REPEAT ANTENATAL CORTICOSTEROIDS: SHOULD IT BE PRESCRIBED AND IF SO WHEN AND HOW?

2008 ◽  
Vol 19 (2) ◽  
pp. 165-180
Author(s):  
TAK YEUNG LEUNG ◽  
DALJIT SINGH SAHOTA
Keyword(s):  
Distress Syndrome ◽  
Neonatal Outcome ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Corticosteroid Treatment ◽  
Therapeutic Effects ◽  
Antenatal Corticosteroids ◽  
Beneficial Effects ◽  
Neonatal Respiratory Distress ◽  
Randomised Controlled

Corticosteroid treatment before preterm delivery was shown to be effective in reducing neonatal respiratory distress syndrome (RDS) more than three decades ago. The beneficial effect of steroids was further confirmed by Roberts and Dalziel's meta-analysis of 21 randomised controlled studies (RCT), which was published as a Cochrane Review in 2006. The authors concluded that the administration of a single course of steroids improved neonatal outcome, reducing RDS by 60%, periventricular haemorrhage (PVH) and necrotizing enterocolitis (NEC) by half, and neonatal death (NND) by 70%. However, these beneficial effects do not last for more than 7 days. Furthermore, steroids take at least 24 hours to be fully effective. Hence, it was advocated in the 1990's that regular weekly booster courses be given in order to maintain the therapeutic effects in high risk cases, as the timing of preterm birth cannot be readily predicted.

scholarly journals Cordyceps Militaris Alleviates Severity of Murine Acute Lung Injury Through miRNAs-Mediated CXCR2 Inhibition

2015 ◽  
Vol 36 (5) ◽  
pp. 2003-2011 ◽  
Author(s):  
Sheng Liu ◽  
Jian Tang ◽  
Lei Huang ◽  
Qirong Xu ◽  
Xiang Ling ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Distress Syndrome ◽  
Mrna Level ◽  
Cordyceps Militaris ◽  
Microvascular Endothelial Cells ◽  
Mouse Lung ◽  
Therapeutic Effects ◽  
Beneficial Effects

Background/Aims: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are lethal diseases in humans, and the current treatments have limited therapeutic effects. Cordyceps militaris (CM) is a caterpillar-grown traditional medicinal mushroom, and has been used as a natural invigorant for longevity, endurance, and vitality in China. Recently, purified extracts from CM have been shown to have beneficial effects on various diseases including cancer. Nevertheless, a role of CM in ALI has not been examined previously. Methods: Here, we used a bleomycin-induced ALI model to study the effects of CM on the severity of ALI in mice. The levels of CXCR2, a receptor for Interleukin 8 (IL-8) in pulmonary microvascular endothelial cells, were examined in different experimental groups. The levels of microRNA (miR)-1321 and miR-3188 were also examined in lung samples and in CM. Adeno-associated viruses carrying miR-1321 and miR-3188 were injected into bleomycin-treated mice for evaluation their effects on the severity of ALI. Results: CM treatment significantly alleviated the severity of bleomycin-induced ALI in mice. The increases in lung CXCR2 by bleomycin were significantly reduced by CM at protein level, but not at mRNA level. CM contained high levels of 2 miRNAs (miR-1321 and miR-3188) that target 3'-UTR of CXCR2 mRNA to inhibit its expression. Overexpression of miR-1321 and miR-3188 in mouse lung through AAV-mediated gene therapy mimicked the effects of CM. Conclusion: CM may alleviate severity of murine ALI through miRNAs-mediated CXCR2 inhibition.

scholarly journals Lung ultrasound in diagnosing neonatal respiratory distress syndrome: a meta-analysis

2019 ◽  
Vol 59 (6) ◽  
pp. 340-8
Author(s):  
Hanum Ferdian ◽  
Dian Ibnu Wahid ◽  
Samad Samad ◽  
Anggun Esti Wardani ◽  
Guntur Surya Alam ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Sensitivity And Specificity ◽  
Diagnostic Tool ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Meta Analysis ◽  
Neonatal Respiratory Distress Syndrome ◽  
Inclusion Criteria ◽  
Neonatal Respiratory Distress

Background Neonatal respiratory distress syndrome (NRDS) is commonly diagnosed by clinical sign and symptoms, blood gas analysis, and chest x-ray. In the past, lung ultrasound (LUS) was not standard for NRDS examination. Many studies show that ultrasound diagnostic tool for NRDS is accurate, reliable, low cost, easy to use, and safe because due to no ionizing radiation. Objective To determine the sensitivity and specificity of LUS in diagnosing NRDS. Methods This meta-analysis study was conducted LUS as a diagnostic tool for NRDS. Inclusion criteria were all studies from PubMed, Embase, and The Cochrane Library, without any limitation on published journals, as well as using keywords or search terms of ultrasound, neonatal, and respiratory distress syndrome. Statistical analysis was undertaken using MedCalc® version 18.2 software. Results Seven studies with a total of 580 patients met the inclusion criteria. Proportional meta-analysis obtained random effects models, with total sensitivity of LUS was 97.2% (95% CI for I2 74.24 to 92.88; P<0.0001) and specificity of LUS was 94.8% (95% CI for I2 88.60 to 98.03; P<0.00001). Conclusion Lung ultrasound should be considered as a diagnostic tool for NRDS because it is high in sensitivity and specificity, inexpensive, safe, as well as limited radiation exposure.

Do Mood Stabilizers Help in Borderline Personality Disorder?

2017 ◽  
Vol 41 (S1) ◽  
pp. S47-S47
Author(s):  
B. Völlm ◽  
J. Stoffers-Winterling ◽  
J. Mattivi ◽  
E. Simonson ◽  
O.J. Storebø ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Evidence Base ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Beneficial Effects ◽  
Drug Classes ◽  
Competing Interest

BackgroundDespite the relatively weak evidence base, individuals with borderline personality disorder are often treated with pharmacological interventions. Amongst the drugs, which have shown most promise, are mood stabilizers, which were one of the two drug classes with the most beneficial effects in a previous cochrane review though the robustness of findings was described as low (Stoffers et al., 2010). Here we present data on the latest evidence for mood stabilizers based on an updated cochrane review currently underway.MethodsA systematic review and meta-analysis of randomized controlled trials was conducted. All randomized comparisons of drug vs. placebo, drug vs. drug, or drug vs. a combination of drugs in adult BPD patients were eligible for inclusion. Outcomes comprised BPD core pathology as depicted by DSM criteria, associated pathology, i.e., depression and anxiety, general measures of overall psychopathology severity, tolerability, and adverse effects. Two researchers selected trials, assessed quality and extracted data independently.ResultsOnly a limited number of additional trials using mood stabilizers was identified since the publication of the last cochrane review, mainly utilizing Sodium Valproate. This added to the evidence base for mood stabilizers though the overall evidence remains very limited.ConclusionMood stabilizers show some initial evidence for their effectiveness in borderline personality disorder. However, these have to be replicated before wider conclusions can be drawn for clinical practice.Disclosure of interestThe authors declare that they have no competing interest.

Sign in / Sign up

Export Citation Format

Share Document