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In human medicine, glucocorticoids such as hydrocortisone, prednisone, prednisolone and dexamethasone, are used in the treatment of conditions where a reduced rate of inflammation is needed, such as for the treatment of asthma. Corticosteroids may also be used after organ transplantation, in cardiovascular surgery, and in the treatment of sepsis and ARDS in critically ill patients. Glucocorticoids modulate the immune system by suppressing the inflammatory and cell proliferative responses, and they increase the phagocytic activity of leukocytes. Glucocorticoid drugs can be administered via oral, intranasal, subcutaneous, or intramuscular routes, or directly as an inhaler or nasal spray. Topical glucocorticoids are available for use on the skin. The most frequently used glucocorticoids include triamcinolone acetonide, betamethasone, dexamethasone, prednisolone, and cortisone. Effective corticosteroid pharmacokinetics and biodistribution are possible using the inhalational route of administration. Because of their low systemic bioavailability, corticosteroids may be effectively delivered to specific target tissues by using combination therapies. Hydrocortisone is the glucocorticoid that is most widely used in the treatment of many conditions. It is also the most frequently used glucocorticoid in healthy dogs or cats. The glucocorticoid cortisol is the natural prednisone
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The most common causes of sneezing are allergens, cold, exercise, mental stress and sudden changes in temperature. Pneuology and otolaryngology societies classify sneezing as sudden or violent, brief and recurrent. Patients with airflow limitation and CRS with nasal polyps classify their sneezing as sudden, with more than 3 consecutive sneezing episodes per hour, with one sneeze lasting more than 10 seconds [ 61 ]. In a previous study, Roberts et al. [ 62 ] showed that nasal polyp size correlates with symptomatic improvement, following steroid-free NPT [ 63 ]. A more recent study from Morocco evaluated the clinical response to NPT. The authors found that the NPT yielded complete symptom relief in only 24% of the patients, which was associated with a significantly higher percentage of polyp recurrence at the end of 6months (47% vs. 18%, p