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  • Title: [Possibilities for a reduction of long-term steroid treatment in asthmatic children during a stay in northsea climate (author's transl)].
    Author: Schütze G.
    Journal: Monatsschr Kinderheilkd (1902); 1976 Jul; 124(7):557-62. PubMed ID: 940564.
    Abstract:
    1. 40 children with Asthma bronchiale under long-term Cortisone therapy were admitted as in-patients of a clinic in the climate of the Northsea. 37 children needed Cortisone therapy because of serious attacks of Asthma bronchiale, and 3 children because of disturbing neurodermitis constitutionalis. -- 2. Corticoids were discontinued abruptly, immediately after admission. a) In 34 children the discontinuation had no adverse effect the following 6 to 8 weeks, or even longer, there was no need for Cortisone therapy. b) In 4 children during the first 2 weeks and in 2 further children during the 5th or 6th week, the asthmatic disorder deteriorated to such a degree that Cortisone therapy had to be re-introduced. -- 3. On the base of the reported observation, it is concluded that under the conditions of the Northsea climate it is of advantage for children with Asthma bronchiale and Neurodermitis to discontinue abruptly Cortisone therapy because a) this type of therapy which involves the potential risk of unwanted side effects can be shortened and b) the specific positive effect of climatic changes during the first couple of weeks is utilized to a greater extent. The gradual reduction of steroid therapy would diminish this particular stimulation. However, this kind of treatment requires close clinical observation to anticipate an acute "Addison-Crises". -- 4. All children with serious dispuce already during the first days of their stay in the clinic clearly need continuation of steroid therapy. -- Otherwise, even previous steroid therapy for more than one year is no contradiction for the recommended procedure as long as the clinical condition of the patient allows for it.
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