scholarly journals Early Corticosteroid Therapy for Mycoplasma pneumoniae Pneumonia Irrespective of Used Antibiotics in Children

2019 ◽  
Author(s):  
Eun-Ae Yang ◽  
Hun-Mi Kang ◽  
Jung-Woo Rhim ◽  
Jin-Han Kang ◽  
Kyung-Yil Lee
Keyword(s):  
Disease Progression ◽  
Mycoplasma Pneumoniae ◽  
Corticosteroid Therapy ◽  
Adverse Reactions ◽  
Clinical Symptoms ◽  
Severe Pneumonia ◽  
Oral Prednisolone ◽  
Intravenous Methylprednisolone ◽  
The Mean ◽  
A Prospective Study

Antibiotics’ effect on Mycoplasma pneumoniae (MP) infection still remains controversial. A prospective study of 257 children with MP pneumonia during a recent epidemic (2015-2016) was conducted. All MP pneumonia patients were treated with corticosteroids within 24-36 h after admission. Initially, oral prednisolone (1 mg/kg) or intravenous methylprednisolone (IVMP) (1-2 mg/kg) was administered for mild pneumonia patients, and IVMP (5 -10 mg/kg/day) for severe pneumonia patients. If patients showed persistent fever for 36-48 hours or disease progression, additive IVMP (5 mg/kg or 10 mg/kg) was given. Eighty-five patients received only a broad-spectrum antibiotic without macrolide. The mean age and the male:female ratio were 5.6 ± 3.1 years, respectively. Seventy-four percent of patients (190/257) showed immediate defervescence within 24 h, and 95.7% (246/257) of patients showed defervescence within 72 h with improvements in clinical symptoms. Eight patients who received additive IVMP also showed clinical improvement within 48 h without adverse reactions. There were no clinical or laboratory differences between patients treated with a macrolide (n = 172) and without (n = 85). Early corticosteroid therapy might reduce disease morbidity and prevent disease progression in MP pneumonia patients without side effects, and antibiotics may have limited effects on MP infection.

scholarly journals Early Corticosteroid Therapy for Mycoplasma pneumoniae Pneumonia Irrespective of Used Antibiotics in Children

2019 ◽  
Vol 8 (5) ◽  
pp. 726 ◽  
Author(s):  
Eun-Ae Yang ◽  
Hyun-Mi Kang ◽  
Jung-Woo Rhim ◽  
Jin-Han Kang ◽  
Kyung-Yil Lee
Keyword(s):  
Disease Progression ◽  
Mycoplasma Pneumoniae ◽  
Corticosteroid Therapy ◽  
Clinical Symptoms ◽  
Severe Pneumonia ◽  
Oral Prednisolone ◽  
Female Ratio ◽  
A Prospective Study ◽  
Male To Female ◽  
Mycoplasma Pneumoniae Pneumonia

Antibiotics’ effect on Mycoplasma pneumoniae (MP) infection still remains controversial. A prospective study of 257 children with MP pneumonia during a recent epidemic (2015–2016) was conducted. All MP pneumonia patients were treated with corticosteroids within 24–36 h after admission. Initially, oral prednisolone (1 mg/kg) or intravenous methylprednisolone (IVMP; 1–2 mg/kg) was administered for mild pneumonia patients, and IVMP (5–10 mg/kg/day) for severe pneumonia patients. If patients showed a persistent fever for 36–48 h or disease progression, additive IVMP (5 mg/kg or 10 mg/kg) was given. Thirty-three percent of patients received only a broad-spectrum antibiotic without a macrolide. The mean age and the male-to-female ratio was 5.6 ± 3.1 years and 1:1, respectively. Seventy-four percent of patients showed immediate defervescence within 24 h, and 96% of patients showed defervescence within 72 h with improvements in clinical symptoms. Three percent of patients (8/257) who received additive IVMP also showed clinical improvement within 48 h without adverse reactions. There were no clinical or laboratory differences between patients treated with a macrolide (n = 172) and without (n = 85). Early corticosteroid therapy might reduce disease morbidity and prevent disease progression in MP pneumonia patients without side effects, and antibiotics may have limited effects on MP infection.

