There are two types of lupus. Systemic lupus erythematosus (SLE) is the form of lupus that can harm your skin, joints, kidneys and brain and may be fatal. The other form of lupus is called " discoid" lupus erythematosus, which affects only your skin. Systemic lupus erythematosus (SLE) that affects the kidneys is called lupus nephritis. Lupus is an "autoimmune" disease, meaning your immune system (your body’s defense system), which usually protects the body from disease, turns against the body. This causes harm to organs and tissues, like your kidneys. Lupus nephritis causes inflammation (swelling or scarring) of the small blood vessels that filter wastes in your kidney (glomeruli) and sometimes the kidneys, by attacking them like they would attack a disease.
Asthma is a chronic inflammatory disease, which is characterised by reversible airflow obstruction in response to a variety of stimuli. Exacerbations in response to airway irritants are part of the natural history of asthma, but often they also represent a failure in chronic treatment. Presentations to emergency departments and other acute care settings are common and frequently lead to hospitalisation and other complications. After treatment, however, most patients are discharged to the care of their primary care physician for further management. This review highlights the role of systemic and inhaled corticosteroids as mainstays of treatment in the acute and sub-acute phase of an exacerbation. These agents form the basis of most current clinical practice guidelines, yet their use is not universal. We will review the evidence for the use of these agents that arises from the Cochrane Collaboration of Systematic Reviews contained in the Cochrane Library.
We included 12 studies with altogether 671 participants. Two high quality randomized controlled trials with altogether 141 participants demonstrated clinical improvement of carpal tunnel syndrome at one month or less following local corticosteroid compared to placebo injection ( relative risk (95% confidence intervals to )). One trial compared local corticosteroid injection to oral corticosteroid and at 12 weeks after treatment there was significantly more improvement in the injection group ( mean difference - (95% confidence intervals - to -)). In one trial , the rate of improvement after one month was greater after local than systemic corticosteroid injection ( relative risk (95% confidence intervals to )). In one trial , symptoms did not improve significantly more in the injection group at eight weeks after injection compared to treatment with anti-inflammatory medication and splinting ( mean difference (95% confidence intervals - to )). Two injections versus one injection of local corticosteroid did not provide further clinical improvement, mean difference - (95% CI - to ).