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Macronutrients
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Steroids are biological compounds derived from cholesterol in the human body. The term steroid applies to a wide range of molecules with varying physiological effects. All steroids contain the same fused four ring core structure and have different biological roles as hormones and signaling molecules (66, 69, 134–135). These are subdivided on the basis of the number of carbons in the core skeleton. There are three main groups of steroids: steroid hormones (sex and adrenocortical hormones), secosteroids (various forms of vitamin D), and bile (acids and salts) (66, 69, 134–135).
Anatomy, physiology, and histology of the skin
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
Despite being prescribed with the best intentions at heart, medications can impair wound healing. Immunosuppressive medications such as glucocorticosteroids are particularly troublesome in impeding healing. Steroids suppress the immune system and therefore are used to treat inflammatory conditions such as rheumatoid arthritis and polymyalgia rheumatica. A decreased immune response will result in a weakened inflammatory phase of wound healing and impaired production of fibrous scar tissue. Having less fibrous tissue has negative implications for wound healing by both increasing the length of time taken for a wound to heal and decreasing the strength of newly deposited tissue.
Chest
Published in Henry J. Woodford, Essential Geriatrics, 2022
Steroids have a clear mortality benefit in severe COVID-19 but no beneficial effect in mild disease. Dexamethasone reduced 28-day mortality in people receiving mechanical ventilation (29.3% v 41.4%) and people receiving oxygen without ventilation (23.3% v 26.2%).68 There was no benefit for people not requiring oxygen. IL-6 receptor blockers (e.g. tocilizumab and sarilumab) are monoclonal antibodies originally used for rheumatoid arthritis. Their action reduces cytokine release. Trial results have been mixed.60 The RECOVERY trial recruited people (mean age 63) with hypoxia (oxygen saturation < 92% on air or requiring oxygen therapy) and evidence of systemic inflammation (serum CRP 75 mg/L or over).69 Mortality with tocilizumab was significantly lower than with usual care (31% v 35%). IL-6 receptor blockers are recommended, in addition to steroids, for people with severe or critical COVID-19.64 The monoclonal antibodies casirivimab and imdevimab can be used in combination for people hospitalised with COVID-19 who have no detectable serum SARS-CoV-2 antibodies.70 Remdesivir is an anti-viral drug that inhibits viral RNA transcription. It may improve time to recovery but has no mortality benefit for COVID-19. At the time of writing, its use is not currently recommended outside of clinical trials.70 Oral antiviral medications, including molnupiravir, are also being developed and appear to reduce the risk of hospital admission or death in people with mild to moderate symptoms.71
Assessment of Toxicity and Wound Healing Activity of Selaginella Bryopteris Extract
Published in Drug and Chemical Toxicology, 2023
Shravan Kumar Paswan, Pritt Verma, Sajal Srivastava, Chandana Venkateswara Rao
Wound healing or repair of tissue is a linear process that involves the proliferation of cells with the integration of blood cells, soluble mediators, the proliferation of parenchymal cells and the production of extracellular matrix (Gonzalez et al.2016). Treatment for wound healing includes glucocorticoids and non-steroidal anti-inflammatory drugs (NSAIDs) that inhibit prostaglandin synthesis (Su et al.2010). Steroids are used to reduce pain, inflammation and duration of healing. However, these conventional drug therapies caused toxicities (Rowan et al.2015). On the other hand, in spite of several advancements in modern scientific research, traditional medicines are still a major source for treating numerous diseases. The demand for herbal medicines has been increasing continuously throughout the world due to their effectiveness and lesser side effects (Yuan et al. 2016; Ekor, 2014).
Idiopathic Granulomatous Mastitis: Etiology, Clinical Manifestation, Diagnosis and Treatment
Published in Journal of Investigative Surgery, 2022
Yulong Yin, Xianghua Liu, Qingjie Meng, Xiaogang Han, Haomeng Zhang, Yonggang Lv
Steroids therapy is the core treatment of IGM. As initial therapy, corticosteroid have been preferred to surgery for IGM [87], with successful outcomes in up to 75% of IGM patients [35]. Likewise, a meta-analysis containing 3060 patients revealed that steroids therapy was the most frequent treatment no matter in developed (69% of cases) or developing countries (75% of cases) [88]. However, long-term use of steroids is injurious due to the well-known, potentially serious adverse reactions, such as weight gain, impaired glucose tolerance, peptic ulcer, osteoporosis, Cushing's syndrome and even mental disorders. Therefore, the dosage of steroids used in IGM treatment should be as low as possible, and the duration of treatment should be adapted to the disease response. However, the current consensus favors a 3–6-month treatment rather than a short course (4–5 weeks), to prevent recurrence [89, 90]. The study by Azlina et al., had an alarmingly high 50% recurrence rate after short-course treatment (4 weeks, 60 mg/day) [91]. High-dose steroid treatment (50 mg/day), confirmed by Montazer et al., had not only a significantly better rate of symptom improvement (93.3% vs. 53.3%) but also a dramatically lower recurrence rate (0% vs. 37.5%) than the low-dose group (5 mg/day) [92]. In general, steroids therapy has reliable efficacy for the initial treatment of IGM [89], and long-duration, adequate-dose administration is recommended.
The impact of chronic steroid use on early postoperative complications in shoulder surgery
Published in The Physician and Sportsmedicine, 2021
Keith T. Aziz, Matthew J. Best, Mark Ren, Suresh K. Nayar, R. Timothy Kreulen, Hari Om Gupta, Uma Srikumaran
While there have been several prior studies looking at risk factors for perioperative complications and readmission following shoulder surgery, to the best of our knowledge the present study is the first to focus specifically on the impact of chronic steroids on outcomes following shoulder surgery [21,27,43,49]. Schairer et al. sought to identify risk factors for complication and readmission – and demonstrated that chronic steroid use was an independent risk factor for readmission (OR 2.63) and any complication (OR 2.58). Schairer et al. did not specifically comment on the complication profile unique to patients on chronic steroids. Heyer et al. found that chronic steroid use with increased complication rates (univariate analysis, 4.08% compared to 1.64%); however, Heyer et al. did not perform a multivariable analysis to control for differences in the chronic steroid patient populations, and did not comment on the specific complication profile of patients on chronic steroids. While our findings are consistent with these studies in that chronic steroid use is associated with increased complication, our study helps to address specific complications that are associated with chronic steroid use – so that more targeted risk mitigation and optimization can be performed.