Physiological effects of glucocorticoids include the inhibition of protein synthesis and the increase in catabolic processes in muscles. Consequently, a long-term intake of steroids in high doses causes myopathy. Myopathic effects of glucocorticoids are observed during systemic as well as inhallatory use. Most frequently, steroid myopathy manifests as the weakness and hypotrophy of lower limbs muscles, weakness of respiratory muscles, dysphonia. Prevention and treatment of steroid myopathy include limitation of indications for long-term usage of glucocorticoids, alternating regimens of treatment, adequate physical activity. The current data demonstrate the efficacy of vitamin D and amino acids mixtures in the prevention and treatment of steroid myopathy.
The National Heart, Lung, and Blood Institute (NHLBI) recommended dosing for systemic prednisone, prednisolone, or methylprednisolone in pediatric patients whose asthma is uncontrolled by inhaled corticosteroids and long-acting bronchodilators is 1–2 mg/kg/day in single or divided doses. It is further recommended that short course, or "burst" therapy, be continued until the patient achieves a peak expiratory flow rate of 80% of his or her personal best or until symptoms resolve. This usually requires 3 to 10 days of treatment, although it can take longer. There is no evidence that tapering the dose after improvement will prevent a relapse.
His specialty interests include adult and pediatric neuro-oncology, mitochondrial medicine, neurofibromatosis, neurometabolic diseases and pediatric neurology. He has served on a number of committees for the Children’s Oncology Group, the American Academy of Neurology (AAN), the Child Neurology Society. He currently serves as chairman of the Coding Subcommittee within the Medical Economics and Management Committee of the AAN, and Secretary-Treasurer of the CNS. His past leadership positions include Chairman of the Pediatric Section of the AAN, Chairman of the Practice Committee of the CNS and Counsellor from the Midwest of the CNS, and President of the Professors of Child Neurology.