InterAmerican Journal of Medicine and Health

Adverse effects of long-term corticosteroid use

2023-05-31T06:06:39-03:00

Corticosteroids, drugs derived from the hormone cortisol, are widely used in clinical practice as part of the treatment for diseases of inflammatory, allergic, immunologic, and oncologic origin. Despite their therapeutic benefits, they should be used with caution, as these drugs are associated with a broad range of adverse effects, some of which are severe and others aesthetically undesirable. Osteoporosis, hyperglycemia, dyslipidemia, infections, cardiovascular diseases, Cushing's syndrome, immunosuppression, and psychiatric disorders are among the most serious adverse effects observed following systemic, prolonged, or high-dose corticosteroid therapy. This descriptive literature review highlights the main adverse effects associated with the use of these medications, presenting current recommendations for their clinical use as well as guidance on how to manage treatment discontinuation when necessary.

From Current Understanding to Future Perspectives in Sjögren’s Syndrome: An Integrated Literature Review and Analysis of Emerging Trends

2024-03-05T10:39:21-03:00

Sjögren's Syndrome is a chronic autoimmune disease that primarily affects the exocrine glands, leading to dryness of the eyes and mouth. The pathogenesis of the disease involves a complex interplay between immune dysregulation, inflammation, and glandular dysfunction. This article presents an overview of the pathophysiology of Sjögren's Syndrome, including the functional alterations and immune responses involved. Additionally, current therapeutic options, including replacement and retention therapy, stimulation of glandular production, and modulation of the immune response, are discussed. Future directions for research in developing more specific and effective therapies for Sjögren's Syndrome are also presented.

Advances in the understanding and treatment of multiple sclerosis: genetic and therapeutic perspectives

2024-07-28T11:38:06-03:00

Multiple sclerosis (MS) is a chronic autoimmune disease characterized by demyelination of axons of the central nervous system, neurodegeneration and neuroinflammation. Although there is no clear etiology, it is a multifactorial disease with a variety of clinical manifestations that can appear at any age, mainly from 20 to 40 years old and with a higher prevalence in women. Depending on the location and extent of the neural injury, MS can present varied physical symptoms, in addition to its psychological and social impact, and is classified into three main subtypes according to the characteristics of relapses, progression and evolution. Considering this diversity, the diagnosis is complex and involves factors such as clinical history, imaging exams and laboratory tests, following the McDonald criteria. Current therapies include drug and non-drug approaches, including drugs, monoclonal antibodies, application of virtual reality, among others that even present positive future perspectives. This integrative review aims to discuss the immunopathogenesis, classification, diagnosis, genetic factors and therapy of MS.

Methylphenidate May be Related to Muscle Pain, Cramps and Stiffness: Two Case Reports

2023-12-12T17:04:24-03:00

This report raises attention to a possible underrecognized and underreported muscular symptoms, such as pain, stiffness and cramps associated with the use of psychostimulants and that were observed in two adult patients, one male and one female, with improvement of the complaints after withdrawal of the medication.

PNEUMONIA E VENTILAÇÃO MECÂNICA NA COVID-19: REVISÃO

2024-10-13T11:11:20-03:00

The COVID-19 pandemic caused a significant global transformation. In light of this scenario, various studies have been conducted to understand the biology of the virus, its symptoms, prevention, and treatment of the disease. In severe cases, mechanical ventilation is crucial for survival, but paradoxically, it may increase the risk of ventilator-associated pneumonia (VAP). Given the growing interest in identifying clinical approaches related to secondary symptoms of the disease, this study aimed to conduct a systematic review on the occurrence of VAP in patients infected with SARS-CoV-2. The databases SCIELO, PUBMED, UpToDate, and ScienceDirect were systematically searched up to early 2023 to identify relevant articles. The central inquiry of this study focused on analyzing works that address VAP in COVID-19 patients, including the identification of the main causative agents. A total of 44 publications were retrieved, and after applying selection criteria and excluding review articles, 23 studies were included. The meta-analysis revealed that the most prevalent bacteria in cases of VAP were: P. aeruginosa (23.83% ± 0.12), Klebsiella sp. (21.78% ± 0.10), and S. aureus (22.03% ± 0.11), while the fungi identified were: Aspergillus fumigatus (10.60% ± 0.07) and Candida spp. (24% ± 0.19). Based on our systematic review of the literature, there is evidence that the main pathogens causing VAP during the COVID-19 pandemic are opportunistic, taking advantage of the cellular changes induced by SARS-CoV-2 infection and the resulting immune fragility to acquire pathogenicity.