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Sample records for betamethasone

  1. Betamethasone: A dermatological clinical evaluation.

    Science.gov (United States)

    DANTO, J L; STEWART, W D; MADDIN, W S; NELSON, A J

    1963-03-30

    The purpose of this study was to determine under carefully controlled clinical conditions the relative anti-inflammatory and anti-pruritic action of betamethasone as compared with prednisone and a placebo. A total of 130 consecutive patients with atopic dermatitis, primary irritant dermatitis, nummular eczema, allergic eczematous contact dermatitis, sweat retention, seborrheic dermatitis and pruritus were selected for study. Under the conditions of this clinical trial, the samples indicated a difference in anti-inflammatory and anti-pruritic response to the therapeutic agents used. The difference between betamethasone and the placebo was highly significant, and the difference in these measured responses was studied on the basis of a careful evaluation and statistically. The result of this study corroborates statistically our clinical impression regarding the therapeutic effect of betamethasone.

  2. Comparison of topical tretinoin and betamethasone in oral lichen planus

    Directory of Open Access Journals (Sweden)

    Kar H

    1996-01-01

    Full Text Available Thirty-one patients of oral lichen planus were enrolled in this study and two groups were made. Group 1 consisting of 16 patients who applied topical tretinoin 0.05% and Group 2 comprising of 15 patients who were given topical betamethasone dipropionate 0.05%. The patients applying tretinoin showed statistically significant improvement as compared to patients applying betamethasone.

  3. [Betamethasone and aqueous extract of Arctium lappa for treating angiostrongyliasis].

    Science.gov (United States)

    Fante, Camila Argenta; Dieterish, Solange; Rodriguez, Rubens

    2008-01-01

    Angiostrongylus costaricensis is a parasite that causes abdominal angiostrongyliasis in humans. The treatment for it includes the use of anti-inflammatory drugs, despite the lack of studies to justify this approach. The objective of this paper was to evaluate the effect of betamethasone and Arctium lappa on the evolution of intestinal lesions induced by this parasite. Adult male Swiss mice were used, distributed into four groups: infected and treated with betamethasone; infected and treated with Arctium lappa; infected and not treated; and control group. The treatments were started on the 15th day after infection and continued for 15 days. The presence of eosinophilic infiltration and granuloma was evaluated (1-mild; 2-moderate; 3-severe). Betamethasone allowed the lesions to evolve into more severe forms, while the extract did not interfere with disease progression. The substances applied were ineffective for protection against the lesions induced by Angiostrongylus costaricensis in mice. These findings discourage the use of betamethasone and Arctium lappa for humans affected by abdominal angiostrongyliasis.

  4. TLC--densitometric method for qualitative analysis of betamethasone and its related compounds in pharmacautical preparations.

    Science.gov (United States)

    Dolowy, Małgorzata; Pyka, Alina

    2014-01-01

    A new simple and rapid TLC-densitometric procedure for the separation and identification of betamethasone and its related substances, betamethasone-17,21-dipropionate, betamethasone-17-valerate, betamethasone-21-valerate and also betamethasone disodium phosphate was developed. One of the chromatographic systems proposed in this study, which has been satisfactory applied in separation of four pairs of examined compounds was silica gel 60F254 (E. Merck, Art. 1.05554) and a mixture containing chloroform-methanol-acetic acid (99.5%) in volume composition 28:5:0.5. Densitometric measurements were done using densitometer TLC Scanner 3 at 246 nm. The proposed method was checked in terms of its specificity for the determination of betamethasone-17,21-dipropionate and betamethasone disodium phosphate in commercially available products containing both compounds, separately, as active ingredients. The results showed that the method is suitable for qualitative analysis of betamethasone derivatives in simple and combined pharmaceuticals in various dosage forms e.g., lotion and injection solution. It also can be applied in quality control of pharmaceutical formulations of betamethasone and its related compounds in form of salts and esters.

  5. Interconversion kinetic studies of betamethasone acetate polymorphs in water.

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    Ke, Xue; Ping, QiNeng; Liao, ZhengGen

    2006-10-01

    This study assessed the effect of polymers on the transformation of polymorphs of betamethasone acetate (BA) when suspended in water. The results showed that the polymers, in particular HPMC E5, retarded the transition of the forms Ialpha and Ibeta. However, the form Ialpha, as the metastable form, with the aid of HPMC E5, was preferred for BA suspension preparation through kinetic studies, while the form Ibeta was not suitable due to its instability in water.

  6. Combination treatment with methotrexate, cyclosporine, and intraarticular betamethasone compared with methotrexate and intraarticular betamethasone in early active rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Stengaard-Pedersen, Kristian; Junker, Peter;

    2006-01-01

    OBJECTIVE: To investigate whether disease control can be achieved in early active rheumatoid arthritis (RA) by treatment with methotrexate and intraarticular betamethasone, and whether the addition of cyclosporine to the regimen has any additional effect. METHODS: Patients (n = 160) were randomized...... to receive methotrexate 7.5 mg/week plus cyclosporine 2.5 mg/kg of body weight/day (combination therapy) or methotrexate plus placebo-cyclosporine (monotherapy). At weeks 0, 2, 4, 6, and 8 and every 4 weeks thereafter, betamethasone was injected into swollen joints (maximum 4 joints or 4 ml per visit......). Beginning at week 8, if synovitis was present, the methotrexate dosage was increased stepwise up to 20 mg/week, with a subsequent stepwise increase in the cyclosporine or placebo-cyclosporine dosage up to 4 mg/kg. RESULTS: At 52 weeks, 20% improvement according to the American College of Rheumatology...

  7. Combination treatment with metrotrexate, cyclosporine, and intraarticular betamethasone compared with methotrexate and intraarticular betamethasone in early active rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete; Stengaard-Pedersen, Kristian; Junker, Peter;

    2006-01-01

    OBJECTIVE: To investigate whether disease control can be achieved in early active rheumatoid arthritis (RA) by treatment with methotrexate and intraarticular betamethasone, and whether the addition of cyclosporine to the regimen has any additional effect. METHODS: Patients (n = 160) were randomized...... to receive methotrexate 7.5 mg/week plus cyclosporine 2.5 mg/kg of body weight/day (combination therapy) or methotrexate plus placebo-cyclosporine (monotherapy). At weeks 0, 2, 4, 6, and 8 and every 4 weeks thereafter, betamethasone was injected into swollen joints (maximum 4 joints or 4 ml per visit......). Beginning at week 8, if synovitis was present, the methotrexate dosage was increased stepwise up to 20 mg/week, with a subsequent stepwise increase in the cyclosporine or placebo-cyclosporine dosage up to 4 mg/kg. RESULTS: At 52 weeks, 20% improvement according to the American College of Rheumatology...

  8. 21 CFR 524.1044b - Gentamicin sulfate, betamethasone valerate otic solution.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Gentamicin sulfate, betamethasone valerate otic solution. 524.1044b Section 524.1044b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1044b Gentamicin sulfate, betamethasone valerate otic solution....

  9. Alterations in male rats following in utero exposure to betamethasone suggests changes in reproductive programming.

    Science.gov (United States)

    Borges, Cibele S; Dias, Ana Flávia M G; Rosa, Josiane Lima; Silva, Patricia V; Silva, Raquel F; Barros, Aline L; Sanabria, Marciana; Guerra, Marina T; Gregory, Mary; Cyr, Daniel G; De G Kempinas, Wilma

    2016-08-01

    Antenatal betamethasone is used for accelerating fetal lung maturation for women at risk of preterm birth. Altered sperm parameters were reported in adult rats after intrauterine exposure to betamethasone. In this study, male rat offspring were assessed for reproductive development after dam exposure to betamethasone (0.1mg/kg) or vehicle on Days 12, 13, 18 and 19 of pregnancy. The treatment resulted in reduction in the offspring body weight, delay in preputial separation, decreased seminal vesicle weight, testosterone levels and fertility, and increased testicular weight. In the testis, morphologically abnormal seminiferous tubules were observed, characterized by an irregular cell distribution with Sertoli cell that were displaced towards the tubular lumen. These cells expressed both Connexin 43 (Cx43) and Proliferative Nuclear Cell Antigen (PCNA). In conclusion, intrauterine betamethasone treatment appears to promote reproductive programming and impairment of rat sexual development and fertility due to, at least in part, unusual testicular disorders.

  10. Antenatal exposure to betamethasone: psychological functioning and health related quality of life 31 years after inclusion in randomised controlled trial

    OpenAIRE

    Dalziel, Stuart R; Lim, Vanessa K; Lambert, Anthony; McCarthy, Dianne; Parag, Varsha; Rodgers, Anthony; Harding, Jane E.

    2005-01-01

    Objectives To determine if antenatal exposure to betamethasone for the prevention of neonatal respiratory distress syndrome alters psychological functioning and health related quality of life in adulthood.

  11. New approach in the treatment of refractory vitiligo: CO2 laser combined with betamethasone and salicylic acid solution.

    Science.gov (United States)

    Cunha, Paulo Rowilson; Scabine Pessotti, Nabila; Bonati Mattos, Camila; Salai, Ana Flavia

    2017-01-01

    The aim of this study is to evaluate the use of fractional carbon dioxide laser (CO2 ) with betamethasone and salicylic acid solution in the treatment of patients with refractory vitiligo in hands. Each hand of the patient was randomly assigned to one of two groups: lesion treated with fractional carbon dioxide laser associated with betamethasone and salicylic acid solution administration or lesion treated only with betamethasone and salicylic acid solution. We conclude that combined treatment with fractional carbon dioxide laser and betamethasone associated with salicylic acid solution could effectively and safely be used in the treatment of refractory vitiligo.

  12. Microstructure of Temporomandibular Joint Cartilage after Intra-Articular Betamethasone Sodium Phosphate/Betamethasone Dipropionate Injection during the Early Stage of Experimental Osteoarthrosis

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    Irina N. Kostina

    2014-06-01

    Full Text Available Objective: to study the morphological changes in cartilage after a single intra-articular betamethasone sodium phosphate (BSP/betamethasone dipropionate (BDP injection during the early stage of experimental osteoarthrosis (OA of the temporomandibular joint (TMJ. Material and Methods: The experiment was performed on 18 male rabbits aged 6 months .The first group consisted of 9 healthy rabbits. The second group included 9 rabbits with mechanically induced TMJ OA. For 5 days, 3 hours daily, a load (with a force of 200N on the TMJ was imposed. In the left TMJ of the second group of rabbits, betamethasone was injected intra-articularly in different doses: 0.1 ml (n=3, 0.3 ml (n=3, and 0.5 ml (n=3. The right TMJ was used for comparison. A combined anesthesia was applied each experimental day. Rabbits of both groups were sacrificed on days 7, 14, and 30 with introductory combined anesthesia and intravenous injection of Zoletil 100® 20 mg/kg to stop their breathing. Results: Betamethasone caused destruction of the chondrocytes, fragmentation of collagen fibers, deficit of proteoglycans (PGs and glycosaminoglycans (GAGs, thinning of the cartilage, and contributed to the progression of TMJ OA. Conclusion: The optimal dose of BSP/BDP for intra-articular injection in the early stages of TMJ OA must be within the range of 0.1-0.3 ml|0.7-1.5 mg.

  13. A Comparative Study of Oral Cyclosporine and Betamethasone Minipulse Therapy in the Treatment of Alopecia Areata

    Science.gov (United States)

    Jang, Yong Hyun; Kim, Sang Lim; Lee, Kyou Chae; Kim, Min Ji; Park, Kyung Hea; Lee, Weon Ju; Lee, Seok-Jong

    2016-01-01

    Background Various systemic agents have been assessed for the treatment of alopecia areata (AA); however, there is a paucity of comparative studies. Objective To assess and compare cyclosporine and betamethasone minipulse therapy as treatments for AA with regard to effectiveness and safety. Methods Data were collected from 88 patients who received at least 3 months of oral cyclosporine (n=51) or betamethasone minipulse therapy (n=37) for AA. Patients with ≥50% of terminal hair regrowth in the alopecic area were considered responders. Results The responder of the cyclosporine group was 54.9% and that of the betamethasone minipulse group was 37.8%. In the cyclosporine group, patients with mild AA were found to respond better to the treatment. Based on the patient self-assessments, 70.6% of patients in the cyclosporine group and 43.2% of patients in the betamethasone minipulse group rated their hair regrowth as excellent or good. Side effects were less frequent in the cyclosporine group. Conclusion Oral cyclosporine appeared to be superior to betamethasone minipulse therapy in terms of treatment effectiveness and safety. PMID:27746635

  14. Betamethasone-in-cyclodextrin-in-liposome: the effect of cyclodextrins on encapsulation efficiency and release kinetics.

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    Piel, Géraldine; Piette, Marie; Barillaro, Valery; Castagne, Delphine; Evrard, Brigitte; Delattre, Luc

    2006-04-07

    Lipophilic drugs have limited solubility in phospholipid systems, hence maximum entrapment levels in liposomes are known to be low. "Drugs-in-cyclodextrin-in-liposome" systems were previously proposed to overcome this drawback but studies were limited to betaCD and HPbetaCD. In some cases, other cyclodextrins may be more interesting than betaCD or HPbetaCD, such as methylated cyclodextrins. However, these cyclodextrins are known to extract lipid components from the lipid membrane, which may destabilize liposomes. We tested the influence of several cyclodextrins (betaCD, gammaCD, Dimeb, Trimeb, Crysmeb, Rameb, HPbetaCD and HPgammaCD) on the aqueous solubility of betamethasone by phase solubility diagrams and on the encapsulation efficiency in liposomes. The release kinetics of betamethasone was studied using Franz diffusion cells. We showed that release kinetics are directly correlated with encapsulation efficiency, which is closely related to betamethasone concentration in cyclodextrin complex solution. No liposome destruction was observed, even with the testing of methylated cyclodextrins at the highest concentration (40 mM). This can be explained by the fact that these cyclodextrins have a higher affinity for betamethasone than for cholesterol. This was proved by the comparison of phase solubility diagrams of both betamethasone and cholesterol.

  15. Relationship between in vivo skin blanching and in vitro release rate for betamethasone valerate creams.

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    Shah, V P; Elkins, J; Skelly, J P

    1992-01-01

    Betamethasone valerate creams from two firms were evaluated using the skin blanching procedure. In both studies, the same cream formulation exhibited significantly higher blanching compared to the other product. An in vitro release rate was determined for these betamethasone valerate cream products using a diffusion cell system, with a cellulose acetate membrane and a 60% ethanol:water receptor medium. The release rate (flux) of betamethasone valerate was higher for the higher blanching formulation and was statistically different from the other product. The integrity of the cellulose acetate membrane in 60% ethanol:water mixture was ascertained using hydrocortisone cream product. The in vitro drug release method, using a diffusion cell system and a synthetic membrane, can serve as a good quality control test method for topical creams.

