cortisol-succinate--sodium-salt and Acute-Disease

Henoch-Schönlein purpura is a systemic vasculitis and sometimes presents as acute scrotal swelling in children. We report a case of Henoch-Schönlein purpura with acute scrotal swelling, which was correctly diagnosed based upon local physical findings. Scrotal ultrasonography showed normal testes and hydrocele testis around the affected testis 3 hours after the sudden onset of the pain. The scrotal symptoms improved in 2 days with steroid therapy. Scrotal ultrasonography was useful to diagnose Henoch-Schönlein purpura with scrotal involvement. Steroid treatment appeared to be effective for this condition.

Topics: Acute Disease; Child; Genital Diseases, Male; Humans; Hydrocortisone; IgA Vasculitis; Male; Scrotum; Treatment Outcome; Ultrasonography

To investigate the efficacy of azathioprine as maintenance therapy in acute severe colitis of Crohn's disease or ulcerative colitis after successful treatment by intravenous corticosteroids.. We conduct an open prospective study between 1999 and 2004. All patients with acute severe colitis and good outcome after seven at ten days of intravenous corticosteroid treatment received azathioprine (2-2.5 mg/kg/day). Rates of relapse, severe relapse and recurrence of acute severe colitis were studied and compared to patients treated between 1990 and 1998 with no azathioprine therapy after remission induced by intravenous corticosteroids.. Between 1999 and 2004, 21 patients with acute severe colitis and favourable outcome with intravenous corticosteroid therapy received azathioprine with a mean follow-up of 26 months. Comparatively to the 22 patients with no azathioprine therapy, the rate of relapse was lower in azathioprine group (10% vs 55%; p=0.002) as well as rate of severe relapse (0% vs 36%; p=0.002) and recurrence of acute severe colitis (0% vs 27%; p =0.01). In univariate analysis, predictive factors of relapses were absence of azathioprine therapy (p=0.002 OR [IC95%]: 11.4 [2.12-61.25]), absence of decrease of levels of ESR the 3rd day of treatment (p=0.004 OR [IC95%]: 10.0 [1.79-55.63]) and absence of sigmoid involving (p=0.03 OR [IC95%]: 4.80 [1.15-19.92]). In multivariate analysis, the independent predictive factor of relapse was absence of azathioprine therapy (p=0.003 adjusted OR [IC95%]: 2.17 (1.44-6.66]). The only predictive factor of severe relapse was also absence of azathioprine therapy (p=0.002 OR [IC95%]: 2.5 [1.66-3.84]).. Maintenance therapy with azathioprine is effective in prevention of relapses in patients with acute severe colitis and favourable outcome with intravenous corticosteroid therapy.

Topics: Acute Disease; Adolescent; Adult; Anti-Inflammatory Agents; Azathioprine; Colitis; Female; Humans; Hydrocortisone; Immunosuppressive Agents; Injections, Intravenous; Male; Middle Aged; Prospective Studies; Remission Induction; Retrospective Studies; Severity of Illness Index; Young Adult

In a multicenter, randomized, double-blind study, we compared the effects of nebulized (5 mg x 2) and intravenous (0.5 mg) albuterol (salbutamol) over 1 h in 47 patients admitted to hospital with severe acute asthma defined as a peak expiratory flow (PEF) below 150 L/min and hypercapnia (Pa(CO2) > or = 40 mm Hg). Additional treatment included nasal oxygen and hydrocortisone succinate. The efficacy was assessed after 1 h. In the group treated by nebulization (NEB group, n = 22) 19 (86%) patients (95% confidence interval: 65 to 97%) had been treated successfully according to predefined criteria, versus 12 (48%) patients (95% confidence interval: 28 to 69%) in the intravenously treated group (i.v. group, n = 25), p = 0.006. The mean increase in PEF was greater in the NEB group than in the i.v. group (+107 +/- 94 L/min versus +42 +/- 66 L/min, p = 0.01) as well as the decrease in Pa(CO2) values (-10 +/- 5 mm Hg versus -2 +/- 12 mm Hg, p < 0.01). Beta agonist-induced hypokalemia was more pronounced in the i.v. group than in the NEB group. We conclude that, in hypercapnic acute asthma, the nebulized route has a greater efficacy and fewer side effects than the intravenous route.

