Medical treatment of coronavirus 19 disease (COVID-19) is a therapeutic challenge. The available data strongly suggest that calcifediol treatment may reduce the severity of COVID-19, and corticosteroids are the treatment of choice worldwide for severe COVID-19. Both have a very similar action profile, and their combined use in patients may modify the contribution of each administered compound.
OBJECTIVE: To evaluate how treatment with calcifediol and/or corticosteroids in medical practice modified the need for ICU admission, death, or poor prognosis of patients hospitalized with COVID-19 during the first outbreaks.
METHODS: A retrospective observational cohort study of patients admitted for COVID-19 to the Pneumology Unit of the Hospital Universitario Reina Sofía (Córdoba, Spain).
METHODS: Patients were treated with calcifediol or/and corticosteroids with the best available therapy and standard care, according to clinical practice guidelines.
METHODS: Admission to the intensive care unit (ICU) or death during hospitalization and poor prognosis.
RESULTS: Seven hundred and twenty-eight patients were included. According to the treatment received, they were included in four groups: calcifediol (n = 68), glucocorticoids (n = 112), both (n = 510), or neither (n = 38). Of the 578 patients treated with calcifediol, 88 were admitted to the ICU (15%), while of the 150 not treated with calcifediol, 39 required ICU admission (26%) (p < 0.01). Among the patients taking calcifediol without glucocorticoids, only 4 of 68 (5.8%) required ICU admission, compared to 84 of 510 (16.5%) treated with both (p = 0.022). Of the 595 patients who had a good prognosis, 568 (82.01%) had received treatment with calcifediol versus the 133 patients with a poor prognosis, of whom 90 (67.66%) had received calcifediol (p < 0.001). This difference was not found for corticosteroids.
CONCLUSIONS: The treatment of choice for hospitalized patients with moderate or mild COVID-19 could be calcifediol, not administering corticosteroids, until the natural history of the disease reaches a stage of hyperinflammation.

Corticoids have found their way into the globe of sports, due to their anti-inflammatory properties, and have often found to be added to dietary supplements for illegally improving the effectiveness of their products. Earlier studies describe the detection of corticoids in several matrices, but this can be an incessant and continuous process as long because the doping practices continue. In this study, we report a technique to verify concurrently 44 of the foremost commonly abused synthetic corticoids (including chiral analogs) in equine plasma supported chiral liquid chromatography-electrospray ionization mass spectrometry. Polysaccharide i-cellulose-5 column was used for chromatographic separation with a gradient mode. The validation studies were also meted out by using equine plasma so as to judge the suitability of the strategy. Detection limits were determined between 0.01 and 0.05 ng/mL and therefore the limit of quantification was between 0.1 and 0.5 ng/mL. Recovery and matrix effect on the analytes was further assessed. Since the developed method was ready to separate the corticoids and to differentiate chiral analogs at very low levels (in picograms), this separation techniques may be employed for the determination (confirmatory analysis) of the corticoids in the forensic and anti-doping application.

SARS‑CoV‑2 infection remains a hot topic; it is characterized by its multi-systemic involvement. Corticosteroid intake has been the subject of worldwide attention as a potentially effective treatment against coronavirus disease 2019 (COVID-19). Corticosteroids are registered on the WHO list of essential medicines, easily accessible for a low price, and particularly useful for different categories of people. The authors highlight the impact of corticosteroid administration for COVID-19 treatment on the occurrence of aseptic osteonecrosis in the femoral head. They also examine the pace of onset in comparison to corticosteroid usage unrelated to COVID-19. This article presents a patient with osteonecrosis of the femoral head after taking corticosteroid therapy in the treatment of COVID-19. The dose taken by the patient is 90 mg of dexamethasone equivalent to 600 mg of prednisone. The patient experienced the onset of OTA, and the duration of development was three months, indicating a relatively brief period. Comparison was made with data from the literature from 6 months to 1 year after taking corticosteroids in a context outside of COVID-19.

