- |||||||||| hydrocortisone / Generic mfg.
Journal, HEOR: Comparative Effectiveness of Fludrocortisone and Hydrocortisone vs Hydrocortisone Alone Among Patients With Septic Shock. (Pubmed Central) - Mar 28, 2023
The primary composite outcome of death in hospital or discharge to hospice occurred among 1076 (47.2%) patients treated with hydrocortisone-fludrocortisone vs 43?669 (50.8%) treated with hydrocortisone alone (adjusted absolute risk difference, -3.7%; 95% CI, -4.2% to -3.1%; P?<?.001). In this comparative effectiveness cohort study among adult patients with septic shock who began hydrocortisone treatment, the addition of fludrocortisone was superior to hydrocortisone alone.
- |||||||||| hydrocortisone / Generic mfg.
Trial completion: Subcutaneous Hydrocortisone Children With Congenital Adrenal Hyperplasia (clinicaltrials.gov) - Mar 27, 2023
P1, N=11, Completed,
Lead compound also induced the accumulation of cells in G1 phase and its combination with enzalutamide was shown to be more effective than enzalutamide alone. Active, not recruiting --> Completed
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J, Stelara (ustekinumab) / J&J
Posterior reversible encephalopathy syndrome following immunosuppressive treatment for ulcerative colitis. () - Mar 27, 2023 - Abstract #BSPGHAN2023BSPGHAN_131;
The patient was started on IV hydrocortisone 2.5mg/kg QDS and a 5-ASA...The patient had some ongoing focal seizure activity so levetiracetam was continued...A review of the literature shows steroids and hypertension as a frequent causative mechanism of PRES. The association between PRES syndrome and infliximab is not well defined, however there are a few single case reports published of PRES syndrome in patients treated with either infliximab or Ustekinumab.
- |||||||||| hydrocortisone / Generic mfg.
Journal, Checkpoint inhibition: Pituitary and adrenal disorders induced by immune checkpoint inhibitors. (Pubmed Central) - Mar 26, 2023
We also highlight several key points, such as the need for emergency treatment by hydrocortisone with the possibility of continuing immunotherapy in these endocrinopathies, and the long-term persistence of corticotropin or adrenal deficiency in most cases, requiring specific "hydrocortisone education?. These points should be kept in mind by oncologists and endocrinologists who treat and monitor patients treated by immunotherapy.
- |||||||||| hydrocortisone / Generic mfg.
Journal, Surgery: Pituitary Surgery in Germany - Findings from the European Pituitary Adenoma Surgery Survey. (Pubmed Central) - Mar 25, 2023
42 centers (72.4%) prescribe hydrocortisone after pituitary surgery routinely...52 (86.7%) respondents perform the first follow-up scan by MRI 3-4 months after surgery. Conclusions The data showed differences as well as similarities between centers and could help to discuss standardization of methods as well as the formation of networks and certification to improve patient care.
- |||||||||| cefepime hydrochloride / Generic mfg., levofloxacin / Generic mfg., hydrocortisone / Generic mfg.
Legionnaires Disease Manifesting as an Acute Leukemoid Reaction (Walter E. Washington Convention Center, Area C, Hall C (Lower Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_8465;
Further long-term randomised control studies are necessary to validate the potential clinical benefit of utilising steroids in paediatric cardiac surgery, especially in the more fragile neonatal population. Despite treatment with cefepime, cessation of hydrocortisone, and liberation from mechanical ventilation by day 7 of hospitalization, the patient's white blood cell count peaked at 64,000 on day 8 of hospitalization...Legionella urine antigen then returned positive, and the patient was started on levofloxacin...However, an acute leukemoid reaction is rarely described in the literature in association with Legionnaires
- |||||||||| prednisone / Generic mfg., thyroxine / Generic mfg., hydrocortisone / Generic mfg.
Bilateral Pleural Effusion Secondary to Myxedema (Walter E. Washington Convention Center, Area K, Hall C (Lower Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_8045;
The mainstay of treatment is correction of the hormonal imbalance with intravenous thyroid hormone and hydrocortisone in an ICU setting. Studies have reported a mortality rate of as high as 60% therefore making an early diagnosis crucial for a positive patient outcome.
