scholarly journals Prednisone combined with antiviral agents for the treatment of early idiopathic brachial plexus neuritis: report of five cases

BioMedica ◽  
2021 ◽  
Vol 37 (3) ◽  
pp. 1-23
Author(s):  
Xueyuan Li ◽  
Miao Yu ◽  
Miaozhong Li ◽  
Kyaw Thura ◽  
Xiaoling Zhou ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Antiviral Therapy ◽  
Corticosteroid Therapy ◽  
Low Dose ◽  
Full Range ◽  
Antiviral Agents ◽  
Antiviral Agent ◽  
Clinical Value ◽  
Brachial Plexus Neuritis ◽  
Dose Corticosteroid

<p><strong>Background and Objective: </strong>The aim of this study was to report the short-term outcomes of early idiopathic brachial plexus neuritis after low-dose corticosteroid combined with antiviral agent.</p> <p><strong>Methods:</strong> Five patients with early brachial plexus neuritis presenting from April to June 2019 were included in this study. According to individual patient conditions, electromyography (EMG), nerve B-ultrasound and/or brachial plexus magnetic resonance imaging (MRI) were performed. After the diagnosis was confirmed, modified conservative treatments were initiated, including low-dose corticosteroid therapy and antiviral therapy for 2 weeks each while neurotrophic therapy for 4 weeks.</p> <p><strong>Results: </strong>Of the five patients, only two patients had symptoms of pain at onset, and three patients had sensory disturbances. Two patients reported a common cold before onset. The lesion involved the upper trunk of the brachial plexus in two patients. MRI showed slightly intense signals, of which one patient also had supraclavicular lymph node augmentation. The other three patients suffered ipsilateral radial nerve (RN) palsy. At 1 month of modified treatment, four patients recovered well with almost complete shoulder and hand movements; however, their muscle strength was still weaker comparing with the contralateral side. One patient restored full range of motion after surgery in 2 months.</p> <p><strong>Conclusion:</strong> Early treatment is the key to good prognosis in patients with brachial plexus neuritis. Antiviral therapy combined with lowdose corticosteroid therapy may be superior to traditional treatment alone. In terms of early diagnosis, the clinical value of imaging examinations such as ultrasound and MRI is more specific as compared to that of EMG.</p>

The past as Prelude to the Future: History, Status, and Future of Antiviral Drugs

1996 ◽  
Vol 30 (9) ◽  
pp. 967-971 ◽  
Author(s):  
Richard J Whitley
Keyword(s):  
Antiviral Therapy ◽  
English Language ◽  
Data Extraction ◽  
Antiviral Agents ◽  
Antiviral Agent ◽  
Nucleoside Analogs ◽  
Phase Iii ◽  
Clinical Value ◽  
Medline Search ◽  
Aids Epidemic

OBJECTIVE: To review the first generation of antiviral agents (e.g., idoxuridine, amantadine, vidarabine) that paralleled discovery of antineoplastic agents. DATA SOURCES: A MEDLINE search (1962 to 1996) of the English-language literature pertaining to antiviral agents was performed. DATA EXTRACTION: All articles were considered for this review. Pertinent references on antiviral therapy, as judged by the author, were selected. DATA SYNTHESIS: Acyclovir, the first second-generation antiviral agent, has a known selective mechanism of action and provides the model for development of future antiviral therapies. Despite the safety and clinical value of acyclovir, therapy does not prevent establishment of latency or decrease frequency of occurrences, resistance has been documented, and outcome is frequently poor. With the emergence of the HIV/AIDS epidemic, several antiretroviral agents have been developed and approved. However, none of the four available nucleoside analogs provides a cure. CONCLUSIONS: Viral resistance has emerged as an important component of antiviral therapy. Improved therapies for cytomegalovirus are needed. Several new therapies for herpes zoster, including prodrugs, are licensed or in Phase III clinical trials. Future directions include the use of molecular biologic techniques to identify enzymes unique to viral replication and to accelerate diagnosis of viral diseases.

Bone Complications of Corticosteroids

1996 ◽  
Vol 1 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Robert S. Lester
Keyword(s):  
Corticosteroid Therapy ◽  
Low Dose ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
High Dose ◽  
Systemic Complications ◽  
High Dose Corticosteroid ◽  
Systemic Corticosteroids ◽  
Dose Corticosteroid ◽  
Bone Complications

Background: Systemic corticosteroids, a mainstay of treatment for severe dermatosis, are associated with systemic complications. Adverse effects of corticosteroids to bone represent a significant adverse effect that, is poorly understood and poorly managed. Objectives: The purpose of this article is to educate dermatologists to the current understanding of the pathogenesis, diagnosis, and treatment options available for bone complications of corticosteroids. Results: Virtually all patients chronically exposed to high-dose corticosteroid therapy lose bone mass and are at risk for osteoporotic fractures. In addition, osteonecrosis is an unpredictable complication of corticosteroid therapy that may occur with even low-dose corticosteroids. Conclusion: Optimal risk management of corticosteroid therapy includes understanding the risk factors associated with bone complications and improving communication with patients.

scholarly journals Early initiation of low-dose corticosteroid therapy in the management of septic shock: a retrospective observational study