scholarly journals Clinical and CT scan findings in patients with COVID-19 pneumonia: A comparison based on disease severity

2021 ◽  
Author(s):  
Sonia Hesam-Shariati ◽  
Susan Mohammadi ◽  
Morteza Abouzaripour ◽  
Behzad Mohsenpour ◽  
Bushra Zareie ◽  
...  
Keyword(s):  
Ct Scan ◽  
Disease Severity ◽  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
White Blood Cells ◽  
Severe Pneumonia ◽  
Duration Of Hospitalization ◽  
The Mean ◽  
Severity Of The Disease ◽  
Interlobular Septal Thickening

Abstract Background The SARS-CoV-2 can cause severe pneumonia and highly impact general health. We aimed to investigate different clinical features and CT scan findings of patients with COVID-19 based on disease severity to have a better understanding of this disease. Methods 90 patients with coronavirus were divided into three categories based on the severity of the disease: mild/moderate, severe, and very severe. Clinical, laboratory and CT scan findings of the patients were examined retrospectively. Any association between these features and disease severity were assessed. Results The mean age and duration of hospitalization of patients increased with increasing the severity of disease. The most common clinical symptoms were shortness of breath, cough, and fever. As the severity of the disease increased from mild/moderate to very severe, there was an increase in neutrophile counts and a decrease in lymphocytes and white blood cells (WBC) showing excessive inflammation associated with severe forms of COVID-19. Subpleural changes (81%) and ground-glass opacification/opacity (GGO) lesions (73%) of the lung were the most common features among CT images of COVID-19 patients, and interlobular septal thickening (10%) was the lowest CT feature among patients. Regarding the affected parts of the lung in COVID-19 patients, bilaterial, peripheral and multiple lesions had the highest prevalence. Conclusions It has been shown that clinical, laboratory and CT scan findings varied in COVID-19 patients based on disease severity, which need to be considered carefully in timely diagnosis and treatment of this illness.

scholarly journals A comparative evaluation between megadose intravenous dexamethasone and intravenous methyl prednisolone in the treatment outcome of optic neuritis

2017 ◽  
Vol 5 (4) ◽  
pp. 49-54
Author(s):  
P Panjiyar ◽  
A K Sharma ◽  
G B Shrestha ◽  
A Shah
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Visual Fields ◽  
Oral Prednisolone ◽  
Intravenous Methylprednisolone ◽  
Methyl Prednisolone ◽  
Group I ◽  
Retrobulbar Optic Neuritis ◽  
The Mean ◽  
Group Ii

To compare the efficacy of intravenous methylprednisolone and intravenous dexamethasone for the treatment of optic neuritis in terms of visual recovery and side-effects and to evaluate the clinical profile of optic neuritis patients admitted in BPKLCOS. 60 patients of acute idiopathic typical optic neuritis presenting to our centre were included in this prospective, randomized comparative study. Study population was randomly divided into two groups. Group I received intravenous dexamethasone 200 mg once daily for three days and Group II received intravenous methylprednisolone 500 mg/twelve-hourly for three days followed by oral prednisolone for 11 days. Optic neuritis was found to be common in the age group of 21 to 30 years with female preponderance. The most frequent mode of presentation was abrupt loss of vision. Retrobulbar optic neuritis dominated the study group. Both groups were age and sex-matched. The mean presenting visual acuity in group I was 0.065±0.59. The mean presenting visual acuity in group II was 0.1±0.15. On day 90 of steroid therapy, visual acuity improved to 0.98±0.073 in Group I and 0.88±0.16 in Group II (p=0.23). At three months, there was statistically significant improvement in both groups in terms of colour vision, contrast sensitivity and Goldmann visual fields as well but difference between the two groups was statistically insignificant. Intravenous dexamethasone is an effective treatment for optic neuritis, which is comparable to intravenous methylprednisolone. However, larger studies are required to establish it as a safe, inexpensive and effective modality for the treatment of optic neuritis.

scholarly journals Review on the laboratory diagnosis of Mycoplasma pneumoniae infection

