 |
153 Diseases |  |
74 Trials |
|
74 Trials |  |
10107 News |  |
| «12...4849505152535455565758...8586» |
- | hydroxychloroquine / Generic mfg., prednisolone / Generic mfg.
Review, Journal: Treat to Target in Systemic Lupus Erythematosus. (Pubmed Central) - May 1, 2020
Therefore, all current recommendations favor better disease control while limiting daily glucocorticoid doses to a maximum of 5 or 7.5 mg of prednisolone daily. Hydroxychloroquine and other prophylactic measures are added, and antiphospholipid syndrome is treated with anticoagulation and not with immunosuppression, which makes the approach of treat to target slightly more complex, mirroring the complexity of the disease.
- || Synacthen Depot (cosyntropin) / Novartis, Mallinckrodt, Alliance, prednisolone / Generic mfg.
Clinical, Journal: Adrenal Insufficiency in Children With Nephrotic Syndrome on Corticosteroid Treatment. (Pubmed Central) - May 1, 2020
A normal early morning cortisol level (275-555 nmol/L) does not exclude adrenal insufficiency in children with steroid-sensitive nephrotic syndrome. Further screening with LDSTs, particularly in children younger than 5 years at diagnosis, may be warranted.
- || prednisolone / Generic mfg.
Clinical, Journal: Coronary arteritis: a case series. (Pubmed Central) - May 1, 2020
Coronary artery bypass grafting was performed after stabilizing inflammation with prednisolone, and the patient remains angina-free beyond 1-year post-CABG...Accurate and early diagnosis with meticulous diagnostic and therapeutic strategies appear to be important for favourable clinical outcomes in the medical treatment of patients with coronary involvement of arteritis. Intravascular imaging has the potential to contribute to optimizing clinical management of CA.
- | prednisolone / Generic mfg., enalapril / Generic mfg.
Journal: Common presentation of micro hematuria and proteinuria in an uncommon disease: Answers. (Pubmed Central) - Apr 30, 2020
Intravascular imaging has the potential to contribute to optimizing clinical management of CA. No abstract available
- Zytiga (abiraterone acetate) / J&J
[VIRTUAL] The study of the treatment efficacy in metastatic castration-resistant prostate cancer of low dose abiraterone with food. () - Apr 29, 2020 - Abstract #ASCO2020ASCO_4469;
Moreover, low dose AA shows more efficacy especially in pre-Docetaxel mCRPC patients. Low dose AA may be helping in reducing cost of cancer care, enabling in delivering affordable cancer care and increasing value of treatment.
- Zytiga (abiraterone acetate) / J&J
[VIRTUAL] A prospective observational study of combinatorial abiraterone (AA) and radical radiotherapy (RT) in node-positive (N+) prostate cancer (PCa). () - Apr 29, 2020 - Abstract #ASCO2020ASCO_4453;
Long-term data will inform if this early efficacy signal leads to improved survival in these patients. Research Funding: None
- prednisolone / Generic mfg., temozolomide / Generic mfg.
[VIRTUAL] Association of leukocyte count (neutrophilia and lymphopenia) with poor prognosis in patients with high-grade gliomas in a Guatemalan cohort. () - Apr 29, 2020 - Abstract #ASCO2020ASCO_3320;
In high-grade gliomas treated with temozolomide and concomitant radiation followed by maintenance with temozolamide, neutrophilia and lymphopenia can be a significant prognostic factor for overall survival, with the advantage that it is not an expensive test and is accessible at all times of patient follow-up. Research Funding: None
- [VIRTUAL] Survival outcome in patients with metastatic castration-resistant prostate cancer according to first-line treatment. (Poster Board 151) - Apr 29, 2020 - Abstract #ASCO2020ASCO_1144;
First-line treatment with abiraterone acetate in mCRPC patients results in a better 36-month overall survival and discontinuation-free survival compared to docetaxel in real-life setting. Research Funding: JANSSEN
- prednisolone / Generic mfg., docetaxel / Generic mfg., capivasertib (AZD5363) / Otsuka, AstraZeneca
[VIRTUAL] ProCAID: A randomized double-blind phase II clinical trial of capivasertib (C) in combination with docetaxel and prednisolone chemotherapy (DP) in metastatic castration-resistant prostate cancer (mCRPC). (Poster Board 101) - Apr 29, 2020 - Abstract #ASCO2020ASCO_1093;
The OS secondary endpoint was significantly increased. PFS and OS results were consistent irrespective of PI3K/AKT/PTEN pathway activation status.
