Hypoglycemia and Cortisol Deficiency Associated With Low-dose Corticosteroid Therapy for Asthma

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 921-924
Author(s):  
Aaron L. Carrel ◽  
Stephanie Somers ◽  
Robert F. Lemanske ◽  
David B. Allen
Keyword(s):  
Adverse Effects ◽  
Low Dose ◽  
Inhaled Corticosteroids ◽  
Chronic Asthma ◽  
Asthma Therapy ◽  
Biochemical Alterations ◽  
Clinically Significant ◽  
Dose Corticosteroid ◽  
Oral Glucocorticoids ◽  
Cortisol Deficiency

Glucocorticoids are a cornerstone of the anti-inflammatory treatment of asthma. To minimize adverse effects of oral glucocorticoids (OGC), clinicians have used alternate-day oral or inhaled corticosteroids (IC), both generally considered safe for chronic asthma therapy in children. Although reversible growth suppression occasionally occurs, the general consensus is that, despite detectable biochemical alterations, these modes of therapy are not associated with clinically significant adrenal insufficiency.1 We report the occurrence of hypoglycemia due to cortisol deficiency during combination alternate-day oral and inhaled corticosteroids. CASE HISTORY A 3½-year-old boy with asthma was found one morning to be unarousable, limp, and blue around the lips.

Hypoglycemia and Cortisol Deficiency Associated With Low-dose Corticosteroid Therapy for Asthma

PEDIATRICS ◽  
1996 ◽  
Vol 98 (4) ◽  
pp. 672-672
Author(s):  
Aaron L. Carrel ◽  
Stephanie Somers ◽  
Robert F. Lemansne ◽  
David B. Allen
Keyword(s):  
Corticosteroid Therapy ◽  
Childhood Asthma ◽  
Low Dose ◽  
Inhaled Corticosteroids ◽  
Beta Agonist ◽  
Chronic Asthma ◽  
Agonist Therapy ◽  
Dose Corticosteroid ◽  
Cortisol Deficiency

In the article by Carrel et al entitled "Hypoglycemia and Cortisol Deficiency Associated With Low-dose Corticosteroid Therapy for Asthma," reference #18 was incomplete. The correct citation is (boldface type indicates the correction): 18. Lemanske RF, Allen DB. The safety of chronic asthma treatments: continuous beta agonist therapy and prolonged inhaled corticosteroids in childhood asthma. In: Middleton E, Reed CE, Ellis EF, Adkinson NF, Yuninger JW, Busse WW, eds. Allergy: Principles and Practice. 4th ed. (Update #15). St Louis: Mosby; 1993

scholarly journals Analgesic effects of intravenous ketamine after spinal anaesthesia for non-elective caesarean delivery: a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044168
Author(s):  
Prahlad Adhikari ◽  
Asish Subedi ◽  
Birendra Prasad Sah ◽  
Krishna Pokharel
Keyword(s):  
Postoperative Pain ◽  
Adverse Effects ◽  
Outcome Measures ◽  
Caesarean Delivery ◽  
Low Dose ◽  
Saline Group ◽  
Secondary Outcome ◽  
Pain Scores ◽  
Intravenous Ketamine ◽  
Elective Caesarean Delivery

ObjectivesThis study aimed to determine if low dose intravenous ketamine is effective in reducing opioid use and pain after non-elective caesarean delivery.DesignProspective, randomised, double-blind.SettingTertiary hospital, Bisheshwar Prasad Koirala Institute of Health Sciences, Dharan, NepalParticipants80 patients undergoing non-elective caesarean section with spinal anaesthesia.InterventionsPatients were allocated in 1:1 ratio to receive either intravenous ketamine 0.25 mg/kg or normal saline before the skin incision.Primary and secondary outcome measuresThe primary outcome was the total amount of morphine equivalents needed up to postoperative 24 hours. Secondary outcome measures were postoperative pain scores, time to the first perception of pain, maternal adverse effects (nausea, vomiting, hypotension, shivering, diplopia, nystagmus, hallucination) and neonatal Apgar score at 1 and 5 min, neonatal respiratory depression and neonatal intensive-care referral.ResultsThe median (range) cumulative morphine consumption during the first 24 hours of surgery was 0 (0–4.67) mg in ketamine group and 1 (0–6) mg in saline group (p=0.003). The median (range) time to the first perception of pain was 6 (1–12) hours and 2 (0.5–6) hours in ketamine and saline group, respectively (p<0.001). A significant reduction in postoperative pain scores was observed only at 2 hours and 6 hours in the ketamine group compared with placebo group (p<0.05). Maternal adverse effects and neonatal outcomes were comparable between the two groups.ConclusionsIntravenous administration of low dose ketamine before surgical incision significantly reduced the opioid requirement in the first 24 hours in patients undergoing non-elective caesarean delivery.Trial registration numberNCT03450499.

Ultra-low dose of intratecal naloxone to minimize morphine - induced adverse effects

2021 ◽  
Vol 6 (2) ◽  
pp. 186
Author(s):  
JaklineS Hny ◽  
EkramA Osman ◽  
Abdelraheem Mahmoud ◽  
EmadZ Kamel
Keyword(s):  
Adverse Effects ◽  
Low Dose

scholarly journals Coexistence of Ankylosing Spondylitis and Löfgren’s Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Senol Kobak ◽  
Fidan Sever ◽  
Oya Sivrikoz ◽  
Ahmet Karaarslan
Keyword(s):  
Ankylosing Spondylitis ◽  
Low Dose ◽  
Histopathological Examination ◽  
Skin Lesions ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Löfgren’S Syndrome ◽  
Significant Regression ◽  
Dose Corticosteroid ◽  
Thorax Ct

A 46-year-old male patient diagnosed with ankylosing spondylitis presented to our polyclinic with complaints of pain, swelling, and limitation in joint mobility in both ankles and erythema nodosum skin lesions in both pretibial sites. The sacroiliac joint graphy and the MRI taken revealed active and chronic sacroiliitis. On the thorax CT, multiple mediastinal and hilar lymphadenopathies were reported. Mediastinoscopic excisional lymph node biopsy was taken and noncalcified granulomatous structures, lymphocytes, and histiocytes were determined on histopathological examination. The patients were diagnosed with ankylosing spondylitis, sarcoidosis, and Löfgren’s syndrome. NSAIDs, sulfasalazine, and low dose corticosteroid were started. Significant regression was seen in the patient’s subjective and laboratory assessments.

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