- |||||||||| Pituitary Apoplexy, A Rare But Life Threatening Complication of Pituitary Adenoma (Walter E. Washington Convention Center, Area K, Hall C (Lower Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_8042;
Pituitary apoplexy is a rare but serious complication of pituitary adenoma associated with significant mortality and morbidity...Transsphenoidal resection of the pituitary gland is the surgical intervention of choice for patients presenting with neuro-ophthalmological findings. Rapid diagnosis, medical stabilization, and early surgical decompression will be lifesaving and will result in better neurological outcomes.
- |||||||||| methimazole / Generic mfg., hydrocortisone / Generic mfg., amiodarone / Generic mfg.
Thyrotoxic Periodic Paralysis: A Grave Disease (Walter E. Washington Convention Center, Area K, Hall C (Lower Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_8041;
CRRT was initiated due to low urine output and Patient was started on Methimazole due to elevated liver enzymes due to shock liver and Hydrocortisone...Slow potassium replacement is considered to be the mainstay of treatment with the danger of rebound hyperkalemia. Definitive treatment includes anti-thyroid medications, surgical thyroidectomy or radioiodine therapy until euthyroid state is achieved.
- |||||||||| remdesivir / Generic mfg., hydrocortisone / Generic mfg.
A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients (Walter E. Washington Convention Center, Area B, Hall C (Lower Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_8017;
Multiple therapeutic agents were used in their COVID-19 management, including corticosteroids, remdesivir, and monoclonal antibodies. All three patients whom have received concurrent therapy with Remdesivir, Hydrocortisone and Monoclonal Antibodies has survived, only one patient has died as a direct complication of COVID-19 ARDS with secondary pulmonary Mucormycosis; Our outcomes suggests the potential benefit of Remdesivir use in combination with Hydrocortisone and Monoclonal Antibodies in the management of severe COVID-19 ARDS in this group, as well as the importance of early administration of broad empirical antimicrobial coverage, including antifungal coverage, given the higher risk of secondary bacterial and fungal infections.
- |||||||||| Mycamine (micafungin) / Astellas
Acute Hypoxic Respiratory Failure and Septic Shock Secondary to Mycetoma (Walter E. Washington Convention Center, Area A, Hall C (Lower Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_7926;
Adrenal insufficiency: PO fludrocortisone 0.05mg, dexamethasone 4mg IV x1, IV Hydrocortisone 100mg q8h...Depite of all measures pt didn't resopded to the therapy. Due to poor prognosis family decided for DNR and comfort meassure only.
- |||||||||| metformin / Generic mfg.
An Ophtha-MALA-gic Anomaly: Metformin Associated Lactic Acidosis Causing Transient Blindness (Walter E. Washington Convention Center, Area I, Hall C (Lower Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_6600;
Home medications included metformin, lisinopril, hydrochlorothiazide, amlodipine, and as-needed ibuprofen and naproxen for pain...He then developed profound shock necessitating initiation of norepinephrine, vasopressin, and stress-dosed hydrocortisone...Return of vision after bicarbonate administration but before hemodialysis in our case would seemingly point towards acidemia playing a key role in precipitating the blindness. Our case highlights the importance of prompt recognition of this clinical syndrome in allowing for correction of acidemia, improvement in hemodynamics and resolution of visual symptoms.
- |||||||||| Jardiance (empagliflozin) / Eli Lilly, Boehringer Ingelheim
A Case of Hyponatremia Precipitated by Discontinuing of Empagliflozin (Walter E. Washington Convention Center, Area I, Hall C (Lower Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_6586;
Pertinent home medicines included hydrocortisone 25mg/day, levothyroxine 125mcg/day, and desmopressin 0.1mg thrice/day. Empagliflozin
- |||||||||| A Unique Case of Tuberculosis Induced Acute Respiratory Distress Syndrome (Walter E. Washington Convention Center, Area I, Hall C (Lower Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_5399;
He was admitted to the general medical floor and started on cefepime and vancomycin...Clindamycin was switched to Flagyl and Cefepime continued...Epinephrine and hydrocortisone were added, and he was started on RIPE therapy (Rifampin, Isoniazid, Pyrazinamide, and Ethambutol)...As clinicians, it is important to keep a broad differential diagnosis to correctly treat patients in a timely manner. In patients with symptoms suggesting tuberculosis or in patients with undetermined ARDS, empiric antimicrobial therapy should be initiated even before results confirm the diagnosis.