- || prednisolone / Generic mfg., doxycycline / Generic mfg.
Clinical, Journal, HEOR: Doxycycline Added to Prednisolone in Outpatient-Treated Acute Exacerbations of COPD: A Cost-Effectiveness Analysis Alongside a Randomised Controlled Trial. (Pubmed Central) - Apr 29, 2020
PFS and OS results were consistent irrespective of PI3K/AKT/PTEN pathway activation status. In patients with mild to severe COPD treated for exacerbations in an outpatient setting, doxycycline added to prednisolone is not cost-effective compared to prednisolone plus placebo over a 2-year period.
- | prednisolone / Generic mfg.
Journal: Therapeutic burden in interstitial lung disease: Lessons to learn. (Pubmed Central) - Apr 29, 2020
There is a high frequency of potential drug-disease interactions among patients who are prescribed systemic corticosteroids. These findings highlight the need for careful evaluation of the impact of therapeutic complexity and burden in patients with ILD.
- | prednisolone / Generic mfg.
Journal: Glucocorticoid receptors α and β are modulated sex specifically in human placentas of intrauterine growth restriction (IUGR). (Pubmed Central) - Apr 29, 2020
Our data support previous findings suggesting that the glucocorticoid metabolism plays a role in the pathophysiology of IUGR. Furthermore, the data suggest that the underlying molecular mechanisms differ between male and female cases.
- | Rituxan (rituximab) / Roche, Biogen, Zenyaku Kogyo
Journal: Balancing immunosuppression and infection: recurrent enterovirus encephalitis in SLE. (Pubmed Central) - Apr 29, 2020
This case highlights the difficulties in managing people with co-existing infective and autoimmune conditions, especially if each affects the CNS. A viral infection and SLE flare can resemble one another clinically, although here the radiological differentiation of CNS lupus versus enterovirus encephalitis helped to guide the diagnosis.
- || Clinical, Review, Journal: Refractory Takayasu arteritis successfully treated with rituximab: case-based review. (Pubmed Central) - Apr 29, 2020
He received a total of six courses of RTX, and doses of prednisolone and methotrexate were tapered without relapse. The current case provided further evidence to the potential role of RTX therapy in patients with refractory TAK, and its efficacy needs to be validated in a controlled trial.
- | Preclinical, Journal, Combination therapy: Elucidating the beneficial effects of melphalan, adriamycin, and corticoids in combination with bortezomib against multiple myeloma in vitro. (Pubmed Central) - Apr 27, 2020
Strikingly, the anti-proliferative potency of bortezomib was not enhanced but slightly lowered in some cell lines when used in combinations. Adriamycin, dexamethasone, melphalan, or prednisolone can enhance bortezomib's chymotrypsin-like subunit inhibitory potency, likely by mechanisms indirectly influencing proteasome functionality.
- Copegus (ribavirin) / Bausch Health
An Exclusively Oral Ribavirin Regimen for Respiratory Syncytial Virus Infection after Lung Transplantation is Effective and Cost-Efficient () - Apr 26, 2020 - Abstract #ISHLT2020ISHLT_480;
Conclusion An exclusively oral regimen of loading and maintenance dose ribavirin for treatment of RSV post LTx appears to be effective and well-tolerated. Furthermore, it carries a significant cost saving and completely avoids hospital admission in 69% of patient episodes.
- || Bredinin (mizoribine) / Asahi Kasei
Clinical, Journal: Effectiveness of cryofiltration and mizoribine combination with oral steroid therapy in a patient with membranoproliferative glomerulonephritis due to essential cryoglobulinemia. (Pubmed Central) - Apr 26, 2020
The PSL and MZR doses were gradually reduced to 2 mg/day and 100 mg/day, respectively, without any reemergence of the symptoms of cryoglobulinemia or relapse of the nephrotic syndrome for three years. Here, we report this case with essential mixed cryoglobulinemia in whom we could achieve complete remission of the disease by adding cryofiltration to the oral corticosteroid and immunosuppressant therapy with mizoribine and could maintain for a long time.