Topics: Acute Disease; Administration, Inhalation; Adolescent; Adult; Aged; Albuterol; Analysis of Variance; Asthma; Carbon Dioxide; Combined Modality Therapy; Confidence Intervals; Double-Blind Method; Drug Monitoring; Female; Humans; Hydrocortisone; Hypercapnia; Hypokalemia; Infusions, Intravenous; Male; Middle Aged; Nebulizers and Vaporizers; Oxygen Inhalation Therapy; Peak Expiratory Flow Rate; Severity of Illness Index; Time Factors

Topics: Acidosis; Acute Disease; Adult; Albuterol; Anti-Asthmatic Agents; Asthma; Biomarkers; Combined Modality Therapy; Creatine Kinase, MM Form; Female; Fentanyl; Humans; Hydrocortisone; Hypnotics and Sedatives; Hypoxia; Male; Midazolam; Respiration, Artificial; Respiratory Muscles; Rhabdomyolysis

Corticosteroids are the basis of treatment of asthma; they interrupt the development of inflammation. However, corticosteroids can also be at the origin of severe allergical reactions.. A 40 Year-old woman, during hospitalisation for severe acute asthma, presented with an allergy to hydrocortisone hemisuccinate (HCHS) in the form of generalised pruritus with, on examination, cutaneous mucosal lesions in the form of purpura and ecchymoses on the abdomen and the upper and lower limbs. The substitution of HCHS led to the return to normal.. Allergic reactions to corticosteroids, generally paradoxical, were for many Years ignored and their existence was controversial. They were usually secondary to the administration of injectable substances containing hydrocortisone hemisuccinate or methylprednisolone. Their physiopathology remains a mystery. Their management requires the immediate and permanent withdrawal of the product implied, antihistamine and adrenalin in the case of shock and symptomatic treatment.

Topics: Acute Disease; Adult; Anti-Asthmatic Agents; Anti-Inflammatory Agents; Arachidonic Acids; Asthma; Biopsy; Diagnosis, Differential; Drug Eruptions; Drug Monitoring; Ecchymosis; Female; Humans; Hydrocortisone; Immunoglobulin E; Medical History Taking; Prednisone; Pruritus; Purpura; Treatment Outcome

Topics: Acute Disease; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Aged; Edema; Epidermis; Humans; Hydrocortisone; Leg; Lung Neoplasms; Male

We report the case of acute adrenal gland failure which occurred one hour after cesarian section for the delivery of a child after 31 weeks of amenorrhoea. The clinical picture of the mother was immediately severe and was dominated by neurological features: profound coma with a bilateral Babinski's sign. The laboratory tests however only revealed severe hypoglycaemia among the classical signs of adrenal gland failure. It was extremely difficult to correct the blood glucose level without concomitant administration of corticosteroids.

Topics: Acute Disease; Adrenal Insufficiency; Adult; Aldosterone; Blood Glucose; Cesarean Section; Coma; Female; Humans; Hydrocortisone; Hypoglycemia; Pregnancy; Puerperal Disorders; Reflex, Babinski

Twenty-seven consecutive patients with acute intractable headaches were treated in an office setting with an intravenous protocol of an antiemetic, hydrocortisone sodium succinate, and dihydroergotamine (DHE). All patients had significant pain relief within 45 minutes. Patients who were not pain-free post-treatment uniformly reported decreasing pain at the time of departure from the office. No patients required further treatment (including narcotic medication) for acute headache. All patients were followed for at least 24 hours. Adverse reactions were transient and mild. Akathisia was not uncommon and has probably been underestimated in previous studies.

Topics: Acute Disease; Adult; Ambulatory Care; Antiemetics; Dihydroergotamine; Drug Therapy, Combination; Female; Headache; Humans; Hydrocortisone; Injections, Intravenous; Male; Middle Aged; Pilot Projects

Topics: Acute Disease; Epiglottitis; Gastrointestinal Hemorrhage; Humans; Hydrocortisone; Infant; Laryngitis; Male; Stress, Physiological

Topics: Acute Disease; Adolescent; Adult; Airway Resistance; Asthma; Female; Humans; Hydrocortisone; Male; Middle Aged