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Journal ArticleDOI

Corticosteroid treatment for sepsis: a critical appraisal and meta-analysis of the literature.

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TLDR
Current evidence provides no support for the use of corticosteroids in patients with sepsis or septic shock, and suggests that their use may be harmful, underscore the need for future methodologically rigorous trials evaluating new immune-modulating therapies in well-defined critically ill patients with overwhelming infection.
Abstract
ObjectiveTo determine the effect of corticosteroid therapy on morbidity and mortality in patients with sepsis.Data SourcesWe searched for published and unpublished research using MEDLINE, EMBASE, and the Science Citation Index, manual searching of Index Medicus, citation review of relevant primary a

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Citations
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Surviving sepsis campaign: international guidelines for the management of severe sepsis and septic shock: 2008

TL;DR: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, the GRADE system was used to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations.
Journal ArticleDOI

The pathophysiology and treatment of sepsis.

TL;DR: This review examines evolving concepts of sepsis and discusses new and potential therapies, including therapy with activated protein C, stringent control of blood glucose, and early goal-directed therapy to treat cellular oxygen deficit.
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Effect of Treatment With Low Doses of Hydrocortisone and Fludrocortisone on Mortality in Patients With Septic Shock

TL;DR: In this trial, a 7-day treatment with low doses of hydrocortisone and fludrocort isone significantly reduced the risk of death in patients with septic shock and relative adrenal insufficiency without increasing adverse events.
References
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Journal ArticleDOI

The L-Arginine-Nitric Oxide Pathway

TL;DR: The discovery that mammalian cells generate nitric oxide, a gas previously considered to be merely an atmospheric pollutant, is providing important information about many biologic processes.
Journal ArticleDOI

A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study.

TL;DR: In this paper, the authors evaluated the efficacy and safety of methylprednisolone and naloxone in a multicenter randomized, double-blind, placebo-controlled trial in patients with acute spinal-cord injury, 95 percent of whom were treated within 14 hours of injury.
Journal Article

The Second National Acute Spinal Cord Injury Study.

TL;DR: The study strongly suggests that methylprednisolone has significant beneficial effects in human spinal cord injury, that these effects occur only when the drug is given within 8 hr, and that it helps even in patients with severe spinal cord injuries.
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A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock.

TL;DR: It is concluded that the use of high-dose corticosteroids provides no benefit in the treatment of severe sepsis and septic shock.
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