- || prednisolone / Generic mfg., methylprednisolone oral / Generic mfg.
Clinical, Journal: A relapsing case of pulmonary-renal syndrome after a sequential rise in MPO-ANCA and anti-GBM antibodies. (Pubmed Central) - Apr 26, 2020
Therefore, this was a rare relapsing case that presented with double-positive serology. Further, our observation that the reappearance of ANCA preceded that of anti-GBM-Ab suggests that ANCA contribute to the reproduction of anti-GBM Ab.
- || Sebifin (terbinafine HCL) / Generic mfg.
Clinical, Journal: Perianal Histoplasmosis Presenting as a Mass Suspicious for Malignancy: A Case Report with Review of Gastrointestinal Manifestations of Histoplasmosis. (Pubmed Central) - Apr 26, 2020
CONCLUSIONS This case represents an extremely rare presentation of histoplasmosis infection, and highlights the fact that presenting symptoms of histoplasmosis can be vague and may mimic other disease processes, including neoplasia. Biopsy of the lesion with PAS staining and serologic testing is critical in establishing the correct diagnosis.
- || prednisolone / Generic mfg.
Clinical, Journal: Thymoma complicated with myasthenia gravis and Good syndrome - a therapeutic conundrum: a case report. (Pubmed Central) - Apr 26, 2020
Biopsy of the lesion with PAS staining and serologic testing is critical in establishing the correct diagnosis. Regular intravenous immunoglobulins combined with low-dose immunosuppression in addition to thymectomy appear to be safe when myasthenia gravis occurs in association with Good syndrome.
- | prednisolone / Generic mfg.
Journal: Oral sarcoidosis aiding in diagnosis of underlying systemic disease. (Pubmed Central) - Apr 26, 2020
The present report deals with a case of sarcoidosis affecting the buccal mucosa in a 48-year-old woman. The patient was treated with oral prednisolone and within 4 months of corticosteroid therapy, the oral lesion regressed with no recurrence or new lesion noted over a period of 1 year.
- || Rituxan (rituximab) / Roche, Biogen, Zenyaku Kogyo
Clinical, Journal: Statin-induced anti-HMGCR antibody-related immune-mediated necrotising myositis achieving complete remission with rituximab. (Pubmed Central) - Apr 26, 2020
One patient had normalisation of anti-HMGCR antibody level, and one patient's antibody level reduced significantly. Rituximab is an effective immunosuppressive treatment for patients with refractory IMNM.
- prednisolone / Generic mfg., methotrexate / Generic mfg.
Pneumocystis jiroveci pneumonia in rheumatoid arthritis patient treated with methotrexate but without prednisolone: A case report (Board Number: P1002) - Apr 25, 2020 - Abstract #IMMUNOLOGY2020IMMUNOLOGY_1480;
High dose trimethoprim/sulfamethoxazole (TMP-SMX) and methylprednisolone pulse therapy were administered... In the RA patient, MTX should be considered an important risk factor of PCP.
- || prednisolone / Generic mfg.
Clinical, Journal: Feasibility of extracorporeal photopheresis in pediatric patients with graft-versus-host disease after hematopoietic stem cell transplantation. (Pubmed Central) - Apr 24, 2020
Prednisolone and/or calcineurin inhibitors (CNI) are first-line treatments, but no superior second-line treatment has yet been established...Six patients had cGVHD when ECP was initiated, and of these, four had a partial response at last ECP treatment. We found ECP to be a feasible and safe treatment, and particularly, children with aGVHD appeared to respond well to ECP.
- || prednisolone / Generic mfg., ipatasertib (GDC-0068) / Roche, Zytiga (abiraterone acetate) / J&J
Clinical, P1 data, Journal, Combination therapy: Phase I study of ipatasertib as a single agent and in combination with abiraterone plus prednisolone in Japanese patients with advanced solid tumors. (Pubmed Central) - Apr 24, 2020
We found ECP to be a feasible and safe treatment, and particularly, children with aGVHD appeared to respond well to ECP. Ipatasertib, at the monotherapy MTD of 600 mg/day and MAD of 400 mg/day in combination with abiraterone and prednisolone, was safe and tolerable in Japanese patients with solid tumors.
- | prednisolone / Generic mfg.