  16. Comparing Betamethasone and Dexamethasone Effects on Concentration of Male Reproductive Hormones in Mice

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    Jalalaldin Gooyande

    2014-01-01

    Full Text Available Most of chemical drugs have side effects on various parts of body. It is necessary to identify these effects to better use of drugs. Betamethasone and Dexamethasone are two of the most usual drugs in human and animal medication. The effect of these drugs on concentration of male reproductive hormones of mice was the goal of this study. Eighteen matured male mice were divided into eight groups including control, placebo and six treatment groups. Placebo group was received physiological serum only and treatments were Betamethasone (0.1, 0.5 and 1 mg/kg and Dexamethasone (0.1, 0.5 and 1 mg/kg which were injected in peritoneum every other day and for twenty days. After 20 days, blood samples were taken and FSH, LH and testosterone levels were measured using Eliza test method. Obtained data were analyzed using one way analysis of variance and mean comparison was done using Duncan's multiple ranges test and SPSS program. Results showed that 0.5 mg/kg of Betamethasone and all levels of dexamethasone caused significant increase in FSH concentration. For LH hormone, 1 mg/kg of Betamethasone and 0.1 mg/kg of Dexamethasone caused significant decrease whereas 1 mg/kg of Dexamethasone increased it significantly. Testosterone was increased significantly by 1 mg/kg of Dexamethasone. So, mentioned drugs are effective on hormone action of reproductive system dose dependently and probable effect of them must be considered in time of using.

  17. The influence of betamethasone and dexamethasone on motor development in young rats

    NARCIS (Netherlands)

    Gramsbergen, A; Mulder, EJH

    1998-01-01

    Synthetic corticosteroids such as dexamethasone and betamethasone are widely used in clinical practice of the perinatal period to enhance lung maturation. However, indications emerged both on the basis of investigations in humans and in experimental animals that such treatment leads to abnormal brai

  18. Development of a new formulation combining calcipotriol and betamethasone dipropionate in an ointment vehicle

    DEFF Research Database (Denmark)

    Simonsen, Lene; Høy, Gert; Didriksen, Erik

    2004-01-01

    ether (PSE) had a marked effect. A 5% PSE formulation resulted in a permeation rate comparable to the marketed products. Thus, by using PSE as solvent, it was possible to combine calcipotriol and betamethasone dipropionate in a single formulation while optimal skin permeability was attained. Recently...

  19. Significant one week efficacy of a calcipotriol plus betamethasone dipropionate scalp formulation

    DEFF Research Database (Denmark)

    Jemec, G.B.E.; Van De Kerkhof, P.C.M.; Enevold, A.;

    2011-01-01

    of the two-compound scalp formulation after 1 week of treatment. Methods Pooled data from two large pivotal phase III trials with 2920 patients receiving once-daily treatment for up to 8 weeks with either the two-compound scalp formulation (n = 1108), betamethasone dipropionate (n = 1118), calcipotriol (n...

  20. The effects of increased penetration of betamethasone dipropionate in a propylene glycol base (Diprolene) for psoriasis.

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    Kansky, A

    1981-01-01

    The efficacy and safety of betamethasone dipropionate, 0.05% in a propylene glycol base (Diprolene), was investigated in an open, fixed-dose study of thirty-one patients with resistant psoriasis. Clearing of lesions or marked improvement occurred in 97% (thirty out of thirty-one) of patients. Increased penetration of corticosteroid did not cause adrenal suppression or other adverse reactions.

  1. Effects of intra-amniotic lipopolysaccharide and maternal betamethasone on brain inflammation in fetal sheep.

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    Elke Kuypers

    Full Text Available RATIONALE: Chorioamnionitis and antenatal glucocorticoids are common exposures for preterm infants and can affect the fetal brain, contributing to cognitive and motor deficits in preterm infants. The effects of antenatal glucocorticoids on the brain in the setting of chorioamnionitis are unknown. We hypothesized that antenatal glucocorticoids would modulate inflammation in the brain and prevent hippocampal and white matter injury after intra-amniotic lipopolysaccharide (LPS exposure. METHODS: Time-mated ewes received saline (control, an intra-amniotic injection of 10 mg LPS at 106d GA or 113d GA, maternal intra-muscular betamethasone (0.5 mg/kg maternal weight alone at 113d GA, betamethasone at 106d GA before LPS or betamethasone at 113d GA after LPS. Animals were delivered at 120d GA (term=150d. Brain structure volumes were measured on T2-weighted MRI images. The subcortical white matter (SCWM, periventricular white matter (PVWM and hippocampus were analyzed for microglia, astrocytes, apoptosis, proliferation, myelin and pre-synaptic vesicles. RESULTS: LPS and/or betamethasone exposure at different time-points during gestation did not alter brain structure volumes on MRI. Betamethasone alone did not alter any of the measurements. Intra-amniotic LPS at 106d or 113d GA induced inflammation as indicated by increased microglial and astrocyte recruitment which was paralleled by increased apoptosis and hypomyelination in the SCWM and decreased synaptophysin density in the hippocampus. Betamethasone before the LPS exposure at 113d GA prevented microglial activation and the decrease in synaptophysin. Betamethasone after LPS exposure increased microglial infiltration and apoptosis. CONCLUSION: Intra-uterine LPS exposure for 7d or 14d before delivery induced inflammation and injury in the fetal white matter and hippocampus. Antenatal glucocorticoids aggravated the inflammatory changes in the brain caused by pre-existing intra-amniotic inflammation

  2. Quantitative determination of betamethasone sodium phosphate and betamethasone dipropionate in human plasma by UPLC-MS/MS and a bioequivalence study.

    Science.gov (United States)

    Chen, Man-Yun; Tang, Yong-Jun; Wang, Yi-Cheng; Wang, Chong-Zhi; Yuan, Chun-Su; Chen, Yao; Tan, Zhi-Rong; Huang, Wei-Hua; Zhou, Hong-Hao

    2016-05-07

    The compound medicine of betamethasone sodium phosphate (BSP) and betamethasone dipropionate (BDP) is widely used for diverse glucocorticoid-sensitive acute and chronic diseases such as asthma, rheumatoid arthritis and systemic lupus erythematosus. It will be useful and beneficial to validate sensitive method for the determination of BSP, BDP and their metabolites for their pharmacokinetic study. Hereby, an ultra-high pressure liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) has been validated for the determination of BSP, BDP and their metabolites betamethasone (BOH), betamethasone 17-monodipropionate (B17P) and betamethasone 21-monodipropionate (B21P) in human plasma. Liquid-liquid extraction with ether and n-hexane (v/v, 4:1) was used for sample preparation of BDP, BOH, B17P and B21P with beclomethasone dipropionate as internal standard (IS), while solid phase extraction was adopted for sample preparation of BSP using prednisolone as IS. The chromatographic separation was performed on a Hypurity C18 column (150 mm×2.1 mm, 5 μm) for BOH, BDP, B21P and B17P, and a Luna C18 (2) column (150 mm×2.0 mm, 5 μm) for BSP. Electrospray ionization interfaced with positive multiple reaction monitoring (MRM) scan mode was used for mass spectrometric detection. The standard calibration curves were linear within the range of 2.525 × 10(-9)-403.9 × 10(-9) mol·dm(-3) for BSP, 0.125 × 10(-9)-55.81 × 10(-9) mol·dm(-3) for BDP, 0.278 × 10(-9)-74.95 × 10(-9) mol·dm(-3) for BOH, 0.098 × 10(-9)-4.688 × 10(-9) mol·dm(-3) for B17P and 0.226 × 10(-9)-5.411 × 10(-9) mol·dm(-3) for B21P, respectively. The validated method was successfully applied to a bioequivalence study in 23 healthy subjects after they were injected with this compound medicine BSP and BDP.

  3. Betamethasone augments the antifungal effect of menadione--towards a novel anti-Candida albicans combination therapy.

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    Jakab, Ágnes; Emri, Tamás; Sipos, Lilla; Kiss, Ágnes; Kovács, Renátó; Dombrádi, Viktor; Kemény-Beke, Ádám; Balla, József; Majoros, László; Pócsi, István

    2015-08-01

    The fluorinated glucocorticoid betamethasone stimulated both the extracellular phospholipase production and hypha formation of the opportunistic human pathogen Candida albicans and also decreased the efficiency of the polyene antimycotics amphotericin B and nystatin against C. albicans in a dose-dependent manner. Importantly, betamethasone increased synergistically the anti-Candida activity of the oxidative stress generating agent menadione, which may be exploited in future combination therapies to prevent or cure C. albicans infections, in the field of dermatology.

  4. [First experiences with prenatal affection of infantile lung maturation by betamethason (author's transl)].

    Science.gov (United States)

    Schwenzel, W; Jung, H; Lahmann, H; Etzrodt, A; Sticherling, C; Korz, K; Liedtke, B; Chantraine, H

    1975-02-01

    Because of premature labour, probability of fetal retardation, discrepance at term of delivery, Rh-incompatibility or EPH-gestosis 185 patients were hospitalized. 76 pregnant women received twice 1.5 ml Celestan Depot i.m. (4.5 betamethasone acetate and 6mg betamethasome dinatrium phosphate per injection) within an interval of 24 hours. It was necessary to maintain a tocolysis for at least 48 hours as a minimum after the first injection of Celestan Depot. The other 109 patients without treatment of glucocorticoids were considered as a controlgroup. We could show that antepartum application of betamethasone before the 38. week of gestation was associated with a reduction of RDS in our premature infants. Only one baby of the betamethasone-treated infants died of hyaline membrane disease during the first 7 days of life compared with 11 of the control group. In 11 patients patients amniocentesis was performed before the first injection of glucocorticoids and was repeated 2 to 7 days later. The amniotid fluid lecithin phosphorus concentration was determined. In the same period of pregnancy and the same iterval the lecithin phosphours level of amniotic fluid was analysed in 11 other patients who were not rreated with glucocorticoids. The difference between amniotic fluid lecithin phosphorus concentration in the first and second anslysis was found significant by a level of significance of alpha = 5%. There was no evidence of an influence of the therapy with Celestan Depot on this increase. The excretion of oestorgens in the urine of 24 hours was analysed in 22 gradidae before and 7 days after the treatment with betamethasone. The oestogen values of the day before application of betamethasone served as baseline figures. All patients showed a market fall in urinary oestrogens excretion, especially after the second day of therapy. After day 2 the values returned rapidly to baseline values. There were no differences between treated and control groups in Apgar scores at birth

  5. Combined effect of terbutaline and betamethasone on glucose homeostasis in preterm labor.

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    Adam, K; Ou, C N; Cotton, D B

    1993-01-01

    The short- and long-term effects of simultaneous administration of terbutaline and betamethasone were investigated in 8 gravidas treated for preterm labor. Their plasma concentrations of glucose, insulin, glucagon, C-peptide, lactate and potassium were compared to a control group receiving intravenous magnesium sulfate and betamethasone. The patients on terbutaline therapy had a marked hyperglycemia at 11 h which remained elevated for 48 h. There was a simultaneous rise in plasma insulin and C-peptide, and a fall in plasma glucagon. Lactate levels were markedly elevated. Only 1 of the 8 patients had an abnormal glucose tolerance test at 1 week of therapy. The metabolic changes of control patients were minimal in comparison and there was no lacticacidemia. This suggests that glucocorticoids potentiate the hyperglycemic response of terbutaline.

  6. The effects of dexamethasone, betamethasone, flunixin and phenylbutazone on bovine natural-killer-cell cytotoxicity.

    Science.gov (United States)

    O'Brien, M A; Duffus, W P

    1990-09-01

    A series of in-vitro experiments was performed utilizing the ability of bovine peripheral-blood mononuclear cells (PBMC) to induce lysis of Madin-Darby bovine kidney (MDBK) cells infected with bovine herpesvirus 1 (BHV1), in an antibody-independent natural-killer(NK)-cell cytotoxic assay. The effects of dexamethasone (dexamethasone sodium phosphate), betamethasone (betamethasone sodium phosphate), flunixin (flunixin meglumine) and phenylbutazone on this NK cytolysis were studied using concentrations of the drugs ranging from well below to well above those normally attained in plasma at recommended therapeutic doses. All four drugs inhibited NK activity. For each agent a minimum inhibitory concentration (MIC50) required to inhibit NK activity by approximately 50% was calculated. For dexamethasone, betamethasone and flunixin the MIC50 was lower after a 24-h pre-incubation of PBMC with each drug, although a marked inhibition was seen when the drug was only present during the 5-h NK assay itself. In contrast the MIC50 for phenylbutazone rose after a 24-h pre-incubation with PBMC.

  7. Maternal and feto-placental prostanoid responses to a single course of antenatal betamethasone.

    Science.gov (United States)

    Cho, Steve; Beharry, Kay D A; Valencia, Arwin M; Guajardo, Leonel; Nageotte, Michael P; Modanlou, Houchang D

    2005-12-01

    We tested the hypothesis that antenatal betamethasone alters prostanoid levels in the maternal and feto-placental compartments. Forty-three singleton pregnancies were studied. Group I were women treated with a single course of antenatal betamethasone and who delivered 38 weeks. Maternal and mixed cord blood; and placental samples were collected at delivery and analyzed for PGE2, PGF(2alpha), 6-ketoPGF(1alpha), and TxB2 levels. Antenatal betamethasone decreased maternal PGE2 levels with concomitant increases in the feto-placental compartment. Umbilical cord TxB2 levels in the treated group were significantly lower than the non-treated pre-term and term groups resulting in a higher 6-ketoPGF(1alpha):TxB2 ratio. Considering the regulatory role of PGE2 and PGI2 in fetal lung development and neonatal transition homeostasis, these results suggest a mechanism, at least in part, for the beneficial effects of antenatal steroids on fetal lung maturation and neonatal cardio-pulmonary homeostasis at birth.

  8. Effect of betamethasone in combination with antibiotics on gram positive and gram negative bacteria.

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    Artini, M; Papa, R; Cellini, A; Tilotta, M; Barbato, G; Koverech, A; Selan, L

    2014-01-01

    Betamethasone is an anti-inflammatory steroid drug used in cases of anaphylactic and allergic reactions, of Alzheimer and Addison diseases and in soft tissue injuries. It modulates gene expression for anti-inflammatory activity suppressing the immune system response. This latter effect might decrease the effectiveness of immune system response against microbial infections. Corticosteroids, in fact, mask some symptoms of infection and during their use superimposed infections may occur. Thus, the use of glucocorticoids in patients with sepsis remains extremely controversial. In this study we analyzed the in vitro effect of a commercial formulation of betamethasone (Bentelan) on several Gram positive and Gram negative bacteria of clinical relevance. It was found to be an inhibitor of the growth of most of the strains examined. Also the effect of betamethasone in combination with some classes of antibiotics was evaluated. Antibiotic-steroid combination therapy is, in such cases, superior to antibiotic-alone treatment to impair bacterial growths. Such effect was essentially not at all observable on Staphylococcus aureus or Coagulase Negative Staphylococci (CoNS).

