Postnatal steroid treatment and brain development

Twenty-one RCTs enrolling a total of 1424 participants were eligible for this review . All were RCTs , but methods used for random allocation were not always clear. Allocation concealment, blinding of the intervention , and blinding of outcome assessments most often were satisfactory. Late steroid treatment was associated with a reduction in neonatal mortality (at 28 days) but no reduction in mortality at 36 weeks, at discharge, or at latest reported age. Benefits of delayed steroid treatment included reductions in failure to extubate by 3, 7, or 28 days; bronchopulmonary dysplasia both at 28 days of life and at 36 weeks' postmenstrual age; need for late rescue treatment with dexamethasone; discharge on home oxygen; and death or bronchopulmonary dysplasia both at 28 days of life and at 36 weeks' postmenstrual age. Data revealed a trend towards increased risk of infection and gastrointestinal bleeding but no increase in risk of necrotising enterocolitis. Short-term adverse affects included hyperglycaemia , glycosuria, and hypertension . Investigators reported an increase in severe retinopathy of prematurity but no significant increase in blindness. Trial results showed a trend towards reduction in severe intraventricular haemorrhage, but only five studies enrolling 247 infants reported this outcome . Trends towards an increase in cerebral palsy or abnormal neurological examination findings were partly offset by a trend in the opposite direction involving death before late follow-up. The combined rate of death or cerebral palsy was not significantly different between steroid and control groups. Major neurosensory disability and the combined rate of death or major neurosensory disability were not significantly different between steroid and control groups. There were no substantial differences between groups for other outcomes in later childhood, including respiratory health or function, blood pressure, or growth, although there were fewer participants with a clinically important reduction in forced expired volume in one second (FEV 1 ) on respiratory function testing in the dexamethasone group.

Journal of Neurology and Neuroscience , Insights in Clinical Neurology , Journal of Neuropsychiatry , Mental Health in Family Medicine , International Journal of Anesthesiology & Pain Medicine , Neuroscience & Clinical Research, Neuroinfectious Diseases, Basic and Clinical Neuroscience, Basic and Clinical Neuroscience, Behavioral Neuroscience, BMC Neuroscience, Clinical EEG and Neuroscience, Cognitive Neuroscience, Affective and Behavioral Neuroscience, Computational Intelligence and Neuroscience, Curre nt Neurology and Neuroscience Reports, Current Protocols in Neuroscience, Current Topics in Behavioral Neurosciences, Developmental Cognitive Neuroscience, Developmental Neuroscience, Dialogues in Clinical Neuroscience, Dialogues in Clinical Neuroscience

Cells of the zona fasciculata and zona reticularis lack aldosterone synthase (CYP11B2) that converts corticosterone to aldosterone, and thus these tissues produce only the weak mineralocorticoid corticosterone. However, both these zones do contain the CYP17A1 missing in zona glomerulosa and thus produce the major glucocorticoid, cortisol. Zona fasciculata and zona reticularis cells also contain CYP17A1, whose 17,20-lyase activity is responsible for producing the androgens, dehydroepiandosterone (DHEA) and androstenedione. Thus, fasciculata and reticularis cells can make corticosteroids and the adrenal androgens, but not aldosterone.

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Postnatal steroid treatment and brain development

postnatal steroid treatment and brain development

New World Encyclopedia writers and editors rewrote and completed the Wikipedia article in accordance with New World Encyclopedia standards . This article abides by terms of the Creative Commons CC-by-sa License (CC-by-sa), which may be used and disseminated with proper attribution. Credit is due under the terms of this license that can reference both the New World Encyclopedia contributors and the selfless volunteer contributors of the Wikimedia Foundation. To cite this article click here for a list of acceptable citing history of earlier contributions by wikipedians is accessible to researchers here:

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