Journal: Lentil aspiration leading to likely hypersensitivity pneumonitis. (Pubmed Central) - Apr 24, 2020
Lentil aspiration is an important cause of HP in infants of weaning age with force-feeding practices. Further studies are needed to identify aspirated antigens which cause HP in aspiration prone children.
- || doxorubicin hydrochloride / Generic mfg., cyclophosphamide intravenous / Generic mfg.
Clinical, Journal: Clinical profile and outcome of classical Hodgkin lymphoma treated with a risk-adapted approach in a tertiary cancer center in India. (Pubmed Central) - Apr 23, 2020
Children with HL have favorable outcomes with manageable toxicities when treated on a risk-stratified and adapted approach. A high proportion of AHL have bulky disease necessitating IFRT, a concern that will have to be factored in future strategies.
- || doxorubicin hydrochloride / Generic mfg., cyclophosphamide intravenous / Generic mfg., Rituxan (rituximab) / Roche, Biogen, Zenyaku Kogyo
Clinical, Journal: A Case of Diffuse Large B-Cell Lymphoma of the Ascending Colon (Pubmed Central) - Apr 23, 2020
He received several chemotherapies and finallydied 8 months after surgery. We report our present case and literature review.
- || prednisolone / Generic mfg.
Clinical, Journal: Myasthenic crisis and late deep vein thrombosis following thymectomy in a patient with myasthenia gravis: A case report. (Pubmed Central) - Apr 23, 2020
Additionally, patients with MG may have an increased risk of DVT possibly attributable to immune-mediated inflammation. These findings highlight the importance of perioperative avoidance of provoking factors including monitoring of stress-induced elevations in serum lactate concentration, close postoperative surveying for myasthenic crisis, and early recognition of possible thromboembolic complications in this patient population.
- | bromfenac ophthalmic solution / Generic mfg.
Journal: Topical steroid alone vs a combination with a posterior segment NSAID after Nd-YAG capsulotomy: Is the posterior segment NSAID really necessary? (Pubmed Central) - Apr 23, 2020
Prophylactic antiglaucoma medications are not recommended in patients undergoing Nd: YAG laser capsulotomy. No evidence of cystoid macular edema was recorded till the end of 6 weeks follow-up.
- prednisolone / Generic mfg., hydrocortisone / Generic mfg.
The Outcomes Of Peri-procedural Corticosteroid Therapy For Preventing Early Recurrence Of Atrial Fibrillation After Cryoballoon Catheter Ablation (Poster Hall) - Apr 22, 2020 - Abstract #RHYTHM2020RHYTHM_3669;
Peri-procedural corticosteroid therapy immediately after CB ablation effectively prevented both immediate AF recurrence and ERAF. Further investigation including long-term outcomes is required to clarify the findings in the present study.
- || prednisolone / Generic mfg., methylprednisolone oral / Generic mfg., azathioprine orodispersible / Generic mfg.
Clinical, Journal: Autoimmune hepatitis in patients with multiple sclerosis: The role of immunomodulatory treatment. (Pubmed Central) - Apr 22, 2020
Autoantibody testing and liver histology play fundamental role in establishing a prompt diagnosis of AIH in these patients. Treatment of AIH in patients with MS seems safe and efficient as complete or partial response was recorded in all of our patients.
- || cyclophosphamide intravenous / Generic mfg.
Biomarker, Clinical, Journal: Clinical features and poor prognostic factors of anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis with rapid progressive interstitial lung disease. (Pubmed Central) - Apr 22, 2020
High serum ferritin level in patients with anti-MDA5 antibody may be associated with the development of RP-ILD and poor prognosis. Early treatment with triple therapy, including intravenous cyclophosphamide, may be important to improve the prognosis of RP-ILD.
- || prednisolone / Generic mfg.
Clinical, Journal: Corticotrophin-ACTH in Comparison to Prednisolone in West Syndrome - A Randomized Study: Correspondence. (Pubmed Central) - Apr 21, 2020
Early treatment with triple therapy, including intravenous cyclophosphamide, may be important to improve the prognosis of RP-ILD. No abstract available
- || prednisolone / Generic mfg.
Clinical, Journal: Coexisting schwannoma of the gallbladder and sarcoidosis: a case report. (Pubmed Central) - Apr 21, 2020
No abstract available Resection of a steroid-resistant tumor resulted in diagnosis of schwannoma, enabling reduction in the patient's steroid dosage for sarcoidosis.
