Glucocorticoid Receptor 

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  • ||||||||||  hydrocortisone / Generic mfg.
    Salivary Cortisol in Children with Congenital Adrenal Hyperplasia and Different Treatment Regimens (Rome, Italy) -  Nov 13, 2022 - Abstract #ESPE2022ESPE_590;    
    With a half-life of hydrocortisone of a few hours, the higher concentrations of cortisol in the morning cannot be explained sufficiently by pharmacokinetics. Assuming that the pharmacokinetics are the same during the day and at night, the cortisol level should be the lowest in the morning.
  • ||||||||||  hydrocortisone / Generic mfg.
    Molecular Analyses of A Virilized Newborn. Implications in Clinical Management (Rome, Italy) -  Nov 13, 2022 - Abstract #ESPE2022ESPE_588;    
    The informativity of gene analyses along with a good genotype/phenotype relationship in CAH facilitates the diagnosis, prognosis and treatment adequacy, even in the absence of pretreatment whole biochemical data or when analytical interferences (not infrequent in direct immunoanalyses of steroids in the neonatal period) difficult the interpretation of results. An expert evaluation of molecular findings and their proper stratification is essential when complex genetic loci, reluctant to massive approaches, are investigated.
  • ||||||||||  hydrocortisone / Generic mfg.
    Effect of maternal steroid medication prescribed during pregnancy on neonatal adrenal function (Rome, Italy) -  Nov 13, 2022 - Abstract #ESPE2022ESPE_587;    
    Dose and duration may play a role. Further studies detailing normal adrenal function in neonates and the effect of maternal steroids use in pregnancy are required to inform in whom HPA-axis assessment maybe necessary, the best method of assessment and interpretation.
  • ||||||||||  anastrozole / Generic mfg.
    Case Series: Anastrozole Monotherapy for Non-Classic Congenital Adrenal Hyperplasia (Rome, Italy) -  Nov 13, 2022 - Abstract #ESPE2022ESPE_582;    
    Monotherapy with AI can be an effective alternative in slowing down bone maturation and improving height outcomes in children with NC-CAH and normal adrenal cortisol production. All three patients had appropriate pubertal progression, normal ovarian ultrasounds, and normal bone mineral density accrual.
  • ||||||||||  hydrocortisone / Generic mfg.
    How Do I Diagnose and manage primary adrenal insufficiency (Rome, Italy) -  Nov 13, 2022 - Abstract #ESPE2022ESPE_484;    
    Oral hydrocortisone is the first choice treatment in children...However, currently available glucocorticoid preparation fails to replicate the physiological cortisol circadian rythm and additional advances are needed to improve therapy and outcomes. In this session, the diagnostic approach and management of children with PAI will be discussed.
  • ||||||||||  Fraxiparine (nadroparin) / Aspen, Metopirone (metyrapone) / HRA Pharma
    The first case of pediatric Cushing disease in Serbia (Rome, Italy) -  Nov 13, 2022 - Abstract #ESPE2022ESPE_415;    
    CD is a serious disorder, which could be life-threatening, where pediatric endocrinologists have limited experience. A multidisciplinary approach is a key to success in timely diagnosis and therapy.
  • ||||||||||  hydrocortisone / Generic mfg.
    Retrospective data, Review, Journal:  Safety and efficacy of corticosteroids in ARDS patients: a systematic review and meta-analysis of RCT data. (Pubmed Central) -  Nov 13, 2022   
    Therefore, evidence suggests patients with age ≥ 18 years and non-COVID-19 should be encouraged during the corticosteroid treatment. However, due to substantial differences in the use of corticosteroids among these studies, questions still remain regarding the dosage, optimal corticosteroid agent, and treatment duration in patients with ARDS.
  • ||||||||||  dexamethasone / Generic mfg.
    Review, Journal:  Management of Severe and Critical COVID-19 Infection with Immunotherapies. (Pubmed Central) -  Nov 12, 2022   
    Following the reduction in mortality demonstrated by dexamethasone treatment in severe COVID-19, many targeted immunotherapies have been investigated...The exclusion of many patients requiring invasive mechanical ventilation, preponderance of ordinal scale based endpoints, and frequent lack of blinding are particular challenges. More data is needed to identify beneficial treatments in the complex milieu of critical illness from COVID-19 infection.
  • ||||||||||  dexamethasone / Generic mfg.
