The initial evaluation should include an assessment accounting for the common manifestations. Other assays of disease activity have been the subject of intense investigation, including serum angiotensin-converting enzyme level, gallium-67 scan, bronchoalveolar lavage fluid characteristics (CD4/CD8 ratio, total lymphocyte count), and numerous other biomarkers; unfortunately, none has consistently predicted disease course in multiple populations. Recent data have demonstrated that the presence of certain human leukocyte antigen (HLA) haplotypes (., HLA-DR17 and HLA-DQB1) confer good prognosis in certain European populations. 33 However, the usefulness of HLA typing in other populations has not been confirmed. For now, chest x-ray stage, demographic features, clinical involvement, and serial pulmonary function testing remain the best indicators in assessing prognosis and therapeutic decisions.
The Story: In February 2005 Canseco released his autobiography and steroid tell-all, Juiced , Wild Times, Rampant 'Roids, Smash Hits, and How Baseball Got Big. In it he described himself as 'the chemist' having experimented on himself for years. He claimed to have educated and personally injected many players including Mark McGwire, Rafael Palmeiro, Juan Gonzalez, Ivan Rodriguez, and Jason Giambi. In his second book, Vindicated , Canseco added Magglio Ordonez to the list of players he had educated and injected with steroids. He also said he introduced Alex Rodriguez to a trainer/PED supplier after Rodriguez had asked where he could get steroids.
Oral corticosteroids have traditionally been prescribed to reduce facial nerve inflammation in patients with Bell's palsy. Prednisone is typically prescribed in a 10-day tapering course starting at 60 mg per day. A 2004 Cochrane review and meta-analysis of three randomized controlled trials comparing corticosteroids with placebo found small and statistically nonsignificant reductions in the percentage of patients with incomplete recovery after six months (relative risk [RR] = ; 95% confidence interval [CI], to ) and the percentage of patients with cosmetic complications (RR = ; 95% CI, to ). 14 However, these trials included only 117 patients; larger prospective trials are needed to establish the benefit of corticosteroids.