2018 ◽  
Vol 7 (3) ◽  
pp. 67-74
Author(s):  
Jin Zhang
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Clinical Symptoms ◽  
Severe Pneumonia ◽  
Laboratory Diagnosis ◽  
Community Acquired Pneumonia ◽  
Resistance Rate ◽  
Diagnostic Methods ◽  
Research Progress ◽  
Advantages And Disadvantages ◽  
Mycoplasma Pneumoniae Infection

AbstractMycoplasma pneumoniae(MP) is an important pathogen of community-acquired pneumonia in children. As a type of self-limited disease, most MP infections cause mild clinical symptoms, but they can also lead to severe pneumonia or extrapulmonary complications. The resistance rate of MP has increased in recent years. Early and rapid diagnosis of MP infection is important for the treatment and prognosis of the disease. Current methods for diagnosing MP infection include isolation culture, serological diagnosis, and molecular biological diagnosis. This review summarizes the recent research progress in the internal and external laboratory diagnoses of MP infection both at home and abroad and the advantages and disadvantages of various diagnostic methods.

scholarly journals A prospective study to determine the role of routine prophylactic oral calcium and vitamin D supplements in prevention of transient hypocalcaemia after total and near total thyroidectomy

2017 ◽  
Vol 5 (1) ◽  
pp. 292
Author(s):  
Kiran Sukumaran Nair ◽  
Jose Gamalial ◽  
Rajesh P. S.
Keyword(s):  
Vitamin D ◽  
Total Thyroidectomy ◽  
Clinical Symptoms ◽  
Vitamin D Supplementation ◽  
Oral Calcium ◽  
Unexposed Group ◽  
Time Period ◽  
The Mean ◽  
Vitamin D Supplements ◽  
A Prospective Study

Background: Transient hypocalcaemia is a frequent complication after total thyroidectomy, and the symptoms are very distressing for the patients. This study is a prospective cohort study to assess the effectiveness of routine postoperative oral calcium and vitamin D supplementation in post thyroidectomy hypocalcaemia.Methods: 135 patients undergoing near total or total thyroidectomy were divided into two groups, exposed and unexposed, based on post-operative calcium and Vitamin D administration. Both groups were followed up at day 3, at discharge and 2 weeks post operatively for the development of hypocalcaemia.Results: Common age group was 31-40 years in both groups. The mean corrected pre-operative serum calcium was 9.06±0.43mg/dl for the exposed and 9.2±0.62mg/dl for the unexposed group (p = 0.12). The mean corrected calcium levels, on third post op day was 8.9±0.61mg/dl for exposed and 8.5±0.69mg/dl for unexposed group p = 0.001), on day of discharge was 9.2±0.56mg/dl for exposed and 9.0±0.48mg/dl for unexposed group (p = 0.019), and at 2 weeks follow-up was 9.5±0.51mg/dl for exposed and 9.2±0.63mg/dl for unexposed group (p = 0.002). Incidence of clinical symptoms of hypocalcaemia in the exposed group was 5.1% and in the unexposed group was 25.9%. Majority of these patients had transient hypo-calcaemic symptoms in the 48-72hr time period after surgery in both the groups.Conclusions: Routine prophylactic oral calcium and Vitamin D supplementation is effective in preventing transient hypocalcaemia following total or near total thyroidectomy.

scholarly journals The Treatment of Macrolide-Resistant Mycoplasma Pneumoniae Pneumonia in Children

2020 ◽  
Author(s):  
Fang-fang DAI ◽  
Feng-qin LIU ◽  
Xing CHEN ◽  
Juan YANG ◽  
Ke WANG ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Adverse Reactions ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Blood Parameters ◽  
Oral Route ◽  
Mycoplasma Pneumonia ◽  
Liver And Kidney ◽  
Medical University