  9. Topical Calendula and Betamethasone Valerate in the prevention of acute radiation dermatitis: a randomized prospective trial

    Directory of Open Access Journals (Sweden)

    Fotouhi M

    2007-07-01

    Full Text Available Background: Acute radiation dermatitis is a very common side effect of radiation therapy for many cancers, including breast cancer. Despite the high prevalence of acute radiation dermatitis as well as wet desquamation, only a few trials studying the prophylaxis of this complication using topical treatment have been conducted. In spite of these studies, some controversy still exists about regarding treatments for acute radiation dermatitis, as does some concern about their long-term complications. For this reason, we conducted a clinical trial for a new treatment with the same effectiveness as corticosteroids, but fewer complications. Methods: This trial included 60 patients with pathologic diagnoses of breast cancer for whom radiotherapy had been planned. Patients were 30-73 years old. Patients with radical mastectomy received 5000 cGy over five weeks, and those with conservative surgery received 6000 cGy over six weeks divided in 200 cGy fractions. Patients were divided randomly into two groups: one group received a moderately-potent glucocorticoid steroid, 0.1% betamethasone ointment (30, and the other received the new treatment, 0.1% calendula ointment (30. All patients applied their respective drugs twice daily within the tangential field from the first day of radiation treatment until one month after treatment was completed. Starting one week after radiation therapy commenced, patients were monitored weekly for symptoms of dermatitis and the degree of severity as well as possible adverse drug effects, in addition to such monitoring on the days of their appointments. Four weeks after termination of therapy, patients were again examined, at which time they completed a questionnaire about dermatologic complications. Results: The mean time to develop dermatitis was 3.7 weeks for the betamethasone group and 3.87 weeks for the calendula group. Maximal dermatitis intensity during treatment in the betamethasone group was: 0, 6.7%; I, 73.3%; II, 16

  10. Preparation of photocatalytic ZnO nanoparticles and application in photochemical degradation of betamethasone sodium phosphate using taguchi approach

    Science.gov (United States)

    Giahi, M.; Farajpour, G.; Taghavi, H.; Shokri, S.

    2014-07-01

    In this study, ZnO nanoparticles were prepared by a sol-gel method for the first time. Taguchi method was used to identify the several factors that may affect degradation percentage of betamethasone sodium phosphate in wastewater in UV/K2S2O8/nano-ZnO system. Our experimental design consisted of testing five factors, i.e., dosage of K2S2O8, concentration of betamethasone sodium phosphate, amount of ZnO, irradiation time and initial pH. With four levels of each factor tested. It was found that, optimum parameters are irradiation time, 180 min; pH 9.0; betamethasone sodium phosphate, 30 mg/L; amount of ZnO, 13 mg; K2S2O8, 1 mM. The percentage contribution of each factor was determined by the analysis of variance (ANOVA). The results showed that irradiation time; pH; amount of ZnO; drug concentration and dosage of K2S2O8 contributed by 46.73, 28.56, 11.56, 6.70, and 6.44%, respectively. Finally, the kinetics process was studied and the photodegradation rate of betamethasone sodium phosphate was found to obey pseudo-first-order kinetics equation represented by the Langmuir-Hinshelwood model.

  11. Effect of betamethasone on the pulp after topical application to the dentin of rat teeth: vascular aspects of the inflammation

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    Elaine Vianna Freitas Fachin

    2009-08-01

    Full Text Available OBJECTIVE: This study investigated the pulpal effect of topically applied betamethasone to the dentin of rat molars in the vascular phase of inflammation. MATERIAL AND METHODS: Deep cavities were prepared on the occlusal face of the maxillary right and left 1st molars with non-refrigerated inverted-cone steel burs at low speed. Three groups were formed: Group I was composed of right 1st molars; Group II was composed of left 1st molars that received the application of a drop of betamethasone on dentin surface for 5 min; and Group III (control was composed of right 2nd molars that received no cavity preparation or betamethasone application. Changes in the vascular characteristics of the pulp tissue were checked by calculating the pulp vascular area in relation to its total area and the number of blood vessels per unit area. Data were subjected to ANOVA and Tukey's test (?=0.05. RESULTS: Group I presented a significantly larger number of vessels (p<0.05 than Group II. Regarding the vascular/total area ratio (%, Group I presented statistically significantly higher values (p=0.01 than Groups II and III. CONCLUSION: Betamethasone applied on the dentin of rat teeth proved to reduce the vascular phase of pulp inflammation regarding vessel diameter and number of blood vessels.

  12. Effects of betamethasone on the course of experimentai. Infection with Trypanosoma cruzi

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    Frederico G.C. Abath

    1986-09-01

    Full Text Available In this experiment, the effect of betamethasone administered in the early post- acute infection of mice by Trypanosoma cruzi was studied. This drug was administered during 30 days after the 42nd day of infection in a dose of 0.15 mg/day. The betamethasone treatment did not cause fresh outbreaks of parasitemia and the histopathological findings in the chronic phase were not different from those in the control group. The higher cumulative mortality after treatment in the experimental group was due to superimposed bacterial infections. Outbred albino mice infected with low numbers ofY strain Trypanosoma cruzi trypomastigotes were not suitable models for Chagas' disease, since after 7 months of observation only mild histological lesions developed in all the animais. Prolonged betamethasone treatment of mice infected with low numbers o/Trypanosoma cruzi of the Y strain, during the post-acute phase did not aggravate the course of infection.Foram estudados os efeitos da betametasona administrada na fase pós-aguda imediata de uma infecção pelo T. cruzi em camundongos. O tratamento consistiu de 30 doses diárias de 0,15 mg de betametasona, a partir de 42° dia de infecção, não havendo aparecimento de novos surtos de parasitemia. No tempo de duração do experimento (7 meses não houve diferença entre as lesões histopatológicas dos animais tratados e dos não tratados. O grupo experimental apresentou uma maior mortalidade acumulada no 75º dia de infecção, o que pode ser atribuído a infecções bacterianas associadas. Por outro lado, camundongos albinos "outbred", infectados com baixo inóculo, não se apresentaram como bom modelo de doença de Chagas, já que não desenvolveram lesões importantes nem na fase aguda nem após 7 meses de infecção. Em conclusão, o tratamento imunosupressivo prolongado, após a fase aguda de uma infecção mínima com a cepa Ydo T. cruzi não tem influência sobre o curso da infecção, pelo menos no que tange

  13. Prenatal betamethasone does not affect glutamatergic or GABAergic neurogenesis in preterm newborns.

    Science.gov (United States)

    Vose, L R; Vinukonda, G; Diamond, D; Korumilli, R; Hu, F; Zia, M T K; Hevner, R; Ballabh, P

    2014-06-13

    Prenatal glucocorticoids (GCs) are routinely used for pregnant women in preterm labor to prevent respiratory distress syndrome and intraventricular hemorrhage in premature infants. However, the effect of antenatal GCs on neurogenesis in preterm neonates remains elusive. Herein, we hypothesized that prenatal GCs might suppress both glutamatergic and GABAergic neurogenesis in preterm rabbits and that this treatment would induce distinct changes in the expression of transcription factors regulating these developmental events. To test our hypotheses, we treated pregnant rabbits with betamethasone at E27 and E28, delivered the pups at E29 (term=32d), and assessed neurogenesis at birth and postnatal day 3. We quantified radial glia (Sox2(+)) and intermediate progenitor cells (Tbr2(+)) in the dorsal cortical subventricular zone to assess glutamatergic neuronal progenitors, and counted Nkx2.1(+) and Dlx2(+) cells in the ganglionic eminence to evaluate GABAergic neurogenesis. In addition, we assayed transcription factors regulating neurogenesis. We found that prenatal GCs did not affect the densities of radial glia and intermediate progenitors of glutamatergic or GABAergic neurons. The number of GABA(+) interneurons in the ganglionic eminence was similar between the prenatal GC-treated pups compared to untreated controls. Moreover, the mRNA expression of transcription factors, including Pax6, Ngn1/2, Emx1/2, Insm1, Dlx1, Nkx2.1, and Gsh2, were comparable between the two groups. However, there was a transient elevation in Mash1 protein in betamethasone-treated pups relative to controls at birth. These data suggest that prenatal GC treatment does not significantly impact the balance of glutamatergic and GABAergic neurogenesis in premature infants.

  14. The effects of betamethasone on allopregnanolone concentrations and brain development in preterm fetal sheep.

    Science.gov (United States)

    Yawno, Tamara; Mortale, Monique; Sutherland, Amy E; Jenkin, Graham; Wallace, Euan M; Walker, David W; Miller, Suzanne L

    2014-10-01

    The risk of preterm delivery often means that the fetus will be exposed to exogenous synthetic glucocorticoids to accelerate fetal lung maturation, but effects on other organs, particularly the brain, are not understood. The neurosteroid allopregnanolone (AP) is a GABAA receptor agonist that influences fetal brain development and has neuroprotective properties. In this study we determined the impact of maternal glucocorticoid (betamethasone) administration on brain development and AP synthesis in preterm fetal sheep. Pregnant ewes underwent surgery at 105 days gestation for implantation of fetal catheters. Ewes received either betamethasone (BM; 11.4 mg; n=10) or vehicle (saline; n=5) by i.m injection on days five (BM1) and six (BM2) following surgery. Five fetuses of the BM treated ewes received an infusion of alfaxalone (20 mg) over 48 h commencing 30 min prior to BM1. All animals were euthanased on day 7, and the fetal brains collected to determine AP concentrations and histopathology. BM significantly reduced AP levels in the fetal brain and placental cotyledons, and also in fetal plasma without altering progesterone concentrations. There was a significant decrease in the number of myelinating cells in subcortical white matter, but no change to total oligodendrocyte number. Co-administration of the AP analogue analog alfaxalone with BM prevented this change in MBP expression. BM, given at a dose clinically prescribed to accelerate lung maturation, adversely affects neurosteroid levels in the preterm fetal brain, and affects the maturational profile of white matter development; these effects were mitigated by the co-administration of alfaxolone.

  15. The Effect of Betamethasone and IFN-γ on Replication of Toxoplasma gondii (RH Strain and Nitric Oxide Production in HeLa Cell Culture

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    "Fatemeh Ghaffarifar

    2006-06-01

    Full Text Available Toxoplasmosis is a protozoal infection caused by Toxoplasma gondii. Toxoplasmosis produce severe damage in patients who are immunosuppresed. In those who are immunosupressed, latent infection can be reactivated resulting in acute disseminating disease. Betamethasone is a synthetic glycocorticoid, used as an anti-inflamatory and immunosuppressant in a wide variety of disorders.The aim of this study was evaluation of betamethasone as an immunosuppressor drug on infected cells by Toxoplasma gondii. In this study, at first HeLa cells were grown in 24 well culture plates in culture medium .When confluent monolayer was obtained, we compared 6 groups to evaluate the effect of betamethasone as a corticosteroid drug (two concentrations 4 and 40μg/ml and the effect of IFN-γ (100 IU/ml on growth, replication and Nitric Oxide (NO production. The results showed, that high number of plaques were seen in group with 40 g/ml of betamethasone and the lowest number of plaques were seen in group with 100 IU of IFN-. The difference between plaque number in control and groups treated with IFN- and betamethasone was significant (P<0.05. The groups with betamethasone or IFN- without tachyzoites did not show any effect on cell structures. Replication rates in the wells treated with IFN- were decreased significantly 72h post inoculation in comparison with control group (P< 0.05. There was no significant difference among different groups in NO production. The results indicated that betamethasone increase the invasion of tachyzoites to host cells in vitro.

  16. Methimazole, but not betamethasone, prevents 131I treatment-induced rises in thyrotropin receptor autoantibodies in hyperthyroid Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Gamstedt, A.; Wadman, B.; Karlsson, A.

    1986-04-01

    The effects of methimazole or betamethasone therapy on the TSH receptor antibody response to radioiodine therapy were compared in a prospective randomized study of 60 patients with hyperthyroidism due to Graves' disease. The patients were followed for 1 yr after treatment with 131I. Twenty-three patients received 131I alone, 17 were treated with methimazole for 2 months before and 3 months after 131I therapy, and 20 patients were treated with betamethasone for 3 weeks before and 4 weeks after 131I therapy. 131I induced a transient rise in the mean serum level of TSH receptor autoantibodies, measured as TSH binding inhibitory immunoglobulin (TBII), but in patients receiving methimazole treatment, no such rise occurred. In the betamethasone-treated patients, TBII increased similarly to that in patients treated with 131I alone. In addition, in patients given betamethasone, there was an early decrease in total serum immunoglobulin G, which persisted throughout the follow-up period. In the other 2 groups, no changes in total immunoglobulin G were found. The results demonstrate that in hyperthyroid Graves' disease, TBII production is influenced by therapy. Methimazole abolished the 131I-induced increase in TBII, whereas betamethasone did not have such an inhibitory effect.

  17. Exaggerated sympathetic mediated responses to behavioral or pharmacological challenges following antenatal betamethasone exposure.

    Science.gov (United States)

    Shaltout, Hossam A; Chappell, Mark C; Rose, James C; Diz, Debra I

    2011-06-01

    Glucocorticoid administration to women at risk for preterm delivery is standard practice to enhance neonatal survival. However, antenatal betamethasone exposure (β-exposure) increases mean arterial pressure (MAP) in adult sheep (1.8 yr old) and results in impaired baroreflex sensitivity (BRS) for control of heart rate (HR). In the current studies we tested the hypothesis that enhanced sympathetic nervous system and hypothalamo-pituitary-adrenal (HPA) axis-mediated responses are evident at an early age in β-exposed sheep. Pregnant ewes were administered betamethasone (0.17 mg/kg twice over 24 h) or vehicle (Veh-control) on the 80th day of gestation, and offspring were delivered at full term. Female β-exposed and control offspring instrumented at age 42 ± 3 days for conscious continuous recording of MAP and HR had similar resting values at baseline. However, BRS was ~45% lower in β-exposed offspring. β-Exposed lambs allowed to suckle for 10 min had a greater elevation in MAP than Veh-control lambs (19 ± 1 vs 12 ± 2 mmHg; n = 4-5, P < 0.05). MAP was reduced by 20% from baseline via sodium nitroprusside infusion (SNP) over 10 min, which triggered a rebound increase in MAP only in β-exposed lambs. HR increased with the reduction in MAP during SNP infusion in Veh-control lambs, whereas there was no change in HR with the reduction in MAP in β-exposed lambs. Combined vasopressin-CRF injection caused greater increases in MAP in the β-exposed lambs. Cortisol and ACTH responses were higher in response to SNP hypotension in the β-exposed lambs. The data reveal enhanced sympathetic and HPA axis responses associated with impaired BRS preceding differences in resting MAP in preweanling female lambs exposed in utero to glucocorticoids. The consequences of these alterations at an early age include eventual development of higher blood pressure in this ovine model of fetal programming.

