Steroid sparing

50 mg/m2 IV 30 to 60 minutes prior to induction of anesthesia, with repeat doses of 50 mg/m2/dose IV every 6 hours or as a continuous infusion until the patient has recovered, has been recommended. For patients with congenital adrenal hyperplasia (CAH), 2 mg/kg/dose IV at induction of anesthesia with repeat doses every 4 hours or as a continuous IV infusion for prolonged procedures or recovery times has also been recommended. Alternatively, an initial stress dose of 25 mg IM followed by IV doses equivalent to 3 to 4 times the daily maintenance dose divided every 6 hours has been recommended.

Childhood nephrotic syndrome (NS) is frequently characterized by a relapsing course. There is no uniform agreement about the precise stage at which a steroid-sparing agent should be introduced to control the disease. In order to evaluate the treatment strategies and outcome of steroid-sensitive NS over the last 2 decades, a retrospective notes review was undertaken in a cohort of children treated at Great Ormond Street Children's Hospital between 1980 and 2000. From a population of 863 children with NS referred, 509 had frequently relapsing or steroid-dependent disease and 261 children received at least one steroid-sparing agent. Cyclophosphamide was the first choice in 178 patients and in 114 no further steroid-sparing agent was needed. Levamisole was prescribed as the first steroid-sparing agent for 65 children and disease control was achieved in 30%. Cyclosporin A was prescribed in 61 children and sustained remission was induced in 69%. It is concluded that cyclophosphamide is a potent agent in inducing sustained remission in steroid-sensitive NS. Levamisole and cyclosporin A have emerged as attractive steroid-sparing agents. Complications and major side effects of treatment are infrequent but occasionally fatal.

Dr. Mimouni is currently a dermatologist at Rabin Medical Center, Petah Tikva, Israel, but undertook the retrospective analysis when he was an immunodermatology fellow at Johns Hopkins School of Medicine, Baltimore. The patients in the series were treated by Grant J. Anhalt, ., professor of dermatology and pathology, and Hossein Nousari, ., co-director of immunodermatology. Those physicians began to explore the efficacy and safety of mycophenolate mofetil as an adjunctive treatment for pemphigus about five years ago based on published literature demonstrating its utility and favorable safety profile when used as a steroid-sparing agent to prevent acute graft rejection in transplant patients as well as more limited reports describing successful treatment of pemphigus patients.

If a patient asks about a specific ergogenic aid, he or she should be told what is known and unknown about the product based on current research, including the side effect profile. The danger is that once athletes start using a commercial supplement, they will continue to use more, eventually trying something that may not be safe. Many athletes feel pressured to use supplements to maintain a competitive advantage over their supplement-using peers. If physicians can guide athletes away from disproven and dangerous supplements, while maintaining open and honest lines of communication, then more serious health risks may be prevented.

A diagnosis is normally made on the basis of first excluding other causes of spinal pain (like bone or soft tissue infections, immune-mediated joint disease, infections) by obtaining a blood sample and performing radiographs. Then, cerebro-spinal fluid (CSF) analysis is performed by obtaining a sample of CSF from the neck or lower spine (or both) in a sterile manner under general anaesthesia . Your pet will have dedicated one-to-one care during their CSF tap by one of our nurses from the prep nursing team who are trained and experienced in anaesthesia and sedation . The demonstration of inflammation and the presence of a specific type of inflammatory cell facilitate a presumptive diagnosis. Although infection is very unlikely, we will normally run a panel of various blood and urine tests to exclude this possibility.

Steroid sparing

steroid sparing

If a patient asks about a specific ergogenic aid, he or she should be told what is known and unknown about the product based on current research, including the side effect profile. The danger is that once athletes start using a commercial supplement, they will continue to use more, eventually trying something that may not be safe. Many athletes feel pressured to use supplements to maintain a competitive advantage over their supplement-using peers. If physicians can guide athletes away from disproven and dangerous supplements, while maintaining open and honest lines of communication, then more serious health risks may be prevented.

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