OBJECTIVE Patients with glucocorticoid deficiency need lifelong glucocorticoid replacement treatment. During acute stressful events, steroid dosage must be increased several times, which is often problematical in children. This study investigated the reliability of rectal hydrocortisone administration as an alternative to the intramuscular route. STUDY DESIGN Serum cortisol was assessed durin...

BACKGROUND AND PURPOSE Hyponatremia caused by excessive natriuresis is common in patients with aneurysmal subarachnoid hemorrhage (SAH). Natriuresis decreases the total blood volume through osmotic diuresis and increases the risk of symptomatic cerebral vasospasm. In such patients, hypervolemic therapy is difficult to achieve without causing hyponatremia because sodium replacement provokes furt...

Intra-articular hydrocortisone therapy has been in extensive use for approximately 5 years. It has been stated that this therapy is strictly for local palliation and has no systemic effects (Hollander, 1953). Local hydrocortisone therapy is especially recommended in cases in which the systemic use of cortisone is contra-indicated on general medical grounds (Kersley, 1953). On the other hand, Yo...

Hollander et al., (I95I) showed that injection of hydrocortisone into the inflamed knee joint of a patient suffering from rheumatoid arthritis was followed by striking relief of pain and stiffness, and a reduction of tenderness and swelling of the joint. There was no improvement in symptoms or signs in other affected joints. Measurements of intra-articular temperature showed a fall of 0.40 to 3...

The incidence of experimentally produced keratitis with Candida albicans was studied in traumatized rabbit eyes; these eyes, 23 out of 30 treated with 1 per cent hydrocortisone drops, 16 out of 30 treated with 1 per cent medrysone drops, and 12 out of 30 treated with control drops without corticosteroid, developed infection as demonstrated by culture of corneal tissue. The increased number of i...

Although cortisone acetate is approved worldwide as corticosteroid substitution therapy in congenital adrenal hyperplasia (21-hydroxylase deficiency), its effectiveness is uncertain since its biologic activity depends on activation by 11β-hydroxysteroid dehydrogenase (11β-HSD). We sought to compare the effect of cortisone acetate with that of hydrocortisone. In 10 patients with congenital adren...

In arthritic individuals who have only one or two peripheral joints causing difficulty, it would seem advisable to treat these joints locally by direct intraarticular injection of medication in an effort to decrease the incidence and severity of toxicity associated with systemic therapy. The first very effective anti-rheumatic preparation for intraarticular injection was hydrocortisone acetate ...

Adrenal crisis is a life-threatening emergency contributing to the excess mortality of patients with adrenal insufficiency. Studies in patients on chronic replacement therapy for adrenal insufficiency have revealed an incidence of 5-10 adrenal crises/100 patient years and suggested a mortality rate from adrenal crisis of 0.5/100 patient years. Patients with adrenal crisis typically present with...

BACKGROUND A key feature of sepsis is systemic inflammatory activation that could be counteracted by steroids. In this experimental model of systemic inflammation, we sought to investigate whether septic neutrophil activation, evaluated by the plasma levels of neutrophil gelatinase-associated protein (NGAL), is modulated by the timing of hydrocortisone treatment. METHODS Sixteen anesthetized ...

Cortisol is known to be an immunomodulatory hormone that exerts suppressive and permissive effects on the immune response. Little is known regarding the evolution of the cytokine response in human septic shock in the presence of hypercortisolemia induced by infusion of stress doses of hydrocortisone. Twenty-four consecutive patients with high-out-put circulatory failure (cardiac index, >4 liter...