  18. Identification of Eight Different Isoforms of the Glucocorticoid Receptor in Guinea Pig Placenta: Relationship to Preterm Delivery, Sex and Betamethasone Exposure.

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    Zarqa Saif

    Full Text Available The placental glucocorticoid receptor (GR is central to glucocorticoid signalling and for mediating steroid effects on pathways associated with fetal growth and lung maturation but the GR has not been examined in the guinea pig placenta even though this animal is regularly used as a model of preterm birth and excess glucocorticoid exposure. Guinea pig dams received subcutaneous injections of either vehicle or betamethasone at 24 and 12 hours prior to preterm or term caesarean-section delivery. At delivery pup and organ weights were recorded. Placentae were dissected, weighed and analysed using Western blot to examine GR isoform expression in nuclear and cytoplasmic extracts. A comparative examination of the guinea pig GR gene identified it is capable of producing seven of the eight translational GR isoforms which include GRα-A, C1, C2, C3, D1, D2, and D3. GRα-B is not produced in the Guinea Pig. Total GR antibody identified 10 specific bands from term (n = 29 and preterm pregnancies (n = 27. Known isoforms included GRγ, GRα A, GRβ, GRP, GRA and GRα D1-3. There were sex and gestational age differences in placental GR isoform expression. Placental GRα A was detected in the cytoplasm of all groups but was significantly increased in the cytoplasm and nucleus of preterm males and females exposed to betamethasone and untreated term males (KW-ANOVA, P = 0.0001, P = 0.001. Cytoplasmic expression of GRβ was increased in female preterm placentae and preterm and term male placentae exposed to betamethasone (P = 0.01. Nuclear expression of GRβ was increased in all placentae exposed to betamethasone (P = 0.0001. GRα D2 and GRα D3 were increased in male preterm placentae when exposed to betamethasone (P = 0.01, P = 0.02. The current data suggests the sex-specific placental response to maternal betamethasone may be dependent on the expression of a combination of GR isoforms.

  19. The influence of sol-gel-derived silica coatings functionalized with betamethasone on adipose-derived stem cells (ASCs).

    Science.gov (United States)

    Donesz-Sikorska, Anna; Grzesiak, Jakub; Smieszeka, Agnieszk; Krzak, Justyna; Marycz, Krzysztof

    2014-09-01

    Silica-based sol-gel coatings have gained attention in bone therapies and orthopedic applications, due to the biocompatibility and bioactivity, including a high potential for the controlled release both in vitro and in vivo. Bioactive materials are created to facilitate the biocompatibility of orthopedic implants. One of the promising alternatives is biomaterials with immobilized drugs. In this study we demonstrated for the first time novel sol-gel-derived silica coatings with active amino groups (SiO2(NH2)) functionalized with a steroid drug-betamethasone, applied to a substrate 316 L using dip coating technique. The presence of betamethasone in functionalized coatings was directly confirmed by Raman spectroscopy and energy-dispersive X-ray spectroscopic analysis. The wettability was evaluated by the sessile drop method, while the surface free energy was estimated based on the contact angles measured. Our results showed a shift in surface properties from hydrophobic to hydrophilic after application of the coatings. We have investigated the morphology, proliferation factor, and the population doubling time of adipose-derived stem cells for biological purposes. Moreover, the analysis of the distribution and localization of cellular microvesicles was performed to evaluate the influence of functionalized surfaces on cellular cytophysiological activity. Increased proliferation and activation of cells, determined by the observations of microvesicles shedding processes, provided evidence of the availability of the drug. Therefore, we conclude that the sol-gel synthesis proposed here allows to improve the metal substrates and can be successfully used for immobilization of betamethasone. This in turn enables the direct delivery of the drug with implanted material into the wound site, and to stimulate the activity of cells to enhance tissue regeneration.

  20. Resposta adrenocortical em caninos tratados com betametasona e fludrocortisona por via auricular Canine adrenocortical response to otic betamethasone and fludrocortisone

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    Luiz Fernando Jantzen Gaspar

    1999-12-01

    Full Text Available Vinte e quatro caninos adultos hígidos, sem raça definida, machos e fêmeas, com peso e idade variados, foram divididos igualmente em grupo controle, betametasona, fludrocortisona, e receberam, por via auricular, 2ml diários das seguintes soluções: salina a 0,9%, fosfato dissódico de betametasona a 0,1% e acetato de fludrocortisona a 0,1%, respectivamente. Os animais foram submetidos a duas aplicações diárias de 0,5ml da solução correspondente em cada conduto auditivo, durante um período de 14 dias. Foram realizadas colheitas de sangue da jugular no 7º e 14º dias de tratamento e no 7º dia após o término dos tratamentos. Realizou-se a determinação dos níveis séricos de cortisol pré e pós-estímulo com ACTH. Os grupos betametasona e fludrocortisona apresentaram um decréscimo significativo (PTwenty four mature mixed-breed dogs, healthy, male and female, of several weights and ages were divided into control, betamethasone and fludrocortisone groups and received 2ml daily of these solutions: 0.9% saline solution, 0.1% betamethasone disodic phosphate and 0.1% fludrocortisone acetate, respectively. The dogs received, twice in day, 0.5ml of corresponding solution into each external ear canal for 14 days. During the treatments were realized collections of data on 7th and 14th day and in post-treatment (seven days later the end of treatments. In these times were obtained blood samples by jugular venopunction, for serologic determination of level serum cortisol pre- and post-ACTH. The pre- and post-ACTH cortisol concentrations of fludrocortisone and betamethasone groups reduced significantly (P<0.05 compared with control, during the experiment. Betamethasone and fludrocortisone by otic administration produce considerable effects in the adrenocortical function.

  1. Comparative assessment of efficacy of two different pretreatment single oral doses of betamethasone on inter-appointment and postoperative discomfort: An in vivo clinical evaluation

    Science.gov (United States)

    Gyanani, Hitesh; Chhabra, Naveen; Parmar, Ghanshyam R.

    2016-01-01

    Aim: Study aimed to evaluate the efficacy of two different pretreatment single oral doses of betamethasone on the incidence of inter-appointment flare up and postoperative discomfort. Materials and Methods: Fifty-four patients aged 18–59 years requiring endodontic treatment were selected and randomly assigned to three groups; single pretreatment oral dose of placebo or betamethasone in two different oral doses of 0.5 mg and 1 mg, respectively. Endodontic therapy was completed in two visits using triple antibiotic paste as intracanal medicament. Patients were given a questionnaire to record their pain at 1, 2, 3, and 7 days after treatment. In the second visit, obturation was done, and the patients were again instructed to record their pain scores after treatment and discharged. The verbal rating scale was used for recording the pain scores. Statistical analysis was done using ANOVA and the Friedman test. Results: 0.5 mg betamethasone group showed least mean pain scores among all experimental groups; however, there was no statistically significant difference between any of the groups (P > 0.05). Conclusion: Pretreatment single oral dose of betamethasone is an effective in managing endodontic flare-ups; however, the results were statistically insignificant. PMID:27994320

  2. Effect of the local administration of betamethasone on pain, swelling and trismus after impacted lower third molar extraction. A randomized, triple blinded, controlled trial

    Science.gov (United States)

    Marques, José; Pié-Sánchez, Jordi; Valmaseda-Castellón, Eduard; Gay-Escoda, Cosme

    2014-01-01

    Objectives: The aim of this study is to compare the analgesic and anti-inflammatory effects of the local postoperative administration of a single 12-mg dose of betamethasone after the surgical removal of impacted lower third molars. Study Design: A split-mouth, triple-blind, randomized, placebo-controlled clinical trial of 25 patients requiring the surgical removal of symmetrical lower third molars was performed. In the experimental side, a 12-mg dose of betamethasone was administered submucosally after the surgical procedure, while in the control side a placebo (sterile saline solution) was injected in the same area. To assess postoperative pain, visual analogue scales and the consumption of rescue analgesic were used. The facial swelling and trismus were evaluated by measuring facial reference distances and maximum mouth opening. Results: There were no significant differences between the two study groups regarding postoperative pain, facial swelling and trismus. Conclusions: The injection of a single dose of betamethasone does not seem to reduce pain, facial swelling and trismus after impacted lower third molar removal when compared to placebo. Key words:Third molar extraction, corticosteroids, betamethasone. PMID:24121915

  3. ANG-(1–7) DEFICIENCY AND BAROREFLEX IMPAIRMENT PRECEDE THE ANTENATAL BETAMETHASONE EXPOSURE-INDUCED ELEVATION IN BLOOD PRESSURE

    Science.gov (United States)

    Shaltout, Hossam A.; Rose, James C.; Chappell, Mark C.; Diz, Debra I.

    2014-01-01

    Betamethasone is administered to accelerate lung development and improve survival of premature infants, but may be associated with hypertension later in life. In a sheep model of fetal programming resulting from exposure at 80th day of gestation to Betamethasone (Betaexposed), adult sheep at 6–9 months or 1.8 yrs of age have elevated mean arterial pressure (MAP), and attenuated spontaneous baroreflex sensitivity (sBRS) for control of heart rate compared to age-matched controls, associated with imbalances in angiotensin (Ang) II versus Ang-(1–7) tone. At 6 weeks of age, evoked BRS is already low in the Beta-exposed animals. In this study we assessed the potential contribution of the renin-angiotensin system to the impaired sBRS. Female lambs (6 weeks old) with Beta-exposure in utero had similar MAP to control lambs (78±2 vs 77±2 mm Hg, n = 4–5 per group), but lower sBRS (8±1 vs 16±3 ms/mm Hg; p < 0.05) and impaired heart rate variability (HRV). Peripheral AT1 receptor blockade using candesartan lowered MAP in both groups (~10 mm Hg) and improved sBRS and HRV in Beta-exposed lambs to a level similar to control. AT7 receptor blockade by infusion of D-ala Ang-(1–7) (700 ng/kg/min for 45 min) reduced sBRS 46±10 % in Beta-exposed vs in control lambs (p<0.15) and increased MAP in both groups (~6±2 mm Hg). Our data reveal that Beta-exposure impairs sBRS and HRV at a time point preceding the elevation in MAP via mechanisms involving an imbalance in the Ang II/Ang-(1–7) ratio consistent with a progressive loss in Ang-(1–7) function. PMID:22215705

  4. Angiotensin-(1-7) deficiency and baroreflex impairment precede the antenatal Betamethasone exposure-induced elevation in blood pressure.

    Science.gov (United States)

    Shaltout, Hossam A; Rose, James C; Chappell, Mark C; Diz, Debra I

    2012-02-01

    Betamethasone is administered to accelerate lung development and improve survival of premature infants but may be associated with hypertension later in life. In a sheep model of fetal programming resulting from exposure at day 80 of gestation to Betamethasone (Beta-exposed), adult sheep at 6 to 9 months or 1.8 years of age have elevated mean arterial pressure (MAP) and attenuated spontaneous baroreflex sensitivity (sBRS) for control of heart rate compared to age-matched controls associated with imbalances in angiotensin (Ang) II vs Ang-(1-7) tone. At 6 weeks of age, evoked BRS is already low in the Beta-exposed animals. In this study, we assessed the potential contribution of the renin-angiotensin system to the impaired sBRS. Female lambs (6 weeks old) with Beta exposure in utero had similar MAP to control lambs (78±2 vs 77±2 mm Hg, n=4-5 per group), but lower sBRS (8±1 vs 16±3 ms/mm Hg; P<0.05) and impaired heart rate variability. Peripheral AT1 receptor blockade using candesartan lowered MAP in both groups (≈10 mm Hg) and improved sBRS and heart rate variability in Beta-exposed lambs to a level similar to control. AT7 receptor blockade by infusion of D-ala Ang-(1-7) (700 ng/kg/min for 45 minutes) reduced sBRS 46%±10% in Beta-exposed vs in control lambs (P<0.15) and increased MAP in both groups (≈6±2 mm Hg). Our data reveal that Beta exposure impairs sBRS and heart rate variability at a time point preceding the elevation in MAP via mechanisms involving an imbalance in the Ang II/Ang-(1-7) ratio consistent with a progressive loss in Ang-(1-7) function.

  5. Supersaturation of Calcipotriene and Betamethasone Dipropionate in a Novel Aerosol Foam Formulation for Topical Treatment of Psoriasis Provides Enhanced Bioavailability of the Active Ingredients

    OpenAIRE

    2016-01-01

    Introduction Previous studies have demonstrated the superior efficacy of a novel aerosol foam formulation of fixed combination calcipotriene 0.005% (Cal) and betamethasone dipropionate 0.064% (BD), compared with the ointment formulation. The aim of this study is to ascertain whether enhanced bioavailability of the active ingredients due to supersaturation and/or occlusive properties can explain the observed greater clinical efficacy. Methods Solubility and evaporation experiments were conduct...

  6. A Synoviocyte Model for Osteoarthritis and Rheumatoid Arthritis: Response to Ibuprofen, Betamethasone, and Ginger Extract—A Cross-Sectional In Vitro Study

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    Søren Ribel-Madsen

    2012-01-01

    Full Text Available This study aimed at determining if synovial cell cultures from rheumatoid arthritis (RA, osteoarthritis (OA, and healthy controls (HC differ and are suitable disease models in pharmacological studies, and tested their response to some anti-inflammatory drugs. Synovial cells were isolated from synovial membrane or joint fluid. Cells were cultivated and exposed to no or TNF-α stimulation without, or in the presence of, betamethasone, ibuprofen, or a standardized ginger extract. Concentrations of a panel of cytokines, growth factors, and chemokines were mapped for each culture and condition. Our cells secreted an increased amount of the cytokines IL-1β, IL-6, and IL-8 in response to TNF-α stimulation in all conditions. OA cells showed a higher IL-6 and IL-8 and a lower IL-1β production, when not stimulated, than RA and HC cells, which were similar. TNF-α stimulation caused similar IL-1β, IL-6, and IL-8 release in all groups. Ibuprofen showed no effect on cytokine production, while ginger extract was similar to betamethasone. Ginger extract was as effective an anti-inflammatory agent as betamethasone in this in vitro model. Cultured fibroblast-like synoviocytes from OA and RA subjects promise to be a useful pharmacological disease model, but further studies, to support results from such a model are needed.