- | prednisolone / Generic mfg.
Journal: An Improved Reversed-Phase High-Performance Liquid Chromatography Method for the Analysis of Related Substances of Prednisolone in Active Ingredient. (Pubmed Central) - Apr 21, 2020
A baseline separation was achieved, and stability indicating capability was demonstrated by a forced degradation study. A full validation procedure was performed in accordance with International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use guidelines.
- | prednisolone / Generic mfg., Ergamisol (levamisole) / J&J
Preclinical, Journal: Low dose bitter leaf improves sperm quality disrupted in immunosuppressed Wistar rats: An experimental study. (Pubmed Central) - Apr 21, 2020
These were significantly increased in the treated groups, and animals given levamisole and 250 mg/kg BL showed significantly increased sperm counts compared to the controls (p = 0.04 and p = 0.04, respectively). Low-dose BL (250 mg/kg) restored the sperm parameters altered by prednisolone administration.
- | prednisolone / Generic mfg.
Journal: Importance of Acute Lymphoblastic Leukemia-type Therapy for Bilineal Acute Leukemia. (Pubmed Central) - Apr 19, 2020
However, all 3 patients eventually achieved complete remission after ALL-type induction therapy. Thus, ALL-type induction therapy should be initiated for bilineal acute leukemia even with AML-dominant, poor prednisolone response, or poor early response features.
- || doxorubicin hydrochloride / Generic mfg., cyclophosphamide intravenous / Generic mfg.
Clinical, Journal: Pediatric Subcutaneous Panniculitis-like T-Cell Lymphoma With Hemophagocytosis Showing Complete Resolution With the BFM90 Protocol: Case Report and Review of Literature. (Pubmed Central) - Apr 19, 2020
The presence of SPTCL with HLH and systemic symptoms should prompt treatment with high-dose multiagent chemotherapy rather than Cyclophosphamide, Vincristine, Adriamycin, Prednisolone-like therapy. BFM90 is one such regimen that is well tolerated, and it can induce significant clinical and biochemical responses.
- | Retrospective data, Journal: Feline hyperaesthesia syndrome with self-trauma to the tail: retrospective study of seven cases and proposal for integrated multidisciplinary diagnostic approach. (Pubmed Central) - Apr 17, 2020
The diagnostic work-up did not reveal any significant abnormalities of the central or peripheral nervous system; dermatological and behavioural problems could not be ruled out. We propose an integrated multidisciplinary diagnostic pathway to be used for the management of clinical cases and for future prospective studies.
- || prednisolone / Generic mfg., methylprednisolone oral / Generic mfg.
Clinical, Journal: Risk factors of infection-associated mortality in children with lupus nephritis in under-resourced areas. (Pubmed Central) - Apr 17, 2020
Prevention of invasive fungal infections and minimization of daily prednisolone should be emphasized in routine clinical practice of children with lupus nephritis in under-resourced areas to achieve better survival. Children with lupus nephritis and a high neutrophil-to-lymphocyte ratio should be under cautious surveillance for infection.
- || prednisolone / Generic mfg., cyclophosphamide intravenous / Generic mfg.
Clinical, Journal: Prednisolone dose during treatment of tuberculosis might be a risk factor for mortality in patients with systemic lupus erythematosus: a hospital-based cohort study. (Pubmed Central) - Apr 17, 2020
For SLE patients, prednisolone dose during TB treatment is an independent risk factor for mortality. Keeping prednisolone dose at less than 25 mg per day during TB treatment might be a reasonable strategy in these patients.
- | Journal: Neuromyelitis optica spectrum disorder and systemic lupus erythematosus. (Pubmed Central) - Apr 17, 2020
At 1 year, she is on maintenance treatment with low dose prednisolone, azathioprine, and hydroxychloroquine, she has had no relapse and no other clinical features of lupus. This case is an illustration that neuromyelitis optica spectrum disorder can be the first manifestation of systemic lupus erythematosus.