Abstract Objective: To evaluate the efficacy and safety of levofloxacin in children with macrolide-resistant Mycoplasma pneumoniae pneumonia. Methods: We retrospectively enrolled six confirmed cases of refractory Mycoplasma pneumoniae pneumonia (n=6) who were admitted in the pediatric respiratory ward of Shandong provincial hospital Affiliated to Shandong first Medical University between January 1st, 2020and February 29th, 2020. Levofloxacin was given to the patients through the intravenous or oral route as per the following dosages :< 5 years, 8-10 mg/kg q12hours; > 5 years, 8-10 mg/kg, qd for ten days. The clinical data were collected and analyzed. Results: The average age of the enrolled cases was six years and nine months (range, four years, and seven months to eleven years and seven months). All cases were found to be drug-resistant and were treated with azithromycin combined with antibacterial drugs. Levofloxacin was used in the patient’s refractory to macrolide antibiotics. The temperature of five cases returned to normal 1 to 2 days after treatment with levofloxacin, and the imaging of the four cases showed expected improvements. The gastrointestinal symptoms, neurological manifestations, joint symptoms, blood parameters, liver and kidney functions, and exercise conditions of the children were closely monitored. The follow-up time of the patients ranged from one week to five months. No drug-related adverse reactions were observed in patients during treatment or during follow up.Conclusions: The clinical symptoms and imaging significantly improved after treatment with levofloxacin, and no drug-related adverse reactions were observed. Levofloxacin proved to be an effective and safe drug in the treatment of children with macrolide-resistant mycoplasma pneumonia.

scholarly journals Efficacy of Corticosteroid Therapy for HTLV-1-Associated Myelopathy: A Randomized Controlled Trial (HAMLET-P)

Viruses ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 136
Author(s):  
Junji Yamauchi ◽  
Kenichiro Tanabe ◽  
Tomoo Sato ◽  
Masanori Nakagawa ◽  
Eiji Matsuura ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Corticosteroid Therapy ◽  
Randomized Clinical Trials ◽  
Controlled Trial ◽  
Oral Prednisolone ◽  
Intravenous Methylprednisolone ◽  
Randomized Controlled ◽  
Rapid Progressors ◽  
Slow Progressors ◽  
To Receive

Corticosteroids are most commonly used to treat HTLV-1-associated myelopathy (HAM); however, their clinical efficacy has not been tested in randomized clinical trials. This randomized controlled trial included 8 and 30 HAM patients with rapidly and slowly progressing walking disabilities, respectively. Rapid progressors were assigned (1:1) to receive or not receive a 3-day course of intravenous methylprednisolone in addition to oral prednisolone therapy. Meanwhile, slow progressors were assigned (1:1) to receive oral prednisolone or placebo. The primary outcomes were a composite of ≥1-grade improvement in the Osame Motor Disability Score or ≥30% improvement in the 10 m walking time (10 mWT) at week 2 for rapid progressors and changes from baseline in 10 mWT at week 24 for slow progressors. In the rapid progressor trial, all four patients with but only one of four without intravenous methylprednisolone achieved the primary outcome (p = 0.14). In the slow progressor trial, the median changes in 10 mWT were −13.8% (95% CI: −20.1–−7.1; p < 0.001) and −6.0% (95% CI: −12.8–1.3; p = 0.10) with prednisolone and placebo, respectively (p for between-group difference = 0.12). Whereas statistical significance was not reached for the primary endpoints, the overall data indicated the benefit of corticosteroid therapy. (Registration number: UMIN000023798, UMIN000024085)

scholarly journals Epidemiological and Clinical Features of Patients Suffering from Severe Pneumonia Caused by RSV in the Respiratory Center of the Viet Nam National Children's Hospital

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Thi Hong Hanh Le ◽  
Thi Thu Hang Hoang ◽  
Thi Le Nguyen ◽  
Phuong Thanh Hoang ◽  
Mai Lien Dang
Keyword(s):  
Risk Factors ◽  
Respiratory Distress ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Severe Pneumonia ◽  
Respiratory Center ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Mean ◽  
Syncytial Virus