  7. An open label prospective randomized trial to compare the efficacy of coal tar-salicylic acid ointment versus calcipotriol/betamethasone dipropionate ointment in the treatment of limited chronic plaque psoriasis

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    Sujay Khandpur

    2014-01-01

    Full Text Available Background: Chronic plaque psoriasis is a common papulosquamous skin disorder, for which a number of topical agents are being used including coal tar, topical steroids and more recently topical calcipotriol/betamethasone dipropionate. There is no study comparing purified coal tar preparation with calcipotriol/betamethasone dipropionate ointment in limited chronic plaque psoriasis. Aims and Objectives: A prospective randomized open label controlled trial to compare the efficacy and safety of topical application of coal tar-salicylic acid ointment with calcipotriol/betamethasone dipropionate ointment applied once at night for 12 weeks for the treatment of limited chronic plaque psoriasis. Materials and Methods: A total of 62 patients of limited chronic plaque psoriasis (body surface area <10% were randomized into two treatment groups: Group A received topical application of 6% coal tar with 3% salicylic acid ointment and Group B received calcipotriol/betamethasone dipropionate, once at night for 12 weeks. Results were assessed based on psoriasis area severity index (PASI scores and patient global assessment (PGA at each visit. Results: Mean PASI was significantly lower at week 2 (P = 0.01 and week 4 follow-up (P = 0.05 and the mean reduction in PASI was significantly higher at week 2 (P = 0.02 with calcipotriol/betamethasone than coal tar-salicylic acid, but this difference was not sustained at subsequent follow-up visits. Similarly, PGA scores at weeks 2 and 4 were significantly lower with calcipotriol/betamethasone dipropionate ointment (P = 0.003 and P = 0.007 respectively. There was no significant difference in any parameter during subsequent follow-up visits or at the end of the treatment phase (12 weeks. Conclusion: Topical nightly application of calcipotriol/betamethasone dipropionate ointment leads to an initial, more rapid reduction in disease severity, but the overall outcome parameters are comparable in the two treatment groups.

  8. Impact of tyloxapol to combat acute phase response in comparison with betamethasone and flunixin meglumine following an ovine experimentally induced endotoxemia model

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    Seyed Mohammad Mehdi Heidari

    2016-09-01

    Full Text Available Systemic inflammatory responses to circulating lipopolysaccharide lead to high mortality rates in affected animals and thus effective treatments of this situation are crucial. However, despite different endotoxemia therapeutic regimens, the lack of an effective treatment still remains a clinical problem in sheep. Tyloxapol is a potential pro- and anti-inflammatory molecule to treat endotoxemia in farm animals. Hence, the present study was an attempt to clarify the antiendotoxic effects of tyloxapol in comparison with betamethasone and flunixin meglumine in experimentally induced endotoxemia in sheep. Thirty clinically healthy 1-year old Iranian fat-tailed ewes were randomly divided into 6 equal experimental (n=5 groups, comprising Negative and Positive control, Flunixin meglumine, Betamethasone, Tyloxapol 1 and Tyloxapol 2. Phenol extracted lipopolysaccharide from Escherichia coli serotype O55:B5 was infused at 2 μg/kg intravenously. Ninety min after endotoxemia induction, Flunixin meglumine (2.2 mg/kg, betamethasone (1 mg/kg and tyloxapol (200 and 400 mg/kg were injected to respective groups, over 60 min along with intravenous fluids. Blood samples were collected from all ewes prior and 1.5, 3, 4.5, 6, 24 and 48 hours after lipopolysaccharide injection and sera and plasmas were separated, subsequently. Haptoglobin, serum amyloid A, tumor necrosis factor-alpha, interferon-gamma, superoxide dismutase and glutathione peroxidase were measured in all samples. Serum concentrations of haptoglobin, serum amyloid A, tumor necrosis factor-alpha, interferongamma in Flunixin meglumine group were found to be lower than other experimental ones after hour 3. Serum levels of haptoglobin, serum amyloid A, tumor necrosis factor-alpha, interferon-gamma in Tyloxapol groups were significantly lower and higher than Betamethasone and Flunixin meglumine ones, respectively. Superoxide dismutase and glutathione peroxidase activities in Flunixin meglumine group were

  9. Development and validation of a stability-indicating RP-HPLC method for simultaneous assay of betamethasone dipropionate, chlorocresol, and for the estimation of betamethasone dipropionate related compounds in a pharmaceutical cream and ointment.

    Science.gov (United States)

    Johnston, Stephen E; Gill, Nicole L; Wei, Yu-Chien; Markovich, Robert; Rustum, Abu M

    2010-10-01

    A new stability-indicating reversed-phase HPLC (RP-HPLC) method has been developed and validated for simultaneous assay of betamethasone dipropionate (BD) and chlorocresol and also for the estimation of BD related compounds in a pharmaceutical cream matrix. In addition, this newly developed RP-HPLC method was also demonstrated as suitable for a pharmaceutical ointment product that does not contain chlorocresol. The RP-HPLC method uses a Waters SymmetryShield RP18 analytical column (150 × 4.6 mm). Water (mobile phase A) and acetonitrile (mobile phase B) were used in the gradient elution with a flow rate of 1.5 mL/min and detection wavelength at 240 nm. A Waters XBridge Shield RP18 analytical column (150 × 4.6 mm) was identified as an alternate column. The limit of detection (LOD) and the limit of quantitation (LOQ) are 0.02 μg/mL and 0.05 μg/mL, respectively. The precision of the method for BD is less than 0.3% RSD, and the accuracy of BD ranged from 99.5% to 102.6%. The stability-indicating capability of this method has been demonstrated by analyzing aged samples of the product. This RP-HPLC method was successfully validated per ICH guidelines and proved to be suitable for routine quality control use.

  10. Expert recommendations: the use of the fixed combination calcipotriol and betamethasone dipropionate gel for the topical treatment of psoriasis.

    Science.gov (United States)

    Daudén, E; Bewley, A; Lambert, J; Girolomoni, G; Cambazard, F; Reich, K

    2014-05-01

    Treatment non-adherence is a general challenge and a complex problem. It is a key factor that impacts the 'real-life' effectiveness of topical treatments for chronic disorders, such as psoriasis. Here, we provide our expert opinion on the real-life effectiveness of topical psoriasis treatment, using the fixed combination gel (Daivobet(®) gel; calcipotriol plus betamethasone dipropionate) as a case study. The fixed combination gel is a first-line topical treatment for mild-to-moderate psoriasis, developed to be the gold-standard therapy for psoriasis patients. This fixed combination gel is an effective and well-tolerated topical psoriasis treatment that the majority of our patients prefer to the ointment formulation. We assessed our real-life experience and considered any gaps between daily practice and clinical trials data. We recommend a multifaceted approach to improve real-life effectiveness and bridge the gap between investigational trials and treatment reality and propose the following recommendations: (1) educate primary healthcare providers on how to effectively manage topical psoriasis treatment and the patients who use the treatment; (2) educate the patient on why treatment needs to be maintained, even when symptoms improve; and (3) provide a supportive environment that will not allow the patient to feel abandoned. A patient-centric approach may improve adherence, which will lead to patients receiving more effective treatment for psoriasis.

  11. Antenatal betamethasone produces protracted changes in anxiety-like behaviors and in the expression of microtubule-associated protein 2, brain-derived neurotrophic factor and the tyrosine kinase B receptor in the rat cerebellar cortex.

    Science.gov (United States)

    Pascual, Rodrigo; Valencia, Martina; Bustamante, Carlos

    2015-06-01

    Using classic Golgi staining methods, we previously showed that the administration of synthetic glucocorticoid betamethasone in equivalent doses to those given in cases of human premature birth generates long-term alterations in Purkinje cell dendritic development in the cerebellar cortex. In the present study, we evaluated whether betamethasone alters the immunohistochemical expression of proteins that participate in cerebellar Purkinje cell dendritic development and maintenance, including microtubule-associated protein 2 (MAP2), brain-derived neurotrophic factor (BDNF) and the tyrosine kinase B receptor (TrkB), which are located predominantly in the cerebellar molecular layer where Purkinje cell dendritogenesis occurs. Consistent with our previous Golgi stain studies, we observed that animals prenatally exposed to a single course of betamethasone showed long-term alterations in the expression of MAP2, BDNF and TrkB. Additionally, these protracted molecular changes were accompanied by anxiety-like behaviors in the elevated plus maze and marble burying tests.

  12. Kojic Acid vis-a-vis its Combinations with Hydroquinone and Betamethasone Valerate in Melasma: A Randomized, Single Blind, Comparative Study of Efficacy and Safety

    Science.gov (United States)

    Deo, Kirti S.; Dash, Kedar N.; Sharma, Yugal K.; Virmani, Neha C.; Oberai, Chetan

    2013-01-01

    Background: Melasma is a relatively common, acquired symmetric hypermelanosis characterized by irregular light to gray-brown macules involving sun-exposed areas. Kojic acid, with its depigmenting potential due to tyrosinase inhibition and suppression of melanogenesis, has become a vital component of the dermatologists’ armamentarium against melasma. Aim: To study and compare the efficacy of kojic acid 1% alone, vis-a-vis its separate combinations with 2% hydroquinone or 0.1% betamethasone valerate and a combination of all these three agents with respect to the duration of symptoms and level of pigmentation in the therapy of melasma. Materials and Methods: Eighty patients from a single tertiary care center objectively assessed by calculating the melasma area severity index (MASI) and randomized (simple randomization) into four parallel groups (A, B, C, and D) of 20 each were prescribed once daily local application at night, (participants blinded regarding the difference in identity of interventions), as follows: Group A – kojic acid 1% cream. Group B – kojic acid 1% and hydroquinone 2% cream. Group C – kojic acid 1% and betamethasone valerate 0.1% cream. Group D – kojic acid 1%, hydroquinone 2%, and betamethasone valerate 0.1% cream. Strict photoprotection and use of a SPF 15 sunscreen was advised during the day. Patients were evaluated every 2 weeks and a fall in MASI score was calculated at the end of the study period of 12 weeks by the same investigator. Results: The response was compared according to percentage decrease in MASI score. Efficacy was evaluated among the groups at the end of 3 months using bivariate analysis and calculated by using the paired ‘t’ test. The clinical efficacy of group B was the highest followed closely by group D and group A, that of group C being the lowest. Conclusion: Kojic acid in synergy with hydroquinone is a superior depigmenting agent as compared with other combinations. PMID:23918998

  13. Betametasona e extrato aquoso de Arctium lappa no tratamento da angiostrongilíase Betamethasone and aqueous extract of Arctium lappa for treating angiostrongyliasis

    Directory of Open Access Journals (Sweden)

    Camila Argenta Fante

    2008-12-01

    Full Text Available Angiostrongylus costaricensis é um parasita que causa angiostrongilíase abdominal em humanos, seu tratamento inclui o uso de antiinflamatórios apesar da falta de estudos que justifiquem esta conduta. O objetivo deste artigo é avaliar o efeito da betametasona e da Arctium lappa na evolução de lesões intestinais induzidas pelo parasita. Utilizou-se camundongos Swiss, machos, adultos, distribuídos em 4 grupos: infectados tratados com betametasona; com Arctium lappa; não tratados e grupo controle. Os tratamentos iniciaram no 15º dia de infecção e permaneceram por 15 dias. Infiltrado eosinofílico e granuloma foram avaliados (1-leve; 2-moderado; 3-severo. A betametasona permitiu a evolução das lesões para formas mais graves, enquanto o extrato não interferiu na progressão da patologia. As substâncias empregadas não mostraram eficácia na proteção das lesões induzidas pelo Angiostrongylus costaricensis em camundongos. Estes achados desmotivam o uso de betametasona e Arctium lappa em humanos acometidos por angiostrongilíase abdominal.Angiostrongylus costaricensis is a parasite that causes abdominal angiostrongyliasis in humans. The treatment for it includes the use of anti-inflammatory drugs, despite the lack of studies to justify this approach. The objective of this paper was to evaluate the effect of betamethasone and Arctium lappa on the evolution of intestinal lesions induced by this parasite. Adult male Swiss mice were used, distributed into four groups: infected and treated with betamethasone; infected and treated with Arctium lappa; infected and not treated; and control group. The treatments were started on the 15th day after infection and continued for 15 days. The presence of eosinophilic infiltration and granuloma was evaluated (1-mild; 2-moderate; 3-severe. Betamethasone allowed the lesions to evolve into more severe forms, while the extract did not interfere with disease progression. The substances applied were

  14. Triple combination treatment with fractional CO2 laser plus topical betamethasone solution and narrowband ultraviolet B for refractory vitiligo: a prospective, randomized half-body, comparative study.

    Science.gov (United States)

    Li, Lu; Wu, Yan; Li, Li; Sun, Yan; Qiu, Li; Gao, Xing-Hua; Chen, Hong-Duo

    2015-01-01

    Vitiligo on extremities and/or bony prominences is very resistant to treatment. Twenty-five patients with symmetrical and stable vitiligo on extremities and/or bony prominences were enrolled. The treatment side received fractional carbon dioxide laser followed by topical compound betamethasone solution and narrowband ultraviolet B phototherapy. The control side received laser treatment plus phototherapy. The result of treatment side showed that 44% patients achieved over 50% re-pigmentation and patient satisfaction score was 5.12 ± 3.23, higher than those of control (p vitiligo.

  15. Antenatal betamethasone exposure is associated with lower ANG-(1–7) and increased ACE in the CSF of adult sheep

    Science.gov (United States)

    Marshall, Allyson C.; Shaltout, Hossam A.; Pirro, Nancy T.; Rose, James C.; Diz, Debra I.

