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Because of the inflammatory mechanisms of most chronic upper airway diseases such as rhinitis and chronic rhinosinusitis, systemic steroids have been used for their treatment for decades. However, it has been very well documented that - potentially severe - side-effects can occur with the accumulation of systemic steroid courses over the years. A consensus document summarizing the benefits of systemic steroids for each upper airway disease type, as well as highlighting the potential harms of this treatment is currently lacking. Therefore, a panel of international experts in the field of Rhinology reviewed the available literature with the aim of providing recommendations for the use of systemic steroids in treating upper airway disease.

Background: The study was carried out to evaluate the effects of short-term transdermal hormone replacement therapy (HRT) on glycaemic control, lipid metabolism, C-reactive protein (CRP) and proteinuria in high-risk post-menopausal women. Methods: A total of 20 well-controlled type 2 diabetic, hypertensive and 21 well-controlled glucose-tolerant, hypertensive postmenopausal women were prospectively enrolled. After 12 weeks of transdermal HRT, the changes in serum lipid sub-fractions, fasting glucose, fructosamine, glycated haemoglobin (HbA1c), CRP, creatinine, 24 h urine protein levels, creatinine clearance and blood pressure were evaluated. Results: After 12 weeks of treatment, serum total-cholesterol and low-density cholesterols (LDL-cholesterol) appeared slightly reduced and serum triglyceride slightly elevated, although non-significantly so in both groups. The increase in HDL-cholesterol (P < 0.05) and reduction in very low density (VLDL)-cholesterol (P < 0.05) levels were significant in hypertensive patients. Elevation in the Apolipoprotein A1 (P < 0.05) and reduction in the Apolipoprotein B (P < 0.05) levels were statistically significant in all patients. HRT was associated with significant decreases in serum fasting glucose (P < 0.05) and fructosamine (P < 0.05) levels in diabetic patients. Serum HbA1c, CRP, creatinine, 24 h urine protein levels, creatinine clearance and systolic and diastolic blood pressure did not change significantly in either group. Conclusions: There were no detrimental effects of transdermal HRT on lipid profile, glucose metabolism, CRP and urine protein levels in our well-controlled diabetic or hypertensive patients. A decision regarding HRT use should be taken on a case-by-case basis., Results:All of the patients completed the study. The mean body mass index (BMI) was 31.27 and 30.95 kg/m2 in the DM-HRT and HT-HRT groups respectively. Estraderm TTS plus NETA was associated with statistically significant decreases in serum mean fasting glucose and fructosamine levels, and with a non-significant reduction in serum mean HbA1c level in the DM-HRT group. Significant changes were seen in mean serum VLDL (decreased) and HDL-cholesterol (increased) levels in the HT-HRT group. The increase in mean serum Apo-A1 level and the reduction in mean serum Apo-B level were statistically significant in both treatment groups. Serum CRP, creatinine, 24 h urine protein levels, creatinine clearance and systolic and diastolic blood pressure did not change significantly during 12 weeks of transdermal HRT in both groups. High-risk postmenopausal women did not have any adverse effect on proteinuria and serum creatinine levels after 3 months of Estraderm TTS plus NETA treatment., TypeofStudy:A prospective, open study evaluating the effects of short-term hormone replacement therapy (HRT) Estraderm TTS plus norethisterone acetate (NETA) (=Estracombi TTS) on glycemic control, lipid metabolism, C-reactive protein (CRP) and proteinuria in high-risk postmenopausal women with diabetes and/or hypertension., DosageDuration:17beta-estradiol 0.05 mg daily and sequential norethisterone acetate 0.25 mg daily transdermally. Duration was 12 weeks., AdverseEffects:2 subjects (10%) in the DM-HRT group and 1 subject (4.7%) in the HT-HRT group complained about abnormal vaginal bleeding such as metrorrhagia and 4 patients (19%) reported breast tenderness in the HT-HRT group. No patient experienced detrimental effects on lipid profile, glucose metabolism, CRP and urine protein levels., AuthorsConclusions:Additional research will be necessary to determine the effects of long-term transdermal HRT in high-risk postmenopausal women. We conclude that decisions about HRT should be taken on a case-by-case basis, and in doing so it is important to include the potential personal benefits and risk profile, especially in high-risk postmenopausal women., FreeText:In order to maintain their glucose levels in an acceptable range, women with type 2 diabetes were on dietary management alone (2 patients) or taking oral antidiabetic drugs that consisted of metformin and sulfonylureas (18 patients). Each diabetic patient received a diabetic diet with, Indications:20 patients with diabetes type 2 and hypertension and 21 patients with hypertension., Patients:41 postmenopausal women. Type 2 diabetes and hypertension group (DM-HRT group): n=20, mean age was 50.9 years. Hypertension group (HT-HRT group): n=21, mean age was 52.6 years.

Summary Since after the first streptomycin 1944 trials, anti-tuberculous chemotherapy research has been focused upon establishing drug combination regimens capable of overcoming drug resistance and amenable to ambulatory treatment in resource strapped countries. The first milestone being the 1959 Madras trial comparing home and sanatorium treatment in South India. Subsequently, the MRC trials led Fox and Mitchison to indicate rifampicin, isoniazid and pyrazinamide as the first line drugs for short course, 6 month, regimens and the 1982 Hong Kong Chest Service trials established intermittent therapy as the ambulatory treatment standard for directly observed therapy (DOT). The rising of the HIV epidemic at the beginning of the 1980s has refuelled tuberculosis spread in Africa and Asia and contributed to the expansion of drug-resistant tuberculosis worldwide making the development of new drugs and drug regimens for ambulatory treatment a top priority. Led by biotechnological advances, molecular biology has been brought into TB laboratory diagnosis for the highly sensitive and specific rapid identification of Mycobacterium tuberculosis in biological samples. The field of immunological diagnosis of TB infection, dominated since the early 1900s by the intradermal tuberculin reaction has been put back in motion by the discovery of M. tuberculosis -specific proteins and peptides, now employed in blood tests of high sensitivity and specificity for the diagnosis of latent TB which may help with the identification of contacts at higher risk of active disease and the eradication of pidemic cases.