Background/Purpose: Pneumonia is a common respiratory and life-threatening disease in pediatrics. Virus is an important cause of pneumonia in children, of which Respiratory syncytial virus (RSV) is the most common cause. The aim of this research is to access the clinical, epidemiological features and risk factors of patients suffering from RSV severe pneumonia. Methods: We studied 250 patients suffering from severe pneumonia caused by RSV from June 2019 to December 2019 in the Respiratory Center of the Vietnam National Children’s Hospital. Results: In Respiratory Center of our hospital, 3472 hospitalizations caused by pneumonia occurred in the last 6 months in 2019; 7.2% of these caused by RSV severe pneumonia. Pneumonia caused by RSV occurred most in male (66,7%), the rate of male/female = 2/1. The mean age was 4,94 ± 6,04  months. The prevalence of RSV in age groups is, respectively, as follows: less than 3 months (21,3%), from 3 months to 6 months (23,4%), from 6 months to 12 months (27%), from 12 months to 24 months (19%), over 2 years (9,3%). The most common symptoms which were accounted for over 80% were rhinorrhea, cough, wheeze, tachypnea and chest recession. The rate of admission increased sharply in December with 25.1% of cases. All hospitalized patients had respiratory distress symptoms with the frequent changes in blood gas, accounting for 59.2% of hypercapnia. The mean of hospitalization was 6,2 ± 7,4 days. Conclusion: the rate of RSV infection increased in the last 6 months in 2019. Most of patients who less than 1 year of age were admitted to hospital because of severe clinical symptoms and respiratory distress. Risk factors were related to the severity of RSV severe pneumonia were: premature, mal-nutrition, bronchopulmonary dysplasia.

Osteotomy for Correction of Premature Growth Plate Closure in 24 Dogs

1994 ◽  
Vol 07 (03) ◽  
pp. 129-135 ◽  
Author(s):  
C.W. Miller ◽  
P.W. Morgan
Keyword(s):  
Corrective Osteotomy ◽  
Functional Results ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Angular Deformity ◽  
Dynamic Correction ◽  
Age At Surgery ◽  
Limb Deformities ◽  
The Mean ◽  
A Prospective Study

SummaryTwenty-four dogs (27 limbs) were evaluated after surgery for correction of forelimb angular limb deformities. Partial ulnar ostectomies or definitive corrective osteotomies were performed depending upon the age of the dog. According to owner assessment nine of fourteen limbs were considered functionally good, or excellent, after partial ulnar ostectomies. Younger dogs appeared to have better functional results after dynamic correction with the mean age at surgery of dogs with good to excellent results being 6.5 months contrasted to the mean age at surgery of dogs with fair to poor results being 9.75 months. Ten of fourteen limbs were considered functionally good or excellent after definitive corrective osteotomy. One dog had definitive osteotomy after partial ulnar ostectomy in order to further correct a residual angular deformity. However, 58% of the limbs with radiographic follow-up had signs of degenerative joint disease (DJD). There were not significant differences between neither degree of angulation remaining after surgery and the functional result nor the degree of angulation remaining after surgery and the development of DJD. A prospective study is warranted to more objectively assess the efficacy of surgical correction of angular limb deformities in dogs.Twenty-four dogs were evaluated after surgery for correction of forelimb angular limb deformities. The results are described.

PITUITARY-ADRENAL RECOVERY FOLLOWING LONG-TERM CORTICOSTEROID THERAPY

1966 ◽  
Vol 51 (1) ◽  
pp. 63-70 ◽  
Author(s):  
P. F. Roe ◽  
D. M. Mitchell ◽  
G. W. Pennington
Keyword(s):  
Corticosteroid Therapy ◽  
Adrenocortical Function ◽  
Endocrine Disorders ◽  
Marked Rise ◽  
Underlying Condition ◽  
Normal Limits ◽  
Small Rise ◽  
The Mean ◽  
Corticosteroid Drugs

ABSTRACT Adrenocortical function was assessed in 20 patients receiving long-term corticosteroid drugs for a variety of non-endocrine disorders. In all cases plasma 17-hydroxycorticosteroids (17-OHCS) levels were within or above normal limits 48 hours after abruptly stopping their drugs and a further marked rise occurred in 7 patients given metyrapone for 24 h. Urinary 17-OHCS excretion did not show a parallel rise. Taking the group as a whole, a small rise in the mean output occurred 48 hours after stopping therapy, and a further slightly greater rise followed metyrapone. 3 patients had a relapse of their underlying condition during the test in spite of normal plasma and urinary 17-OHCS levels.

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