    2013-01-01

    Antenatal betamethasone (BM) therapy accelerates lung development in preterm infants but may induce early programming events with long-term cardiovascular consequences. To elucidate these events, we developed a model of programming whereby pregnant ewes are administered BM (2 doses of 0.17 mg/kg) or vehicle at the 80th day of gestation and offspring are delivered at term. BM-exposed (BMX) offspring develop elevated blood pressure; decreased baroreflex sensitivity; and alterations in the circulating, renal, and brain renin-angiotensin systems (RAS) by 6 mo of age. We compared components of the choroid plexus fourth ventricle (ChP4) and cerebral spinal fluid (CSF) RAS between control and BMX male offspring at 6 mo of age. In the choroid plexus, high-molecular-weight renin protein and ANG I-intact angiotensinogen were unchanged between BMX and control animals. Angiotensin-converting enzyme 2 (ACE2) activity was threefold higher than either neprilysin (NEP) or angiotensin 1-converting enzyme (ACE) in control and BMX animals. Moreover, all three enzymes were equally enriched by approximately 2.5-fold in ChP4 brush-border membrane preparations. CSF ANG-(1–7) levels were significantly lower in BMX animals (351.8 ± 76.8 vs. 77.5 ± 29.7 fmol/mg; P < 0.05) and ACE activity was significantly higher (6.6 ± 0.5 vs. 8.9 ± 0.5 fmol·min−1·ml−1; P < 0.05), whereas ACE2 and NEP activities were below measurable limits. A thiol-sensitive peptidase contributed to the majority of ANG-(1–7) metabolism in the CSF, with higher activity in BMX animals. We conclude that in utero BM exposure alters CSF but not ChP RAS components, resulting in lower ANG-(1–7) levels in exposed animals. PMID:23948771

  16. Fetal betamethasone exposure attenuates angiotensin-(1-7)-Mas receptor expression in the dorsal medulla of adult sheep.

    Science.gov (United States)

    Marshall, Allyson C; Shaltout, Hossam A; Nautiyal, Manisha; Rose, James C; Chappell, Mark C; Diz, Debra I

    2013-06-01

    Glucocorticoids including betamethasone (BM) are routinely administered to women entering into early preterm labor to facilitate fetal lung development and decrease infant mortality; however, fetal steroid exposure may lead to deleterious long term consequences. In a sheep model of fetal programming, BM-exposed (BMX) offspring exhibit elevated mean arterial pressure (MAP) and decreased baroreflex sensitivity (BRS) for control of heart rate by 0.5-years of age associated with changes in the circulating and renal renin-angiotensin systems (RAS). In the brain solitary tract nucleus, angiotensin (Ang) II actions through the AT1 receptor oppose the beneficial actions of Ang-(1-7) at the Mas receptor for BRS regulation. Therefore, we examined Ang peptides, angiotensinogen (Aogen), and receptor expression in this brain region of exposed and control offspring of 0.5- and 1.8-years of age. Mas protein expression was significantly lower (>40%) in the dorsal medulla of BMX animals at both ages; however, AT1 receptor expression was not changed. BMX offspring exhibited a higher ratio of Ang II to Ang-(1-7) (2.30±0.36 versus 0.99±0.28; p<0.01) and Ang II to Ang I at 0.5-years. Although total Aogen was unchanged, Ang I-intact Aogen was lower in 0.5-year BMX animals (0.78±0.06 vs. 1.94±0.41; p<0.05) suggesting a greater degree of enzymatic processing of the precursor protein in exposed animals. We conclude that in utero BM exposure promotes an imbalance in the central RAS pathways of Ang II and Ang-(1-7) that may contribute to the elevated MAP and lower BRS in this model.

  17. Antenatal betamethasone exposure is associated with lower ANG-(1-7) and increased ACE in the CSF of adult sheep.

    Science.gov (United States)

    Marshall, Allyson C; Shaltout, Hossam A; Pirro, Nancy T; Rose, James C; Diz, Debra I; Chappell, Mark C

    2013-10-01

    Antenatal betamethasone (BM) therapy accelerates lung development in preterm infants but may induce early programming events with long-term cardiovascular consequences. To elucidate these events, we developed a model of programming whereby pregnant ewes are administered BM (2 doses of 0.17 mg/kg) or vehicle at the 80th day of gestation and offspring are delivered at term. BM-exposed (BMX) offspring develop elevated blood pressure; decreased baroreflex sensitivity; and alterations in the circulating, renal, and brain renin-angiotensin systems (RAS) by 6 mo of age. We compared components of the choroid plexus fourth ventricle (ChP4) and cerebral spinal fluid (CSF) RAS between control and BMX male offspring at 6 mo of age. In the choroid plexus, high-molecular-weight renin protein and ANG I-intact angiotensinogen were unchanged between BMX and control animals. Angiotensin-converting enzyme 2 (ACE2) activity was threefold higher than either neprilysin (NEP) or angiotensin 1-converting enzyme (ACE) in control and BMX animals. Moreover, all three enzymes were equally enriched by approximately 2.5-fold in ChP4 brush-border membrane preparations. CSF ANG-(1-7) levels were significantly lower in BMX animals (351.8 ± 76.8 vs. 77.5 ± 29.7 fmol/mg; P < 0.05) and ACE activity was significantly higher (6.6 ± 0.5 vs. 8.9 ± 0.5 fmol·min(-1)·ml(-1); P < 0.05), whereas ACE2 and NEP activities were below measurable limits. A thiol-sensitive peptidase contributed to the majority of ANG-(1-7) metabolism in the CSF, with higher activity in BMX animals. We conclude that in utero BM exposure alters CSF but not ChP RAS components, resulting in lower ANG-(1-7) levels in exposed animals.

  18. Clinical efficacy of intra-articular injections in knee osteoarthritis: a prospective randomized study comparing hyaluronic acid and betamethasone

    Science.gov (United States)

    Trueba Davalillo, Cesáreo Ángel; Trueba Vasavilbaso, Cesáreo; Navarrete Álvarez, José Mario; Coronel Granado, Pilar; García Jiménez, Ozcar Alejandro; Gimeno del Sol, Mercedes; Gil Orbezo, Félix

    2015-01-01

    Background Osteoarthritis (OA) is the most common joint disease and leading cause of disability. Intra-articular (IA) administration of hyaluronic acid (HA) or corticosteroids (CS) have been previously studied, though using insufficient number of patients or short follow-up periods. Objective We evaluate HA and CS in patients with knee OA in terms of clinical efficacy over 12 months. Methods We used a prospective, randomized study with parallel groups. Randomized patients received IA injections of HA or betamethasone (BM). The primary outcomes were improvement in pain using Visual Analog Scale and function in the Western Ontario and McMaster University Osteoarthritis Index (Likert scale). Follow-up visits were scheduled at 3 months, 6 months, 9 months, and 12 months. Results A total of 200 patients were included. Pain was significantly reduced in both groups at the first follow-ups. At 12 months, the mean pain reduction in the HA group was 33.6% (95% CI: 31.1–36.1) compared to 8.2% (95% CI: 5.2–11.1) in BM (P<0.0001). Function improvement was higher in HA through every visit, and mean improvement at 12 months was 47.5% (95% CI: 45.6–49.3) in HA patients vs 13.2% (95% CI: 11.4–14.9) in the BM group (P<0.0001). All patients from both groups achieved the Minimal Clinically Important Improvement (MCII) for both pain and function up to 6 months. At 9 months and 12 months, the MCII figures were higher in HA group with ≥80% compared to ≤10% in BM group (P<0.0001). Adverse reactions were rare and related to the administration procedure. Conclusion Both treatments effectively controlled OA symptoms. BM showed higher short-term effectiveness, while HA showed better long-term effectiveness, maintaining clinical efficacy in a large number of patients 1 year after administration.

  19. Therapeutic effect of topical application of linoleic acid and lincomycin in combination with betamethasone valerate in melasma patients.

    Science.gov (United States)

    Lee, Mu-Hyoung; Kim, Hyun-Jin; Ha, Dong-Ju; Paik, Jong-Hyun; Kim, Hong-Yong

    2002-01-01

    Melasma is an acquired symmetric hypermelanosis characterized by irregular light-to gray-brown macules and patches on sun-exposed areas. Many therapeutic agents are available but are unsatisfactory. Recently, it has been demonstrated that lincomycin (LM) and linoleic acid (LA) can inhibit melanogenesis in vitro. Our purpose was to investigate the clinical efficacy of topical application of LM and LA in combination with betamethasone valerate (BV) in melasma patients. Forty-seven Korean female adults with clinically diagnosed melasma were enrolled in a 6-week, double-blind, randomized clinical trial. Patients were treated with one application of the vehicle (group A), 2% LM mixed with 0.05% BV (group B), or 2% LM mixed with 0.05% BV and 2% LA (group C) on the face every night. Determination of efficacy was based on the Melasma Area and Severity Index (MASI) score and objective assessment (no effect, mild, moderate, or excellent) at intervals of 2 weeks until the end of the study at 6 weeks. After 6 weeks, in comparison with the pre-treatment MASI score, the average MASI score of group C decreased to 68.9%, compared with 98% in group A (p<0.05) and 85.4% in group B. There was no statistically significant difference between group A and group B. Seven patients (43.7%) in group C revealed more than moderate improvement in objective assessment, compared with none in group A and two patients (12.5%) in group B. There were no significant side effects. Topical application of linoleic acid is considered to be effective in the treatment of melasma patients. PMID:12172049

  20. Feasibility of measuring the bioavailability of topical betamethasone dipropionate in commercial formulations using drug content in skin and a skin blanching bioassay.

    Science.gov (United States)

    Pershing, L K; Silver, B S; Krueger, G G; Shah, V P; Skelley, J P

    1992-01-01

    An in vivo technique has been developed which simultaneously compares a skin blanching bioassay with drug content in human stratum corneum following topical application of four 0.05% betamethasone dipropionate formulations. Bioavailability of drug from commercial cream and ointment formulations was assessed by quantification of drug content in tape-stripped stratum corneum and skin blanching in the treated skin site under occluded conditions. Tape-stripping removed stratum corneum to a varying degree between individuals but was consistent (35%) within an individual with all formulations, day to day. A correlation (r = 0.9935) between the amount of drug in the treated stratum corneum normalized for surface area and the corresponding skin blanching score was observed with four 0.05% betamethasone dipropionate formulations. Increasing the amount of drug in the tape-stripped stratum corneum correlated with an increased skin blanching score. Ointment formulations delivered more drug to the skin and produced greater blanching scores than the cream formulations. Topical corticosteroid content in the treated skin site can therefore be quantified and correlates well with the resulting pharmacodynamic activity.

  1. Acute AT(1)-receptor blockade reverses the hemodynamic and baroreflex impairment in adult sheep exposed to antenatal betamethasone.

    Science.gov (United States)

    Shaltout, Hossam A; Rose, James C; Figueroa, Jorge P; Chappell, Mark C; Diz, Debra I; Averill, David B

    2010-08-01

    To accelerate lung development and protect neonates from other early developmental problems, synthetic steroids are administered maternally in the third trimester, exposing fetuses that are candidates for premature delivery to them. However, steroid exposure at this point of gestation may lead to elevated blood pressure [mean arterial pressure (MAP)] during adolescence. We hypothesize that fetal exposure to steroids activates the renin-angiotensin system, inducing an elevation in blood pressure and attenuation of baroreflex sensitivity (BRS) that is angiotensin II dependent in early adulthood. To test this hypothesis, fetal sheep were exposed to betamethasone (Beta) or vehicle (control) administered to ewes at day 80 of gestation and delivered at full term. At 1.8 yr of age, male offspring were instrumented for conscious recording of MAP, heart rate, and measurement of BRS [as low-frequency-alpha, high-frequency-alpha, sequence (seq) UP, seq DOWN, and seq TOTAL]. Beta-exposed sheep (n = 6) had higher MAP than control sheep (n = 5) (93 + or - 2 vs. 84 + or - 2 mmHg, P < 0.01). Acute blockade of angiotensin type 1 receptors with candesartan (0.3 mg/kg iv) normalized MAP in Beta-exposed sheep (85 + or - 4 mmHg), with no effect in control sheep (82 + or - 3 mmHg). Before angiotensin type 1 blockade, BRS maximum gain was significantly lower in Beta-exposed vs. control sheep (11 + or - 3 vs. 26 + or - 3 ms/mmHg, P < 0.0.01). However, 45 min after candesartan injection, BRS was increased in Beta-exposed (21 + or - 5 ms/mmHg) and control (35 + or - 4 ms/mmHg) sheep. Heart rate variability (HRV) and blood pressure variability (BPV) revealed lower HRV (SD of beat-to-beat interval and root mean square of successive beat-to-beat differences in R-R interval duration) and higher BPV (SD of MAP, systolic arterial pressure in low-frequency range) in Beta-exposed sheep. Candesartan partially restored HRV in Beta-exposed sheep and fully corrected BPV. Thus, in utero exposure to

  2. Clinical efficacy of intra-articular injections in knee osteoarthritis: a prospective randomized study comparing hyaluronic acid and betamethasone

    Directory of Open Access Journals (Sweden)

    Trueba Davalillo CA

    2015-01-01

    Full Text Available Cesáreo Ángel Trueba Davalillo,1,2 Cesáreo Trueba Vasavilbaso,2 José Mario Navarrete Álvarez,2 Pilar Coronel Granado,3 Ozcar Alejandro García Jiménez,2 Mercedes Gimeno del Sol,3 Félix Gil Orbezo2 1School of Medicine (UNAM, México DF, Mexico; 2Orthopedic Service, Hospital Español de México, México DF, Mexico; 3Scientific Department, TEDEC-MEIJI FARMA,SA, Alcalá de Henares, Spain Background: Osteoarthritis (OA is the most common joint disease and leading cause of disability. Intra-articular (IA administration of hyaluronic acid (HA or corticosteroids (CS have been previously studied, though using insufficient number of patients or short follow-up periods.Objective: We evaluate HA and CS in patients with knee OA in terms of clinical efficacy over 12 months.Methods: We used a prospective, randomized study with parallel groups. Randomized patients received IA injections of HA or betamethasone (BM. The primary outcomes were improvement in pain using Visual Analog Scale and function in the Western Ontario and McMaster University Osteoarthritis Index (Likert scale. Follow-up visits were scheduled at 3 months, 6 months, 9 months, and 12 months.Results: A total of 200 patients were included. Pain was significantly reduced in both groups at the first follow-ups. At 12 months, the mean pain reduction in the HA group was 33.6% (95% CI: 31.1–36.1 compared to 8.2% (95% CI: 5.2–11.1 in BM (P<0.0001. Function improvement was higher in HA through every visit, and mean improvement at 12 months was 47.5% (95% CI: 45.6–49.3 in HA patients vs 13.2% (95% CI: 11.4–14.9 in the BM group (P<0.0001. All patients from both groups achieved the Minimal Clinically Important Improvement (MCII for both pain and function up to 6 months. At 9 months and 12 months, the MCII figures were higher in HA group with ≥80% compared to ≤10% in BM group (P<0.0001. Adverse reactions were rare and related to the administration procedure.Conclusion: Both treatments

  3. Formulation factors affecting the isomerization rate of betamethasone-17-valerate in a developmental hydrophilic cream - a HPLC and microscopy based stability study.