    Preclinical, Journal:  TMT-Based Quantitative Proteomic Analysis Reveals Downregulation of ITGAL and Syk by the Effects of Cycloastragenol in OVA-Induced Asthmatic Mice. (Pubmed Central) -  Nov 12, 2022   
    This study is aimed at investigating the effects of CAG on asthma, comparing its efficacy with dexamethasone (DEX), and elucidating the mechanism of CAG's regulation...We then focused on 3 differentially expressed proteins (ITGAL, Syk, and Vav1) and demonstrated that CAG treatment downregulated ITGAL, Syk, and Vav1 by quantitative real-time PCR, western blot analysis, and immunohistochemical staining. These findings suggest that CAG exerts preventive and protective effects on asthma by inhibiting ITGAL, Syk, and the downstream target Vav1.
  • ||||||||||  A Rare Case of Bacterial Meningitis in an Infant with Milk-protein Allergy (Anaheim Convention Center, Hall A, Board # 211) -  Nov 10, 2022 - Abstract #AAPNCE2022AAP_NCE_2304;    
    He also had a generalized tonic-clonic seizure which was aborted with lorazepam...The patient was started on ceftriaxone, vancomycin, dexamethasone, and acyclovir, for suspected bacterial meningitis... Given that Streptococcus gallolyticus pasteurianus can become an enteric pathogen, it should be considered as a rare cause of bacterial meningitis, especially in infants with milk-protein allergy and preceding gastrointestinal symptoms.
  • ||||||||||  metformin / Generic mfg., hydrocortisone / Generic mfg., midodrine hydrochloride / Generic mfg.
    Obesity and Hyperosmolar Hyperglycemia: The Brain Can Explain (Anaheim Convention Center, Hall A, Board # 196) -  Nov 10, 2022 - Abstract #AAPNCE2022AAP_NCE_2289;    
    Tracking growth parameters and monitoring trends in children with CNS injury, particularly brain cancer survivors, can dramatically reduce the chances of illness. Medical professionals should be aware of hypothalamic obesity to intervene early and avoid severe presentations and other comorbidities.
  • ||||||||||  Potts Puffy Tumor: A Case of Medical Management of This Surgical Emergency (Anaheim Convention Center, Hall A, Board # 195) -  Nov 10, 2022 - Abstract #AAPNCE2022AAP_NCE_2288;    
    As the etiology of PPT is often related to sinusitis and has been found to be polymicrobial when surgical drainage is performed, empiric antibiotic treatment consists of broad-spectrum antibiotics. In uncomplicated cases of PPT, such as with this patient, it may be acceptable to treat with broad-spectrum antibiotics and close monitoring alone without surgical intervention.
  • ||||||||||  Pulmonary Embolism in Pediatric Patients with Recent COVID-19 Infection: A Case Series (Anaheim Convention Center, Hall A, Board # 188) -  Nov 10, 2022 - Abstract #AAPNCE2022AAP_NCE_2281;    
    He was discharged after 24 hours, continued enoxaparin for 5 days, and then transitioned to oral dabigatran for three months with hematology follow-up...The patient was treated initially with heparin and then with enoxaparin, remdesivir, albuterol, azithromycin, and IV solumedrol...He was started on heparin, transitioned to enoxaparin therapy, and subsequently oral rivaroxaban due to insurance coverage... These three cases emphasize that pediatric patients with identifiable prothrombotic risk factors are at risk for developing serious complications secondary to COVID-19 infection, and as such, increased suspicion for VTE development should be present in these situations.
  • ||||||||||  hydrocortisone / Generic mfg.
    Adrenal Insufficiency in Multisystem Inflammatory Syndrome in Children ( MIS-C) (Anaheim Convention Center, Hall A, Board # 058) -  Nov 10, 2022 - Abstract #AAPNCE2022AAP_NCE_2214;    
    He was treated with 40 ml/kg normal saline bolus, 1 g/kg of dextrose followed by dextrose containing fluids and stress dose steroid therapy (intravenous hydrocortisone: 50 mg/m2/day) on suspicion of acute adrenal insufficiency... As we continue to learn more about MIS-C, an assessment of adrenal function must be undertaken in MIS-C patients presenting with hypoglycemia, hyponatremia and hypotension.
  • ||||||||||  levetiracetam / Generic mfg., hydrocortisone / Generic mfg.
