Objectives: Dexamethasone is increasingly used for the management of children hospitalized with asthma in place of prednisone, yet data regarding the effectiveness of dexamethasone in children with asthma exacerbation severe enough to require hospitalization are limited. Our objective is to compare the effectiveness of dexamethasone versus prednisone in children hospitalized with an asthma exacerbation on 30-day reutilization.
Methods: We conducted a retrospective cohort study at an urban, quaternary children's hospital of children aged 4 to 17 years, hospitalized from January 1, 2014 to December 31, 2017, with a primary discharge diagnosis of asthma. A covariate-balanced propensity score was derived to account for physician discretion in steroid selection. A generalized linear model, including inverse probability treatment weighting, was used to detect differences in 30-day return utilization (unplanned readmission or emergency department visit) between children whose first dose of corticosteroid was dexamethasone versus prednisone.
Results: Inclusion criteria were met by 1161 patients, of which 510 (44%) first received dexamethasone versus 651 (56%) who first received prednisone. The total cohort had a mean age of 8.5 years (SD 3.4). The covariate-balanced cohort had no significant differences in demographic characteristics or illness severity between groups. The dexamethasone group had a return utilization of 3.9% (20 of 510) versus 2.2% (14 of 651) for children treated with prednisone. The propensity score-adjusted analysis revealed the steroid treatment was not found to significantly affect the 30-day reutilization (adjusted odds ratio [aOR] 1.61; 95%CI 0.80-3.31).
Conclusions: The initial steroid choice (dexamethasone versus prednisone) was not associated with 30-day reutilization after hospitalization for an asthma exacerbation.
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http://dx.doi.org/10.1542/hpeds.2021-006276 | DOI Listing |
J Arthroplasty
December 2024
Department of Orthopaedic Surgery, University of California at Davis, 4301 X St., Sacramento, CA 95817.
Background: The American Association of Hip and Knee Surgeons (AAHKS) strongly recommends the use of dexamethasone in patients undergoing total joint arthroplasty (TJA) due to its therapeutic effects. However, use in diabetic patients is controversial due to safety. Therefore, the objective of this study was to determine safety: (1) calculating the post-operative glucose levels; (2) finding the ideal dexamethasone dosing regimen; and (3) reporting complications of dexamethasone administration in diabetic patients undergoing TJA.
View Article and Find Full Text PDFDiagnostics (Basel)
November 2024
Department of Ophthalmology, Policlinico Riuniti Foggia, University of Foggia, 71122 Foggia, Italy.
Background And Aim: Despite the abundant literature, internal limiting membrane (ILM) peeling remains a controversial topic, especially in diabetic eyes. We compared the safety and effectiveness of intraoperative optical coherence tomography (iOCT)-assisted selective epiretinal membrane (ERM) peeling with dye-assisted ERM and ILM peeling, for the treatment of tractional diabetic macular edema (tDME).
Material And Methods: In this single-center retrospective study, we evaluated consecutive patients with tDME who underwent iOCT-assisted selective ERM peeling (Group A) or "dual blue" dye-assisted ERM and ILM peeling (Group B).
J Clin Oncol
December 2024
Heidelberg Myeloma Center, Department of Internal Medicine V, Heidelberg University Hospital and Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
Previously, addition of isatuximab (Isa) to standard-of-care lenalidomide-bortezomib-dexamethasone (RVd) in transplant-eligible patients with newly diagnosed multiple myeloma in the GMMG-HD7 trial (ClinicalTrials.gov identifier: NCT03617731) resulted in a significant increase of minimal residual disease negativity (MRD-) rates after induction therapy. A total of 662 patients were randomly assigned to receive induction therapy with Isa-RVd (n = 331) or RVd (n = 329), followed by single or tandem autologous stem-cell transplant and second random assignment to maintenance with lenalidomide alone or Isa-lenalidomide.
View Article and Find Full Text PDFEur J Haematol
December 2024
Quality of Life Research Center, Department of Haematology, Odense University Hospital, Odense, Denmark.
Background: In the CONPET study, multiple myeloma patients with abnormal 18FDG positron emission/computed tomography scan after upfront autologous stem cell transplantation were treated with four cycles of carfilzomib-lenalidomide-dexamethasone (KRd). Side effect registrations show that carfilzomib might cause dyspnea, cough, respiratory tract infections, and heart failure. The aims were to investigate patient-reported shortness of breath and dyspnea during KRd consolidation.
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