The effect of a steroid "burst" and long-term, inhaled fluticasone propionate on adrenal reserve.

Background: Although widely used, the effects of steroid "bursts" on the hypothalamic-pituitary-adrenal axis, especially with long-term, concomitant topical steroids use, have not been studied.

Objective: To examine the effect of a prednisone burst, long-term intranasal steroids, and inhaled fluticasone propionate on the suppression and recovery of adrenal function.

Methods: Adult patients taking long-term intranasal steroids, either moderate-dose (440 microg/d) or high-dose (880 microg/d) inhaled fluticasone propionate, underwent a low-dose cosyntropin stimulation test (LDCST) before and 2 days after a prednisone burst.

Occupational reactions to foods.

The spectrum of occupational diseases most commonly seen in the food industry includes occupational asthma, rhinitis, conjunctivitis, dermatitis, and hypersensitivity pneumonitis. Occupational asthma represents between 3% and 20% of all asthma cases and is the most common form of occupational lung disease. Occupational skin diseases may represent between 10% and 15% of all occupational diseases, and they have significant economic impact.