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Glucocorticoid


Presentation

  • In this review, we present evidence that post-transcriptional mechanisms of action are highly important to the anti-inflammatory actions of glucocorticoids.[ncbi.nlm.nih.gov]
  • In the present study, we found dexamethasone (Dex) dramatically increased the expression of NPR-A in IMCD cells in vitro.[doi.org]
  • We present the case of a 10-year-old boy with no prior psychiatric history and no prior exposure to glucocorticoid medication who received a single 5-week course of glucocorticoids for an acute asthma flare.[doi.org]
Cushingoid
  • Cushingoid Features Patients with Cushing's syndrome symptoms due to GC therapy are more likely to have a suppressed HPA axis and adrenal atrophy ( 19 ).[ncbi.nlm.nih.gov]
  • The most common adverse events attributed to steroids were restlessness and sleeplessness ( Paulsen 2014 ), gastrointestinal and cardiovascular events ( Popiela 1989 ), Cushingoid facies, anxiety, fluid retention ( Bruera 1985 ), hypocalcaemia and hyperglycaemia[doi.org]
Leg Edema
  • A continuous, approximately linear rising with increasing dose was found for cushingoid phenotype, ecchymosis, leg edema, mycosis, parchment-like skin, shortness of breath, and sleep disturbance.[ncbi.nlm.nih.gov]
Overeating
  • Beginning during steroid treatment, and persisting for over 3 years after stopping treatment, he showed a significant decline from his pre-morbid academic performance and estimated IQ, verified by longitudinally administered testing and school records[ncbi.nlm.nih.gov]
  • GCs have many diverse (pleiotropic) effects, including potentially harmful side effects, and as a result are rarely sold over the counter.[dbpedia.org]
  • RESULTS: The study was conducted over 5 months (July to November 2006). Of 202 questionnaires sent out, 186 (92%) were completed.[ncbi.nlm.nih.gov]
  • Then, tap water was given, and water intake was monitored over 12 hours.[doi.org]
Cognitive Deficit
  • In the 3 years since stopping steroid medication, the patient has shown gradual but possibly incomplete resolution of his cognitive deficits.[ncbi.nlm.nih.gov]
Motor Symptoms
  • In addition, SEL occurs in patients on glucocorticoid therapy, which can lead to myopathy, thereby mimicking the motor symptoms of SEL.[ncbi.nlm.nih.gov]

Workup

Amino Acids Increased
  • acids, increased urea formation, negative nitrogen balance Glaucoma due to increased ocular pressure Cataracts Topical steroid addiction In high doses, hydrocortisone (cortisol) and those glucocorticoids with appreciable mineralocorticoid potency can[en.wikipedia.org]

Treatment

  • The treatment of these patients requires a systematic approach to rule out underlying conditions that lead to steroid resistance or treatment failure, as well as the use of alternative strategies to inhibit tissue inflammation.[ncbi.nlm.nih.gov]
  • Beginning during steroid treatment, and persisting for over 3 years after stopping treatment, he showed a significant decline from his pre-morbid academic performance and estimated IQ, verified by longitudinally administered testing and school records[ncbi.nlm.nih.gov]
  • Treatment was not discontinued due to side-effect in any of the cases.[hungary.pure.elsevier.com]
  • […] of treatment ( 81 ).[ncbi.nlm.nih.gov]

Prognosis

  • Fujieda, Masaru Kato, Kenji Oku, Toshiyuki Bohgaki, Tetsuya Horita, Ichiro Kusumi and Tatsuya Atsumi, Post-steroid neuropsychiatric manifestations are significantly more frequent in SLE compared with other systemic autoimmune diseases and predict better prognosis[doi.org]

Etiology

  • Nieman, Physiological Basis for the Etiology, Diagnosis, and Treatment of Adrenal Disorders: Cushing's Syndrome, Adrenal Insufficiency, and Congenital Adrenal Hyperplasia, Comprehensive Physiology, (739-769), (2014).[doi.org]
  • Chronic tendinopathy tissue pathology, pain mechanisms, and etiology with a special focus on inflammation. Scand J Med Sci Sports. 2008;18:3–15. CrossRef PubMed Google Scholar 21. Furukawa TA. From effect size into number needed to treat.[doi.org]

Epidemiology

  • Born too soon: the global epidemiology of 15 million preterm births. Reprod Health 2013; 10(Suppl 1):S2. [ Links ] 3. Crowley P. Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev 2000; 2:CD000065. [ Links ] 4.[scielo.edu.uy]
  • The epidemiology of glucocorticoid-associated adverse events. Curr Opin Rheumatol. 2008; 20 (2):131–7. [ PubMed : 18349741 ] 5. Nicolaides NC, Charmandari E.[ncbi.nlm.nih.gov]
  • Epidemiology of women and depression. J. Affect. Disord. 74, 5–13 (2003). 126. Harlow, B. L., Cohen, L. S., Otto, M. W., Spiegelman, D. & Cramer, D. W.[doi.org]
  • Methods to convert continuous outcomes into odds ratios of treatment response and numbers needed to treat: meta-epidemiological study. Int J Epidemiol. 2012;41:1445–1459. CrossRef PubMed Google Scholar 17.[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • Keeping these potential limitations in mind, there are important physiological and pathophysiological implications of glucocorticoid-mediated regulation of pulmonary endothelial COX-1 expression.[doi.org]
  • Pathophysiological basis of vulnerability to drug abuse: role of an interaction between stress, glucocorticoids, and dopaminergic neurons. Annu. Rev. Pharmacol. Toxicol. 36, 359–378 (1996). 17. Kapoor, A., Petropoulos, S. & Matthews, S. G.[doi.org]

Prevention

  • Current literature suggests that androgens do not prevent atrophy but may retard growth suppression accompanying glucocorticoid treatment.[ncbi.nlm.nih.gov]
  • Early postnatal (less than 96h) corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev 2003:CD001146; Yeh TF, Lin YJ, Lin HC, et al.[ncbi.nlm.nih.gov]
  • The activated GR complex, in turn, up-regulates the expression of anti-inflammatory proteins in the nucleus (a process known as transactivation) and represses the expression of proinflammatory proteins in the cytosol by preventing the translocation of[dbpedia.org]
  • A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics 1972; 50(4): 515-25. [ Links ] 13. Ballard P, Ballard R.[scielo.edu.uy]
  • They are also administered as post-transplantory immunosuppressants to prevent the acute transplant rejection and the graft-versus-host disease. Nevertheless, they do not prevent an infection and also inhibit later reparative processes.[en.wikipedia.org]

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