| Title |
Recovery of hypothalamo–pituitary–adrenal axis suppression during treatment with inhaled corticosteroids for childhood asthma
|
|---|---|
| Published in |
Journal of Asthma and Allergy, December 2017
|
| DOI | 10.2147/jaa.s142874 |
| Pubmed ID | |
| Authors |
Arundoss Gangadharan, Paul McCoy, Aye Phyo, Michael P McGuigan, Poonam Dharmaraj, Renuka Ramakrishnan, Paul S McNamara, Joanne Blair |
| Abstract |
To describe recovery of adrenal insufficiency in asthmatic children treated with inhaled corticosteroids (ICS) and cortisol replacement therapy. Retrospective, observational study. A total of 113 patients, 74 male; age 10.4 (3.3-16.5) years; beclomethasone-equivalent ICS dose, 800 μg, (100-1,000), tested by low dose short Synacthen (tetracosactide) test (LDSST), were studied. Test results were classified by basal and peak cortisol concentration: "normal" (basal >100 nmol/L, peak >500 nmol/L), "suboptimal" (basal >100 nmol/L, peak 350-499 nmol/L), "abnormal" (basal <100 nmol/L and/or peak <350 nmol/L). Patients with suboptimal results received hydrocortisone during periods of stress only, and those with abnormal responses received daily hydrocortisone, increased during periods of stress. A total of 73 patients (68%) had ≥2 LDSSTs over 2.2 years (0.2-7.7). Change in cortisol response to repeat LDSST (movement between diagnostic groups, difference in basal and peak cortisol >15% [2× the inter-assay coefficient of variation]), change in BMI and height standard deviation score (SDS). Baseline test results were abnormal in 17 patients (15%) and all of them had repeat tests. In 13 patients (76%), test results improved (normal in six, suboptimal in seven) and four (24%) remained abnormal. Baseline tests results were suboptimal in 54 patients (48%), of whom 50 (93%) were retested. Repeat tests were normal in 36 patients (72%), remained suboptimal in 11 (22%), and were abnormal in three (6%). Baseline tests results were normal in 42 patients, of whom six patients (14%) were retested. Results remained normal in three (50%), were suboptimal in two (33%), and abnormal in one (17%). Basal and peak cortisol levels increased by >15% in 33/73 (45%) and 42/73 (57%) patients, respectively, and decreased by >15% in 14/73 (19%) and 7/73 (10%), respectively. There was no significant change in height or BMI SDS. Recovery of adrenal function is common and occurs during continued ICS and cortisol replacement therapy. |
Mendeley readers
The data shown below were compiled from readership statistics for 24 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 24 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 4 | 17% |
| Student > Master | 4 | 17% |
| Student > Ph. D. Student | 4 | 17% |
| Student > Postgraduate | 2 | 8% |
| Other | 2 | 8% |
| Other | 4 | 17% |
| Unknown | 4 | 17% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 50% |
| Psychology | 3 | 13% |
| Arts and Humanities | 1 | 4% |
| Business, Management and Accounting | 1 | 4% |
| Nursing and Health Professions | 1 | 4% |
| Other | 2 | 8% |
| Unknown | 4 | 17% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 January 2018.
All research outputs
#14,372,208
of 23,015,156 outputs
Outputs from Journal of Asthma and Allergy
#275
of 463 outputs
Outputs of similar age
#236,506
of 437,955 outputs
Outputs of similar age from Journal of Asthma and Allergy
#4
of 6 outputs
Altmetric has tracked 23,015,156 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 463 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.2. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 437,955 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 43rd percentile – i.e., 43% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 6 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.