BACKGROUND: Autoimmunity has been associated with different types of cancer, including hematological malignancies like lymphomas, and solid tumors. Additionally, the potential role of medication-induced immunosuppression should be considered.
OBJECTIVE: Our study aimed to investigate the relationship between autoimmunity and the development of cancer, as well as the impact of immunosuppressive drugs on increasing cancer risk.
METHODS: The study sample was composed of patients who developed cancer after the administration of biological agents for the treatment of autoimmune disorders. Selected patients were treated in our hospital between 1st January 2011 and 31st December 2021 and followed up in internal medicine, gastroenterology, or dermatology consult. From 434 patients with autoimmune diseases using biological agents, only 20 developed cancer, which was our final study sample. The data analysis was performed using the IQVIR package version 2.0.2 (IQVIA, Durham, NC). A p-value of <0.05 was considered statistically significant.
RESULTS: We found a significant correlation between long-term corticosteroid therapy and an increased risk of cancer. However, the effect of biological therapies on cancer risk was not statistically significant. It\'s worth noting that our sample size was small, so we cannot extrapolate these findings.
CONCLUSIONS: Physicians need to be aware that treating autoimmune diseases with immunosuppressive therapies may contribute to the development of cancer. Further research is needed to determine the impact of such treatments on cancer prognosis.

Electronic cigarettes, a recent and burgeoning product, are gaining traction among the general population. However, despite their growing popularity, there is a lack of comprehensive research on their potential health risks. A prominent concern is EVALI (electronic cigarette or vaping product use-associated lung injury), a newly recognized condition currently under intense investigation. Here, we report the case of a 24-year-old male with a history of chronic smoking e-cigarettes and vaping products heavily over the past year. He sought urgent care at the emergency room due to symptoms that had been present for seven days before seeking medical attention. These symptoms included a sudden onset of difficulty breathing at rest, an intermittent dry cough producing a small amount of greenish sputum, and occasional episodes of mild hemoptysis. Chest radiograph showed bilateral diffuse infiltrates including almost innumerable tiny interstitial nodules. Multiple lobes of the lungs were affected by consolidations and patches of ground-glass opacities in the chest high-resolution computed tomography (HRCT) image. Throughout the following week, the patient\'s health showed gradual improvement with the aid of supportive measures and corticosteroid treatment. As part of the recovery plan, the patient was released with a gradually reducing regimen of oral corticosteroids and was scheduled for regular outpatient monitoring. The progression of the recovery was notable through enhancements in clinical symptoms, biological markers, and radiological findings.

OBJECTIVE: To assess the effectiveness and safety of the intravitreal fluocinolone-acetonide implant (FAc-i) in patients with chronic diabetic macular edema who did not sufficiently respond to other available therapies.
METHODS: This was a multicenter, prospective, non-randomized, and phase-IV observational study conducted on patients with recurrent-DME who were insufficient responders to currently available therapies (REACT-Study). The primary end-point was the mean change in best-corrected-visual-acuity from baseline to month-24 values.
RESULTS: Thirty-one eyes from 31 patients were included in the study. Mean age was 68.0 ± 7.7 years, and 10 (32.3%) were women. Study patients had received 5.3 ± 7.3 previous DME treatments before starting the study. In the overall study sample, BCVA improved from 56.1 ± 12.3 letters at baseline to 62.4 ± 17.0 letters at month-24 (p = 0.0510). The eyes with a baseline BCVA < 70 ETDRS letters had a significant improvement in BCVA from 53.2 ± 10.2 letters at baseline to 61.5 ± 17.9 letters at month-24 (p = 0.0165). In the overall study population, central-subfoveal-thickness (CST) was significantly reduced from 474.0 ± 135.1 µm at baseline to 333.4 ± 135.6 at month-24 (p < 0.0001). Similarly, macular-volume (MV) was significantly reduced from 10.7 ± 2.7 mm3 at baseline to 9.6 ± 2.9 mm3 (p = 0.0027) at month-24. Among the 31 study eyes, 19 (61.3%) required an additional treatment for DME. Throughout the study, 9 (29.0%) eyes required ocular hypotensive medication for controlling their intraocular-pressure and 5 (16.1%) eyes underwent cataract surgery.
CONCLUSIONS: In DME eyes who did not sufficiently respond to previous therapies, the FAc-i was associated with an improvement in visual and anatomic outcomes. There were no unexpected adverse-events.
BACKGROUND: EudraCT identifier: 2016-001680-37.