- | doxorubicin hydrochloride / Generic mfg., cyclophosphamide intravenous / Generic mfg., Rituxan (rituximab) / Roche, Biogen, Zenyaku Kogyo
Journal, Heterogeneity, IO Biomarker: Heterogeneous Pattern of Dependence on Anti-Apoptotic BCL-2 Family Proteins upon CHOP Treatment in Diffuse Large B-Cell Lymphoma. (Pubmed Central) - Apr 17, 2020
Expression of the anti-apoptotic B-cell lymphoma 2 (BCL-2) protein in patients with diffuse large B-cell lymphoma (DLBCL) strongly correlates with resistance to standard therapy with cyclophosphamide, vincristine, doxorubicin, prednisolone, and rituximab (R-CHOP)...In conclusion, we show for the first time that CHOP treatment induces increased anti-apoptotic dependency on MCL-1 and BCL-XL, and not just BCL-2. These results provide new perspectives for the treatment of CHOP-resistant DLBCL and underline the potential of BH3 profiling in predicting therapy outcomes.
- | prednisolone / Generic mfg.
Preclinical, Journal: Effect of prednisolone on glyoxalase 1 in an inbred mouse model of aristolochic acid nephropathy using a proteomics method with fluorogenic derivatization-liquid chromatography-tandem mass spectrometry. (Pubmed Central) - Apr 17, 2020
The renal protective mechanism might be associated with down-regulation of GLO1 via reducing the contents of methylglyoxal derived from glycolysis. With the aid of proteomics analysis and the determination of methylglyoxal and its metabolite-D-lactate, we have demonstrated for the first time the biochemical efficacy of prednisolone, and urinary methylglyoxal and its metabolite-D-lactate might be potential biomarkers for AAN.
- || mycophenolate mofetil / Generic mfg., cyclophosphamide intravenous / Generic mfg.
Clinical, Journal: The safety and efficacy of mycophenolate mofetil in children and adolescents with steroid-dependent nephrotic syndrome: a single-centre study. (Pubmed Central) - Apr 17, 2020
Steroid-dependent nephrotic syndrome (SDNS) patients experience frequent relapse or adverse effects on long-term treatment with steroids or cyclophosphamide...Seventy-two (83%) patients were MMF-sensitive, and these patients had a reduction in mean prednisolone dose from 1.28 to 0.35 mg/kg (P < 0.05)...Continuous MMF therapy achieved remission in 83% of patients. MMF was well tolerated in the study population and discontinuation of MMF resulted in 100% relapse.
- || dexamethasone / Generic mfg., Decadron (dexamethasone) / Merck (MSD), DSP-Visulex (dexamethasone sodium phosphate ophthalmic) / Aciont
Clinical, P1/2 data, Journal: Novel Dexamethasone Sodium Phosphate Treatment (DSP-Visulex) for Non-Infectious Anterior Uveitis: A Randomized Phase I/II Clinical Trial. (Pubmed Central) - Apr 16, 2020
The efficacy of the DSP-Visulex applications was comparable to the daily PA drops in the treatment of non-infectious anterior uveitis. Both 8% and 15% DSP-Visulex treatments were safe and well tolerated.
- || prednisolone / Generic mfg.
Clinical, Journal: Predicting flares in patients with stable systemic lupus erythematosus. (Pubmed Central) - Apr 16, 2020
Flares are common in Asian SLE patients with initial stable disease. Close monitoring is needed for patients who are younger, with longer disease duration, thrombocytopenia, hypocomplementemia, or who required a higher baseline prednisolone dose.
- || prednisolone / Generic mfg.
Clinical, Journal: Role of Methyl Prednisolone in Longitudinal Extensive Transverse Myelitis (LETM) in Children. (Pubmed Central) - Apr 16, 2020
The correlation of response to treatment (recovery) with gender, area of spinal cord involvement, muscle power and autonomic dysfunction is found at significance level of five percent according to Chi square test. Early consideration and administration of methyl prednisolone in longitudinally extensive transverse myelitis in children can be beneficial and can help to reduce the morbidity.
- ||| Sonsuvi (brimapitide) / Xigen, Auris Medical
Clinical, P3 data, Journal: Efficacy and Safety of AM-111 in the Treatment of Acute Unilateral Sudden Deafness-A Double-blind, Randomized, Placebo-controlled Phase 3 Study. (Pubmed Central) - Apr 15, 2020
AM-111 provides effective otoprotection in case of profound ISSNHL. Activation of the JNK stress kinase, AM-111's pharmacologic target, seems to set in only following pronounced acute cochlear injury associated with large hearing threshold shifts.