    An Unusual Presentation of Child Abuse and Subsequent Osmotic Demyelination Syndrome (Anaheim Convention Center, Hall A, Board # 045) -  Nov 10, 2022 - Abstract #AAPNCE2022AAP_NCE_1849;    
    While the exact etiology of her ODS is not completely clear, her case emphasizes the importance of having a high index of suspicion for potential ODS and creating a broad differential when patients present with abnormal mentation, as well as inconsistent history. Our patient had a favorable outcome, however 39% of patients with ODS die within a few months of symptom onset, and only 60% recover neurologically from the insult, according to reported data.
  • ||||||||||  remdesivir / Generic mfg., dexamethasone / Generic mfg., enoxaparin sodium / Generic mfg.
    Impact of sars-cov-2 Infection at Delivery on Maternal and Neonatal Outcomes (Anaheim Convention Center, Hall A, Board # 056) -  Nov 10, 2022 - Abstract #AAPNCE2022AAP_NCE_1574;    
    Although a majority of women were asymptomatic at the time of delivery, there was significant morbidity among newborns including prematurity, low birth weight and respiratory distress even in PCR negative newborns. Two PCR positive infants were symptomatic requiring mechanical ventilation and antiviral medication.
  • ||||||||||  dexamethasone / Generic mfg.
    Reducing Time from Pediatric Emergency Department Arrival to Dexamethasone Administration in Wheezing Patients (Anaheim Convention Center, Hall A, Board # 037) -  Nov 10, 2022 - Abstract #AAPNCE2022AAP_NCE_1466;    
    ED LOS for discharged asthma exacerbation patients did not change despite an overall rise in ED LOS for all discharged patients. Conclusion/Discussion : Using QI methodology, we successfully decreased the time from ED arrival to administration of dexamethasone in asthma exacerbation patients from 62 to 42 minutes.
  • ||||||||||  fluticasone / Generic mfg.
    Tracking Asthma Medication Use in Children After an Emergency Department Visit with a Smart Inhaler and Connected Mobile Application (Anaheim Convention Center, Hall A, Board # 027) -  Nov 10, 2022 - Abstract #AAPNCE2022AAP_NCE_1456;    
    Our study is a successful proof of concept, demonstrating moderate feasibility of real-time tracking of pediatric inhaled asthma medication using a “smart” inhaler device after an ED visit. Further studies are in development to construct an asthma risk profile by connecting medication use events and environmental data as a predictive tool to prevent future asthma exacerbations.
  • ||||||||||  Asmanex Twisthaler (mometasone furoate) / Merck (MSD), QVAR (beclomethasone dipropionate hydrofluoroalkane inhalation) / Teva
    Journal:  Using Filters to Estimate Regional Lung Deposition with Pressurized Metered Dose Inhalers. (Pubmed Central) -  Nov 10, 2022   
    The direct measurement of estimated regional deposition is possible when using the FBA. This method is far less resource intensive than existing methods and so may be useful both for comparison of generic alternatives and the development of innovative products.
  • ||||||||||  dexamethasone / Generic mfg.
    Journal:  New flexible cembrane-type macrocyclic diterpenes as TNF-α inhibitors from the South China Sea soft coral Sarcophyton mililatensis. (Pubmed Central) -  Nov 10, 2022   
    The structures and absolute configurations of natural macrocyclic compounds 1-6 were established by the extensive spectroscopic analysis, X-ray diffraction analysis, time-dependent density functional theory/electronic circular dichroism (TDDFT ECD) calculations, chemical reaction, and modified Mosher's method. In the bioassays, the macrocyclic diterpene 2 exhibited potent TNF-α inhibition (IC = 6.1 μmol/L), which was better than the positive control dexamethasone (IC = 8.7 μmol/L), and no obvious cytotoxicity against RAW264.7 cells with CC values over 50 μmol/L, indicating natural macrocyclic compound 2 could be served as a model compound to develop a new and prospective chemotype of an anti-inflammatory lead compound or drug candidate.
  • ||||||||||  Evusheld (cilgavimab/tixagevimab) / AstraZeneca, Paxlovid (nirmatrelvir and ritonavir) / Pfizer
    Journal:  COVID-19, how to treat the disease during Fall 2022? (Pubmed Central) -  Nov 10, 2022   
    Evusheld, administered in the hospitals, is recommended in patients with a documented negative serology, for treatment in early disease or as a pre-exposure prophylaxis...Dexamethasone is reserved for the hospital management of an oxygen-dependent patient. There is no place for antibiotic therapy apart from additional bacterial infection.