    Science.gov (United States)

    Byrne, Jonathan; Wyraz, Anke; Velasco-Torrijos, Trinidad; Reinhardt, Robert

    2016-02-19

    The formulation of betamethasone-17-valerate (BV) into topical medicines presents a significant challenge for the formulation chemist. The substance is susceptible to acid and base catalyzed isomerization in aqueous environments, which results in valerate transesterification from carbon 17 to carbon 21 of the steroid ring system. This acyl migration process is of significant clinical importance since the 21-valerate ester possesses only a fraction of the potency of the 17-valerate parent compound. Isomerization of BV should therefore be reduced to a minimum through design of a suitable drug vehicle. In this study, the effect of varying the concentration of several excipient components on the isomerization rate of betamethasone valerate in a model hydrophilic cream has been investigated. These excipients include the emulsifier macrogolstearylether-20/21, the co-emulsifier cetylstearyl alcohol and the thickening agent hydroxyl propyl methylcellulose. Additionally, the influence of pH, the presence of the antioxidant, alpha-tocopherol, as well as the chelating agent, disodium edetate, on the stability of the formulation have been investigated. Trial drug product formulations, which were designed to investigate the influence of the above-mentioned components/parameters were manufactured and their stability was tested according to current ICH Guidelines. The content, purity and crystalline structure of the active substance in these formulations was analyzed by a combination of HPLC and microscopy techniques. The study demonstrates that the rate of isomerization of betamethasone valerate depends significantly on the concentration of emulsifier used in the cream formulation. At higher concentrations of emulsifier the isomerization proceeds rapidly with significant degradation over a period of weeks, whereas at lower concentrations significant degradation may not be observed, even after several years' storage. The influence of the emulsifier has been shown to be

  4. An efficient new formulation of fusidic acid and betamethasone 17-valerate (fucicort lipid cream) for treatment of clinically infected atopic dermatitis

    DEFF Research Database (Denmark)

    Larsen, Finn Schultz; Simonsen, Lene; Melgaard, Anita

    2007-01-01

    To relieve the dryness of atopic dermatitis skin, a lipid formulation of fusidic acid and betamethasone 17-valerate (Fucicort Lipid cream) was developed as an additional treatment option to the established Fucicort cream. The two formulations were compared in patients with clinically infected...... atopic dermatitis. A total of 629 patients were randomized to twice daily double-blind treatment for 2 weeks with either Fucicort Lipid cream, Fucicort cream, or the new lipid cream vehicle. Clinical assessment was based on a Total Severity Score of the eczematous lesions. Bacteriological samples were...... taken at inclusion and at subsequent visit(s) if clinically infected lesions persisted. At the end of treatment, the mean reduction in Total Severity score was 82.9% in the lipid cream group, 82.7% in the cream group, and 33.0% in the vehicle group. The percentage of patients with a successful...

  5. A SynoviocyteModel for Osteoarthritis and Rheumatoid Arthritis: Response to Ibuprofen, Betamethasone, and Ginger Extract—A Cross-Sectional In Vitro Study

    DEFF Research Database (Denmark)

    Ribel-Madsen, Søren; Bartels, Else Marie; Stockmarr, Anders

    2012-01-01

    This study aimed at determining if synovial cell cultures from rheumatoid arthritis (RA), osteoarthritis (OA), and healthy controls (HC) differ and are suitable disease models in pharmacological studies, and tested their response to some anti-inflammatory drugs. Synovial cells were isolated from...... cells secreted an increased amount of the cytokines IL-1β, IL-6, and IL-8 in response to TNF-α stimulation in all conditions. OA cells showed a higher IL-6 and IL-8 and a lower IL-1β production, when not stimulated, than RA and HC cells, which were similar. TNF-α stimulation caused similar IL-1β, IL-6...... synovial membrane or joint fluid. Cells were cultivated and exposed to no or TNF-α stimulation without, or in the presence of, betamethasone, ibuprofen, or a standardized ginger extract. Concentrations of a panel of cytokines, growth factors, and chemokines were mapped for each culture and condition. Our...

  6. Domoprednate (Stermonid), a topical D-homocorticosteroid, skin atrophy and telangiectasia. A double-blind, randomized comparison with hydrocortisone butyrate, betamethasone valerate, clobetasole propionate and placebo.

    Science.gov (United States)

    Serup, J; Holm, P

    1985-01-01

    Five corticosteroid ointments and placebo were compared in 17 volunteers with regard to their influence on normal skin under occlusive conditions. Each volunteer had six simultaneous applications on the forearms and six on the back. The trial was double-blind and lasted 4 weeks. The ointments were placed in randomized order. The treatments were 0.1 and 0.03% domoprednate, 0.1% hydrocortisone butyrate, 0.1% betamethasone valerate, 0.05% clobetasole propionate and placebo. Skin thickness was measured on days 0, 7, 14, 21 and 28, transepidermal water loss on days 0, 14 and 28, while blood flow and telangiectasias were evaluated only on day 28 at termination of the trial. The skin thickness became significantly reduced on all corticosteroids, but not on placebo; 0.03% domoprednate, however, tended to have an intermediate position between placebo and the other ointments. The transepidermal water loss did not change. Rating of telangiectasia under stereomicroscope showed a significantly lower score after 0.03% domoprednate and placebo as compared to the other ointments. Assessment of telangiectasia by laser-Doppler flowmetry showed a similar tendency. It is concluded that 0.1% domoprednate is comparable to other topical corticosteroids with respect to atrophogeneity and formation of telangiectasia, but the 0.03% concentration seems to result in fewer side effects.

  7. Full spectrum and selected spectrum based multivariate calibration methods for simultaneous determination of betamethasone dipropionate, clotrimazole and benzyl alcohol: Development, validation and application on commercial dosage form

    Science.gov (United States)

    Darwish, Hany W.; Elzanfaly, Eman S.; Saad, Ahmed S.; Abdelaleem, Abdelaziz El-Bayoumi

    2016-12-01

    Five different chemometric methods were developed for the simultaneous determination of betamethasone dipropionate (BMD), clotrimazole (CT) and benzyl alcohol (BA) in their combined dosage form (Lotriderm® cream). The applied methods included three full spectrum based chemometric techniques; namely principal component regression (PCR), Partial Least Squares (PLS) and Artificial Neural Networks (ANN), while the other two methods were PLS and ANN preceded by genetic algorithm procedure (GA-PLS and GA-ANN) as a wavelength selection procedure. A multilevel multifactor experimental design was adopted for proper construction of the models. A validation set composed of 12 mixtures containing different ratios of the three analytes was used to evaluate the predictive power of the suggested models. All the proposed methods except ANN, were successfully applied for the analysis of their pharmaceutical formulation (Lotriderm® cream). Results demonstrated the efficiency of the four methods as quantitative tool for analysis of the three analytes without prior separation procedures and without any interference from the co-formulated excipient. Additionally, the work highlighted the effect of GA on increasing the predictive power of PLS and ANN models.

  8. 钙泊三醇倍他米松软膏治疗非泛发型白癜风的疗效观察%Effect of calcipotriol betamethasone ointment on treatment of non-generalized vitiligo

    Institute of Scientific and Technical Information of China (English)

    周隽; 李剑; 傅雯雯

    2013-01-01

    目的 观察钙泊三醇倍他米松软膏治疗非泛发型白癜风的临床疗效和安全性.方法 51例非泛发型白癜风患者外用钙泊三醇倍他米松软膏,每日1次涂于患处,连续使用3个月,每月1次观察临床疗效及不良反应.结果 51例患者中,痊愈8例,显效21例,好转10例,无效12例;显效率56.86%(29/51,复色面积≥50%),有效率76.47%(39/51,复色面积≥10%).结论 钙泊三醇倍他米松软膏治疗非泛发型白癜风安全、有效,不良反应小.%Objective To evaluate the therapeutic effect and safety of calcipotriol betamethasone ointment on the treatment of non-generalized vitiligo. Methods Calcipotriol betamethasone ointment was topically applied to the vitiliginous patches once daily in 51 patients with non-generalized vitiligo for 3 months, and the therapeutic effect and adverse effect were observed in each month. Results Of these 51 patients, 8 had complete repigmentation, 21 achieved excellent response, 10 experienced improvement, and the other 12 achieved almost no response. The excellent response rate was 56.86% (29/51, area of repigmentation ≥ 50% ), and the effective rate was 76.47% (39/51, area of repigmentation ≥ 10%). Conclusion Calcipotriol betamethasone ointment is effective and safe in the treatment of vitiligo, with less adverse effect.

  9. Study Of Topical Anti-Inflammatory Potency And Clinical Efficacy Of Formulations Of Mometasone And Betamethasone By Cutaneous Blood Flow Measurements In Psoriatic Patients Using Laser Doppler Velocimetry

    Directory of Open Access Journals (Sweden)

    Mulekar S. V

    1997-01-01

    Full Text Available Laser Doppier Velocimetry (LDV was used to measure cutaneous blood flow (CBF in psoriatic skin lesions to assess the effect of once daily application of Mometasone furoate (MF in a base claimed to possess a “reservoir” effect, as against Betamethasone-17-valarate (BV in a conventional cream base, applied twice daily, for 4 weeks. Bilaterally symmetrical active lesions were studied in 10 psoriatics, at baseline and at the end of 2 and 4 weeks’ treatment. The formulations were also evaluated for topical anti-inflammatory potency in terms of their ability to inhibit the Post-Ischaemic-Reactive-Hyperaemic-Response (PIRHR induced on normal uninvolved skin treated under occlusion. The lesions were also assessed subjectively for clinical Psoriatic Hyperaemia Index (PHI = CBF on lesions/CBF on uninvolved skin: 8.42 + 1.74 & 10.13 + 1.70 correlating with high CPI (9 + 0.50 & 9.1 + 0.51. During treatment with MF or BV, the lesions resolved rapidly, with a concomitant decrease in PHI and CPI (Week 2 : PHI = 3.40 + 0.46 & 5.19 + 1.65, CPI = 4.15 + 0.86& 5.20 + 0.87 and Week 4 : PHI = 1.99 + 0.23 & 2.81 + 0.74 CPI = 2.00 + 0.50 & 2.88 + 0.72 respectively. The two formulations Inhibited PIRHR to same extent (auc/min: Control = 1871 + 399.22, MF = 536.11 + 153.34 & BV = 567.5 + 110.76, indicating equal potency. The results show that pharmaceutical factor such as vehicle can significantly influence the clinical efficacy of corticoids.

  10. Long-term betamethasone 21-phosphate disodium treatment has distinct effects in CD1 and DBA/2 mice on animal behavior accompanied by opposite effects on neurogenesis.

    Science.gov (United States)

    Aiello, Rossana; Crupi, Rosalia; Leo, Antonio; Chimirri, Serafina; Rispoli, Vincenzo; Marra, Rosario; Citraro, Rita; Cuzzocrea, Salvatore; De Sarro, Giovambattista; Russo, Emilio

    2015-02-01

    One of the most peculiar characteristics of the stress response is the pronounced inter-individual and inter-strain variability both in behavioral and neurochemical outcomes. Several studies confirm that rodents belonging to the same or different strain and/or gender, when exposed to a stressor, may show behavioral and cognitive differences. We compared the effects of long-term betamethasone 21-phosphate disodium (BTM), a widely clinically used corticosteroid, on animal behavior and neurogenesis in CD1 and DBA/2 mice. BTM treatment, in CD1 mice, increased body weight gain and anxiety parameters while having pro-depressant effects. Furthermore, BTM significantly reduced neurogenesis in the dentate gyrus of the hippocampus. Finally, BTM treatment induced a significant impairment in memory and learning performance in the Morris water maze. At odds, BTM administration, in DBA/2 mice, caused a significant reduction in the body weight while not modifying anxiety parameters. In addition, both an increased synaptogenesis and neurogenesis were found. Similarly to CD1 mice, also in DBA/2 mice, memory and learning were impaired. Our data confirm that long-term exposure to corticosteroids can generate or aggravate psychiatric/neurologic disorders such as depression, anxiety, memory and learning. Our study did not reveal significant differences between corticosterone and BTM treatment in CD1 mice. In contrast, BTM treatment in mice with an anxious phenotype (DBA/2 mice) revealed some contrasting results indicating that genetic factors can influence corticosteroids dependent effects. Finally, our data further underline the need for a re-evaluation of neurogenesis role; the increased neurogenesis observed in DBA/2 mice and behavioral effects might be distinguished phenomena.

  11. Effect of a treat-to-target strategy based on methotrexate and intra-articular betamethasone with or without additional cyclosporin on MRI-assessed synovitis, osteitis, tenosynovitis, bone erosion, and joint space narrowing in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Møller-Bisgaard, S; Ejbjerg, B J; Eshed, I;

    2017-01-01

    OBJECTIVES: To investigate whether a treat-to-target strategy based on methotrexate (MTX) and intra-articular (IA) betamethasone suppresses magnetic resonance imaging (MRI)-determined measures of disease activity and reduces joint destruction in early rheumatoid arthritis (eRA) patients, and to i......OBJECTIVES: To investigate whether a treat-to-target strategy based on methotrexate (MTX) and intra-articular (IA) betamethasone suppresses magnetic resonance imaging (MRI)-determined measures of disease activity and reduces joint destruction in early rheumatoid arthritis (eRA) patients......, and to investigate whether concomitant cyclosporin A (CyA) provides an additional effect. METHOD: In the 2-year randomized, double-blind, treat-to-target trial CIMESTRA, 160 patients with eRA (... no consistent statistically significant differences between treatment groups. CONCLUSIONS: In this eRA treat-to-target trial, MTX and intra-articular glucocorticoids markedly reduced, but did not eliminate, MRI osteitis, synovitis, and tenosynovitis. Accordingly, minimal but statistically significant increases...

  12. Evaluation of human skin tolerance to creams containing tazarotene and betamethasone dipropionate%他扎罗汀倍他米松乳膏人体皮肤耐受性研究

    Institute of Scientific and Technical Information of China (English)

    宗文凯; 吴黎莉; 陈沄; 佘晓东; 陈正琴; 吴国华

    2015-01-01

    Objective To evaluate skin tolerance to creams containing different concentrations of tazarotene and betamethasone dipropionate in healthy volunteers after single or multiple applications,and to predict potential adverse effects of these creams as well as their degree.Methods Thirty-four healthy volunteers were enrolled in a single-dose trial group,and divided into six subgroups to receive single session of topical treatment with creams containing tazarotene and betamethasone dipropionate both at the concentrations of 0.025%,0.05%,0.1%,0.15%,0.2% and 0.25% respectively.Another 12 healthy volunteers were enrolled in a multiple-dose trial group,and divided into two subgroups to topically apply creams containing tazarotene and betamethasone dipropionate both at the concentrations of 0.2% and 0.15%,respectively,once a day for 7 consecutive days.General status and subjective feelings of these testees were evaluated,skin reactions at application sites were observed,and routine laboratory examinations (including routine blood test,routine urine test,hepatic and renal function examination) were performed,before and after the application of these creams in both single-and multiple-dose trials.Endogenous cortisol levels were measured before and 7,14 days after the initial application of the creams,and the amount of drugs percutaneously absorbed into systemic circulation was determined before and 1,3,5,7 days after that in the multiple-dose trial.Results No serious adverse events were found in the study.In the single-dose trial,the testees showed no drug-related adverse reactions or abnormal changes in test patameters after the application of the creams.In the multiple-dose trial,no aberrant skin reaction or self-reported discomfort was noted in any of the testees from day 0 to 7 after the first initial application of the creams,but mild irritation occurred in 5 out of 6 volunteers applying the cream containing 0.2% tazarotene and 0.2% betamethasone

  13. Enhanced therapeutic anti-inflammatory effect of betamethasone on topical administration with low-frequency, low-intensity (20 kHz, 100 mW/cm(2)) ultrasound exposure on carrageenan-induced arthritis in a mouse model.

