MED-20. Solumedrol versus dexamethasone in the management of acute exarcerbations of COPD. The SOLVeD study.Methylprednisolone methylprednisolone /meth·yl·pred·nis·o·lone/ (-pred-nis´ah-lon) a synthetic glucocorticoid derived from progesterone, used in replacement therapy for adrenocortical insufficiency and as an antiinflammatory and immunosuppressant; also (MP) and prednisone are part of the standard of care in the management of acute exarcerbations of Chronic Obstructive Pulmonary Disease chronic obstructive pulmonary disease n. Abbr. COPD A chronic lung disease, such as asthma or emphysema, in which breathing becomes slowed or forced. (AECOPD). Recent shortage in MP necessitated the use of an equivalent dose of dexamethasone dexamethasone /dex·a·meth·a·sone/ (dek?sah-meth´ah-son) a synthetic glucocorticoid used primarily as an antiinflammatory in various conditions, including collagen diseases and allergic states; it is the basis of a screening test in the in acute COPD COPD chronic obstructive pulmonary disease. COPD abbr. chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) exacerbations. There is however inadequate clinical data supporting the use of the dexamethasone or comparing the efficacy of MP to dexamethasone in AECOPD. This is a retrospective study of eighty patients treated for acute COPD exarcerbations with MP on non-telemetry units in the first quarter of 2002 at St. Agnes hospital St. Agnes Hospital is a fictional mental institution created for MTV's Fear reality series. It was featured on Season 1, Episode 2. The real location was attempted to be kept under wraps since local ghost hunters would surely head to the site to do their own "investigations. , Baltimore, MD. This group was compared with eighty-two patients with similar diagnosis treated with dexamethasone in the first quarter of 2003, a period of MP shortage. The two groups were matched for age, gender, and mean duration of tobacco use, prior intubations and use of home oxygen. The primary end points analyzed included mortality, treatment failures (transfer to telemetry units, intubations/use of non-invasive mask ventilation or escalation/ dose intensification of steroids. The secondary end points analyzed were length of hospital stay, transfer to rehabilitation facilities, and proportions of patients requiring new home oxygen prescription and readmission readmission Managed care The admission of a Pt to a health care facility for a condition–eg, stroke, MI, GI bleeding, hip fracture, cancer surgery, shortly after discharge. See nth admission. Cf Admission, Discharge. rates. No statistically significant differences were noted in the primary end points (p>0.05). Statistically significant differences in favor of the dexamethasone group were noted for the 30 day readmission rates and number of patients started on home oxygen. This study demonstrates the comparative efficacy of dexamethasone to MP in the management of acute COPD exarcerbations. It however limited by its lack of information on objective clinical markers like spirometric improvement. Prospective clinical trails are required to validate these findings. Zakari Y. Aliyu, MD, MPH, Ayodele Erinle, MD, Mukar Aliyu, MD, MPH, Hamisu Salihu MD, MPH. Department of Internal Medicine, St. Agnes Hospital, Baltimore, MD, and the University of Alabama at Birmingham UAB began in 1936 as the Birmingham Extension Center of the University of Alabama. Because of the rapid growth of the Birmingham area, it was decided that an extension program for students who had difficulties which prevented them from studying in Tuscaloosa was needed. , AL. |
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