. Some participants were already wearing foot orthoses in their regular footwear. However, other strategies recommended for reducing HD pain for the general population, such as rest, or wearing footwear with less stiff heel counters, are not feasible options for figure skaters when skating. Corticosteroid injections may reduce pain, but increases the risk of tendon ruptures (Pekala et al., 2017) in athletes. Even surgical correction, an effective option for non-athletes (Zhang et al., 2021), has not been found to be a viable option for athletes (Lee et al., 2021). As the findings suggests, heel raises are not effective in reducing HD pain in skaters, and the recommendation of using heel raises to reduce HD pain in skaters is challenged. Further studies investigating other therapeutic options should be studied.
Mortality in mechanically ventilated patients with COVID-19: a systematic review
Published in Expert Review of Medical Devices, 2021
Maria Tsikala Vafea, Raina Zhang, Markos Kalligeros, Evangelia K. Mylona, Fadi Shehadeh, Eleftherios Mylonakis
The World Health Organization (WHO) Rapid Evidence Appraisal for COVID-19 Therapies Working Group used data from 7 trials (RECOVERY, REMAP-CAP, CoDEX, CAPE COVID, and 3 additional trials) and conducted a prospective fixed-effects meta-analysis including 1703 patients to compare 28-day mortality outcomes among patients receiving corticosteroids vs placebo [155]. The results from the meta-analysis showed that corticosteroids were associated with lower mortality compared to usual care (OR 0.66; 95% CI, 0.53–0.82; P < .001) and that this association was similar for patients receiving dexamethasone or hydrocortisone compared to usual care, yet not significant for hydrocortisone [155].
COVID-19: a pandemic challenging healthcare systems
Published in IISE Transactions on Healthcare Systems Engineering, 2021
Lidong Wang, Cheryl Ann Alexander
Because antiviral therapeutics are limited, the strategy for handling COVID-19 is a combination of supportive care, off-label therapeutics and EUAs, and a supplementation through a mixture of antivirals, antibiotics, convalescent plasma therapy, and corticosteroids. Available therapeutics and pending clinical trials are summarized in Table 3 (Yang et al., 2020) and Table 4 (COVID-19 Treatment Guidelines Panel, 2021; Aid et al., 2020).