BACKGROUND: Dexamethasone-cyclophosphamide pulse (DCP) and dexamethasone pulse (DP) have been successfully used to treat pemphigus, but DCP/DP outcomes comparing pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are scarce.
OBJECTIVE: To compare DCP/DP outcomes in a Brazilian cohort of PV and PF patients according to demographic and clinical data.
METHODS: Retrospective analytical cohort study, reviewing medical charts of PV and PF patients (for DCP/DP Phases I‒IV consult Pasricha et al.16‒18).
RESULTS: 37 PV and 41 PF patients non responsive to usual treatments were included similarly for DCP or DP therapy. Disease duration was longer among PF before DCP/DP prescription (p < 0.001); PF required a higher number of monthly pulses to acquire remission in Phase I (median 10 and 6 pulses, respectively; p = 0.005). DCP/DP outcomes were similar in both groups: remission in 37.8% of PV and 34.1% of PF after completed DCP/DP cycles following a median of 13 months (1-56 months follow-up); failure occurred in 13.5% of PV and 14.6% of PF in Phase I; relapse in 13.5% of PV and 12.2% of PF, and dropout in 27% of PV and 24.4% of PF in Phases II to IV. Mild side effects were documented.
CONCLUSIONS: The severity of PV and PF disease was not assessed by score indexes.
CONCLUSIONS: PV and PF patients presented similar DCP/DP outcomes. DCP/DP should be initiated earlier in PF patients due to the longer duration of their disease in order to decrease the number of pulses and the duration of Phase I to acquire remission.

Pigeon racing is a sport in which trained homing pigeons (Columba livia domestica) are released between 60 and 1200 km from their loft and then have to return home as quickly as possible. The first race was held in 1818 in Belgium and since then, Belgium has led the world in pigeon breeding. Unfortunately, as in other sports, doping has become a major issue and doping controls have been implemented. This review provides information about pigeon racing, rules from the Royal Federation Colombophile of Belgium, and laws applicable in Belgium as doping control issues cannot be understood without including them as part of pigeon racing. The main pharmacological data concerning corticoids, non-steroidal anti-inflammatory drugs, anabolic steroids, pain relievers and narcotic analgesics, bronchodilators and β-agonists, drugs acting on the central nervous system and other performance-enhancing drugs, in addition to methods relevant to doping in pigeons are presented. Moreover, the chosen matrix and analytical methods are described.

Hypercalcemia is a common complication in cancer patients Mainly caused by Parathyroid hormone-related protein (PTHrP) secretion and metastasis. Calcitriol secretion is a rare source of hypercalcemia in solid tumors, especially in gastrointestinal stromal tumors (GIST). We present a case report of a female patient with a 23 cm gastric GIST that expressed somatostatin-receptors and presented with severe hypercalcemia due to calcitriol secretion. Calcium control was achieved with medical treatment before the use of targeted-directed therapies. Surgery was performed and allowed complete tumor resection. Two years later, patient remains free of disease. Molecular analysis revealed the mRNA expression of 25-hydroxyvitamin D3-1-hydroxylase (1αOHase) and vitamin-D receptors in the tumor cells, confirming the calcitriol-mediated mechanism. Furthermore, the expression of the endotoxin recognition factors CD14 and TLR4 suggests an inflammatory mediated mechanism. Finally, the expression of somatostatin-receptors, especially SST2 might have been related with clinical evolution and prognosis in this patient.

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