- |||||||||| hydrocortisone / Generic mfg., furosemide / Generic mfg.
Spontaneous Right Ventricular Rupture Following Drainage of Pericardial Effusion: An Unusual Case of Pericardial Decompression Syndrome (Walter E. Washington Convention Center, Room 209 A-C (Level 2)) - Mar 25, 2023 - Abstract #ATS2023ATS_3546;
He was transferred to the ICU on vasopressor support and hydrocortisone...He was weaned off norepinephrine, pleural effusions gradually reduced with daily furosemide, and chest tubes were removed once output was <100 mL/day.DiscussionPericardiocentesis and pericardial window are lifesaving therapeutic procedures for patients presenting with cardiac tamponade...Also, the acute withdrawal of sympathetic stimulus after removal of effusion likely provoked an autonomic imbalance which unmasked a pre-existing myocardial dysfunction similar to stress-induced cardiomyopathy. This uncommon case of PDS highlights the high morbidity associated with this complication and the importance of close clinical monitoring in patients after drainage of pericardial effusion.
- |||||||||| amiodarone / Generic mfg.
Amiodarone Induced Myxedema Coma Presenting With Cardiogenic Shock and Junctional Rhythm (Walter E. Washington Convention Center, Room 209 A-C (Level 2)) - Mar 25, 2023 - Abstract #ATS2023ATS_3545;
Norepinephrine and dobutamine were initiated...Ten days after starting intravenous levothyroxine and liothyronine in addition to hydrocortisone, TSH and fT4 improved to 7.18 uIU/mL and 0.9 ng/dL, respectively...Treatment was instituted without delay for laboratory confirmation of myxedema coma as this endocrine emergency has a high mortality rate (30-60%), even with treatment. Thyroid function testing prior to initiation of amiodarone and in cases of cardiogenic shock or cardiac dysrhythmias can help to avoid potentially fatal complication of hypothyroidism.
- |||||||||| Thyroid Storm Leading to Cardiogenic Shock: To ECMO or Not to ECMO (Walter E. Washington Convention Center, Room 209 A-C (Level 2)) - Mar 25, 2023 - Abstract #ATS2023ATS_3540;
Given concern for thyroid storm, she was quickly treated with methimazole, hydrocortisone, propranolol, and cholestyramine before admission to a medical-surgical intensive care unit (MSU)...She was treated with clevidipine and dobutamine drips...Although VA-ECMO is becoming increasingly utilized in cases of thyroid storm leading to cardiogenic shock, our case shows an example in which the use of VA-ECMO was deferred due rapid patient stabilization prior to thyroidectomy and improvement post-procedure. Given that VA-ECMO has significant risks and may not be necessary in all cases, more investigation to stratify patients regarding risk, benefits, and comorbidities is needed to achieve optimal outcomes.
- |||||||||| colchicine / Generic mfg.
A Case of Severe Colchicine Associated Vacuolar Myopathy and Respiratory Failure (Walter E. Washington Convention Center, Room 103 A-B (Street Level)) - Mar 25, 2023 - Abstract #ATS2023ATS_3526;
Upon admission, methylprednisolone was transitioned to stress-dose hydrocortisone, all other home medications were held.On hospital day 2, the patient developed hypercapnic respiratory failure requiring intubation and mechanical ventilation...It is possible that co-administration with immunosuppressive medications can precipitate colchicine toxicity, as prior reports have documented increased risk of colchicine induced side effects in patients with concomitant cyclosporine or corticosteroid use. Prescription of colchicine with immunomodulatory medications may require increased pharmacovigilance to prevent serious side effects.
- |||||||||| hydrocortisone / Generic mfg.
The Use of Steroids in Patients With Combined ARDS, Septic Shock, and Pneumonia Across US Hospitals (Walter E. Washington Convention Center, Room 201 (Level 2)) - Mar 25, 2023 - Abstract #ATS2023ATS_2976;
Further work is needed to understand the factors driving variation in practice patterns. While patient-level factors suggesting more severe septic shock were strongly associated with the use of hydrocortisone over methylprednisolone, the hospital of admission was also strongly associated with clinician
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