Critical Care ◽  
2012 ◽  
Vol 16 (1) ◽  
pp. R3 ◽  
Author(s):  
Hey Yun Park ◽  
Gee Young Suh ◽  
Jae-Uk Song ◽  
Hongseok Yoo ◽  
Ik Joon Jo ◽  
...  
Keyword(s):  
Septic Shock ◽  
Observational Study ◽  
Corticosteroid Therapy ◽  
Low Dose ◽  
Early Initiation ◽  
Retrospective Observational Study ◽  
Dose Corticosteroid

scholarly journals New-Onset Diabetes Mellitus in Patients with Idiopathic Membranous Nephropathy Undergoing Tacrolimus and Low-Dose Corticosteroid Therapy

2019 ◽  
Vol 44 (6) ◽  
pp. 1352-1362 ◽  
Author(s):  
Lina Shao ◽  
Juan Jin ◽  
Binxian Ye ◽  
Baihui Xu ◽  
Yiwen Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Factor ◽  
Corticosteroid Therapy ◽  
Low Dose ◽  
Significant Difference ◽  
Dose Corticosteroid ◽  
New Onset Diabetes Mellitus ◽  
New Onset

Background: Idiopathic membranous nephropathy (IMN) is the most common cause of nephrotic syndrome in adults. Although various studies have demonstrated the efficacy of tacrolimus combined with corticosteroids for treating IMN, both tacrolimus and corticosteroids have been shown to be diabetogenic, particularly following organ transplantation. Furthermore, the frequency and risk factors for new-onset diabetes mellitus (NODM) in IMN patients treated with tacrolimus plus low-dose corticosteroids remain unclear. Objectives: To evaluate the incidence of NODM in IMN patients undergoing tacrolimus plus low-dose corticosteroid therapy and to confirm the risk factors for NODM development. Methods: This retrospective study recruited 72 eligible patients with biopsy-proven IMN from our center, between September 2013 and June 2018. All subjects were treated with tacrolimus plus low-dose corticosteroids for a minimum of 3 months. The primary outcome was NODM development during the follow-up period. The secondary outcome was complete or partial remission. Patients were divided into 2 groups: patients with NODM (NODM group) and those without NODM (No-NODM group). Demographic and clinical data at baseline and follow-up were assessed. Results: During follow-up, 31 of the 72 patients developed NODM (43.0%). The median time to occurrence was 3 months after treatment initiation. NODM patients were significantly older (median age 59 vs. 40 years) than No-NODM patients. Baseline fasting blood glucose levels were slightly higher in the NODM group; however, the difference was not significant (p = 0.07). Older age was an independent risk factor for NODM (OR 1.73 and 95% CI 1.20–2.47, p = 0.003). Overall kidney remission rates were 80.6%. There was no significant difference in remission rate between groups. There was a significant difference in development of pulmonary infection, which occurred in 7 NODM patients and only in 1 No-NODM patient (p = 0.018). IMN reoccurred in 5 NODM patients but only 1 No-NODM patient. Conclusions: Tacrolimus plus low-dose corticosteroid therapy was an efficient treatment for IMN; however, it was accompanied by increased NODM morbidity, which should be considered serious, due to the increased risk of life-threatening complications. Increasing age was a major risk factor for NODM in IMN patients treated with tacrolimus plus low-dose corticosteroid therapy.

scholarly journals Bone turnover biomarkers in COPD patients randomized to either a regular or shortened course of corticosteroids: a substudy of the randomized controlled CORTICO-COP trial

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Pradeesh Sivapalan ◽  
Niklas R. Jørgensen ◽  
Alexander G. Mathioudakis ◽  
Josefin Eklöf ◽  
Therese Lapperre ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Dose Group ◽  
Low Dose ◽  
Corticosteroid Treatment ◽  
High Dose ◽  
Short Term ◽  
Copd Patients ◽  
Dose Corticosteroid

Abstract Background Long-term treatment with corticosteroids causes loss of bone density, but the effects of using short-term high-dose systemic-corticosteroid therapy to treat acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are unclear. Our aim was to determine whether high-dose corticosteroid therapy affected bone turnover markers (BTMs) to a greater extent compared to low-dose corticosteroid therapy. Methods The CORTICO-COP trial (NCT02857842) showed that an eosinophil-guided corticosteroid intervention led to approximately 60% lower accumulated corticosteroid dose for hospitalized patients with AECOPD (low-dose group) compared with 5-day standard corticosteroid treatment (high-dose group). We compared the levels of BTMs C-terminal telopeptide of type 1 collagen (CTX) and procollagen type 1 N-terminal propeptide (P1NP) in 318 participants during AECOPD and at 1- and 3-month follow-up visits. Results CTX decreased and P1NP increased significantly over time in both treatment groups. There were no significant differences between the groups at 1- or 3-months follow-up for P1NP. A significant drop in CTX was seen at 3 months (down Δ24% from the baseline, p = 0.017) for the high dose group. Conclusion Short-term, high-dose systemic corticosteroid treatment caused a rapid suppression of biomarkers of bone resorption. Corticosteroids did not suppress biomarkers of bone formation, regardless of patients receiving low or high doses of corticosteroids. This therapy was, therefore, harmless in terms of bone safety, in our prospective series of COPD patients. Trial registration ClinicalTrials.gov Identifier: NCT02857842. Submitted August 2nd, 2016.

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