    Science.gov (United States)

    Cohen, Gadi; Natsheh, Hiba; Sunny, Youhan; Bawiec, Christopher R; Touitou, Elka; Lerman, Melissa A; Lazarovici, Philip; Lewin, Peter A

    2015-09-01

    The purpose of this work was to investigate whether low-frequency, low-intensity (20 kHz, mW/cm(2), spatial-peak, temporal-peak intensity) ultrasound, delivered with a lightweight (imaged by measuring glycolytic activity with near-infrared labeled 2-deoxyglucose. The outcome of the experiments indicated that the combination of ultrasound exposure and topical application of 0.1% (w/w) betamethasone gel resulted in statistically significantly (p < 0.05) enhanced anti-inflammatory activity in comparison with drug or ultrasound treatment alone. The present study underscores the potential benefits of low-frequency, low-intensity ultrasound-assisted drug delivery. However, the proof of concept presented indicates the need for additional experiments to systematically evaluate and optimize the potential of, and the conditions for, tolerable low-frequency, low-intensity ultrasound-promoted non-invasive drug delivery.

  14. The effects of intrathecal administration of betamethasone over the dogs' spinal cord and meninges Efeitos determinados na medula e nas meninges pela administração subaracnóidea de betametasona em cães

    Directory of Open Access Journals (Sweden)

    Guilherme Antonio Moreira de Barros

    2007-10-01

    Full Text Available PURPOSE: To determinate the potential clinical and histological changes due the injection of betamethasone, when administered into the canine intrathecal space. METHODS: Twenty one animals were included in a random and blind manner in the study. After general anesthesia, intrathecal puncture was performed and 1 ml of the random solution was injected. The G1 dogs received 0.9% saline solution, the G2 dogs received 1.75 mg betamethasone and the G3 dogs received 3.5 mg of betamethasone. The animals were clinically evaluated for 21 days and then sacrificed. The lumbar and sacral portions of the spinal cord were removed for light microscopy histological analyses. RESULTS: No clinical changes were observed in any of the animals included in this study. No histological changes were observed in G1 animals. Inflammatory infiltration was observed in two dogs, one in G2, another in G3. Hemorrhage and necrosis were also seen in the G2 dog which inflammatory infiltration was detected. In other two dogs, one from G2 and another from G3, there was discreet fibrosis and thickness of the arachnoid layer which was focal in one and diffuse in the other. CONCLUSION: Intrathecal administration of betamethasone caused histological changes in the spinal cord and meninges in some of the dogs involved in this study.OBJETIVO: Determinar possíveis alterações clínicas e histológicas determinadas pela administração da betametasona no espaço subaracnóideo de cães. MÉTODOS: Vinte e um cães foram incluídos no estudo de forma aleatória e encoberta. Depois de anestesiados, os cães foram submetidos a punção subaracóidea com injeção de 1 ml da solução sorteada. Os animais receberam solução salina 0,9% em G1, betametasona na dose de 1,75 mg em G2 e betametasona na dose de 3,5 mg em G3. Todos os animais foram mantidos em observação clínica por 21 dias, sendo posteriormente sacrificados. Porções da medula espinhal e sacral foram removidas para an

  15. Doppler de las arterias pulmonares fetales posterior al uso de betametasona para la maduración pulmonar (Fetal lung arteries Doppler after to use of betamethasone for lung maturation

    Directory of Open Access Journals (Sweden)

    Keibis Jiménez Castillejo

    2014-06-01

    Full Text Available Resumen (español El objetivo de la investigación fue determinar las modificaciones del Doppler de las arterias pulmonares fetales posterior al uso de betametasona para la maduración pulmonar. Se realizó una investigación de tipo explicativa, prospectiva y longitudinal con un diseño cuasi-experimental y una muestra no probabilística intencional de 106 pacientes que acudieron a la consulta Pre-natal de Alto Riesgo del Hospital Central “Dr. Urquinaona". Una vez seleccionadas las pacientes se les administró inyecciones intramusculares de betametasona (12 mg/día por dos días consecutivos. Se realizaron las mediciones de índice de pulsatilidad, índice de resistencia y relación sistólico / diastólica de las arterias pulmonares fetales. Se observó disminución significativa de los valores promedio del índice de pulsatilidad en la segunda medición comparado con la medición inicial (p < 0,05. Sin embargo, el promedio de la tercera medición no mostró diferencia significativas con los valores iniciales (p = ns. El índice de resistencia disminuyó en la segunda medición para luego aumentar en la tercera medición comparado con el valor inicial (p < 0,05 para las dos mediciones. El valor promedio de la relación sistólico / diastólica presentó disminución significativa durante la segunda medición para luego presentar un aumento significativo al momento de la tercera medición comparado con el valor inicial (p < 0,05 para las dos mediciones. Se concluye que el uso de betametasona para la inducción de la maduración pulmonar produce modificaciones en las mediciones Doppler de las arterias pulmonares fetales. Abstract (english The objective of research was to determine Doppler modifications of fetal pulmonary arteries after use of betamethasone for lung maturation. An explicative, prospective and longitudinal research was done with a quasi-experimental design and an intentional non-probabilistic sample of 106 patients who assisted

  16. An RP-HPLC Method for the Stability-Indicating Analysis of Impurities of Both Fusidic Acid and Betamethasone-17-Valerate in a Semi-Solid Pharmaceutical Dosage Form.

    Science.gov (United States)

    Byrne, Jonathan; Velasco-Torrijos, Trinidad; Reinhardt, Robert

    2015-10-01

    A topical pharmaceutical cream containing the active pharmaceutical ingredients (APIs) betamethasone-17-valerate and fusidic acid has been developed for the treatment of inflammatory skin conditions and associated secondary infections. In this work, a novel stability-indicating RP-HPLC method has been developed for the simultaneous quantitation of impurities of both APIs present in this cream. The HPLC column was a 150 mm × 4.6 mm I.D. YMC-Pack Pro C18 column with 3 µm particles. The column-oven temperature was maintained at 40°C and UV detection at 235 nm was used. A gradient programme was employed at a flow rate of 0.7 mL/min. Mobile phase A comprised of a 16:21:21:42 (v/v/v/v) mixture of methanol, 10 g/L phosphoric acid, HPLC grade water and acetonitrile. Mobile phase B comprised of a 24:5:5:66 (v/v/v/v) mixture of methanol, 10 g/L phosphoric acid, HPLC grade water and acetonitrile. The method has been validated according to current International Conference on Harmonisation (ICH) guidelines and applied during formulation development and stability studies. The procedure has been shown to be stability-indicating for the topical cream.

  17. StudyofCompoundBetamethasoneInjectionCombinedwithUreaCreaminTreatmentof138CasesofHandEczema%复方倍他米松局部注射联合尿素乳膏治疗138例手部湿疹的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张连清

    2013-01-01

    Objective Appraisal compound prescription betamethasone partial injection union urea cream treatment hand eczema curative effect. Method Will be selected 138 example patients divide into the treatment group and the control group stochastically, the treatment group compound prescription betamethasone partial injection unite 10%urea cream external use, Topical creams halometasone control group and 10%urea cream, were treated for 4 weeks. Records and adverse reactions during treatment. Results After the treatment had ended, the treatment group and control group effectiveness respectively are 87.32%and 56.72%, the difference has statistics signiifcance (P=0.001). Conclusion Compound prescription betamethasone partial injection union urea cream treatment hand eczema safe effective, improved patient's quality of life obviously.%  目的评价复方倍他米松局部注射联合尿素乳膏治疗手部湿疹疗效。方法将入选的138例患者随机分为治疗组和对照组,治疗组复方倍他米松局部注射联合10%尿素乳膏外用,对照组卤米松乳膏和10%尿素乳膏外用,共治疗4周,记录治疗过程及不良反应。结果治疗结束后,治疗组和对照组有效率分别为87.32%和56.72%,差异有统计学意义(P=0.001)。结论复方倍他米松局部注射联合尿素乳膏治疗手部湿疹安全有效,明显提高了患者的生活质量。

  18. Effect of Betamethasone on Neonatal Outcomes in Twin Pregnancies Delivered by Elective Caesarean Section%倍他米松对双胎择期剖宫产新生儿结局作用探讨

    Institute of Scientific and Technical Information of China (English)

    高岩; 杜晓红; 董江华; 周羽

    2013-01-01

    Objective:To explore the impact of antenatal betamethasone on neonatal morbidity and mortality in twin pregnancies delivered by elective prelabor caesarean section.Methods:The clinical data of 72 cases of twin pregnancies (study group) delivered by elective prelabor caesarean section from January 2011 to February 2012 in Sichuan Provincial Hospital for Women and Children were retrospectively analyzed.156 cases of singleton pregnancies delivered by elective prelabor caesarean section at same period were included as control group.Both singletons and twins caesarean delivery were undertaken electively only after prophylactic antenatal betamethasone administration.The neonatal outcomes were compared between the two groups.Results:There was no difference between the distribution of gestational age and the mean gestational age(P >0.05).The birth weight in study group was lower than that in control group,the difference was statistically significant(P < 0.05).There was no difference between the groups in Apgar scores,neonatal deaths,and morbidity of neonatal diseases such as NRDS(2.78% & 2.56%),PPHN(0.69% & 1.28%),IVH(2.78% & 3.21%),NEC(2.08% & 1.28%).The proportion of NICU and hospital stays in NICU in research group was significantly higher than that in control group (P < 0.05).Conclusions:Antenatal betamethasone for the prevention neonatal morbidity and mortality in twins after elective prelabor caesarean section is as effective as singletons.%目的:探讨倍他米松对双胎妊娠择期剖宫产新生儿结局的影响.方法:对2011年1月至2012年2月在四川省妇幼保健院临产前行择期剖宫产的72例双胎妊娠(研究组)临床资料进行回顾性分析,选择同期156例单胎妊娠作为对照组,两组患者剖宫产前均常规预防性使用倍他米松,比较两组新生儿结局.结果:两组在分娩孕周分布、平均孕周比较,差异无统计学意义(P>0.05);但研究组新生儿体重低于对照

  19. Combination of intraarticular injection of hyaluronate and pain-point injection of betamethasone for improving the pain symptom in patients with osseous gonarthritis%玻璃酸钠关节腔内注射结合倍他米松痛点注射改善骨性膝关节炎患者的疼痛症状

    Institute of Scientific and Technical Information of China (English)

    罗芳; 许长洪; 王恩真

    2005-01-01

    BACKGROUND: Conservative treatment of osseous gonarthritis (OG) is mainly to reduce the loading of knee joint and maintain muscle exercise,and non-steroidal anti-inflammatory drugs serve as supplements in case of acute occurrence.OBJECTIVE: To investigate the effect of combination of intraarticular in jection of hyaluronate and pain-point injection of betamethasone in improving the pain symptom in patients with OG.DESIGN: Open experiment.SETTING: Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: We selected 45 OG patients, who were aged 40 to 85years and received treatment in the clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between January 2004 and October 2004.METHODS: OG parenteral solution was intraarticularly injected into the knee joint, 2.5 mL once a week, 5 weeks set as a disease course. Pain points around knee joint were searched for following thorough physical examination. Anti-inflammatory analgesic solution of 2.0-3.0 mL was injected at each pain point. Physical examination was repeated before treatment in each week. Injection at pain points was maintained if they were still present. Intraarticular injection of hyaluronate was performed only when the pain points disappeared after treatment.MAIN OUTCOME MEASURES: ① Pain score at rest and at exercise.② Time when pain disappeared and times of betamethasone administration.RESULTS: Totally 45 patients entered the result analysis. ① Pain at rest and at exercise 1 week after combination treatment of intraarticular injection of hyaluronate and pain-point injection of betamethasone was ignificantly lessened compared to that before treatment (P < 0.01). Pain relief was more significant at rest than at exercise (P < 0.01). ② Pain disappeared at (17.07±6.00)days after treatment on average. The average times of betamethasone administration was (2.42±0.78) times. ③ No local joint pain and other adverse reactions

  20. 超声引导下复方倍他米松联合玻璃酸钠注射治疗肩峰下滑囊炎的临床研究%Effectiveness of ultrasound-guided subacromial bursa injection of betamethasone combined with hyaluronate in treatment of subacromial bursitis

    Institute of Scientific and Technical Information of China (English)

    成雪晴; 卢漫; 贺凡丁; 郭璇妍

    2015-01-01

    目的:评价超声引导下复方倍他米松联合玻璃酸钠注射治疗肩峰下滑囊炎(SAB)的疗效。方法收集2013年1月至2014年9月因肩部疼痛于四川省人民医院附属医院超声科就诊的门诊患者200例,将其中72例诊断为单纯性SAB且欲行超声引导下肩峰下滑囊注射治疗的患者纳入本研究,随机分为2组。试验组给予复方倍他米松联合玻璃酸钠注射,对照组给予复方倍他米松注射,所有患者治疗后第1周和第4周进行电话随访,治疗前、后均进行疼痛评分(视觉模拟评分法, VAS)和肩关节主动外展活动度评分。结果2组患者治疗后1周和4周,VAS评分及肩关节主动外展活动度评分均较治疗前明显改善(P均<0.05)。治疗后1周,试验组与对照组VAS评分及肩关节主动外展活动度评分比较,差异无统计学意义(P均>0.05);治疗后4周,试验组VAS评分明显低于对照组(2.08±1.95vs 3.14±2.0,P<0.05),试验组肩关节主动外展活动度评分明显高于对照组(7.12±2.10vs 6.11±1.93,P<0.05)。结论超声引导下肩峰下滑囊内复方倍他米松联合玻璃酸钠注射可有效治疗SAB,其缓解疼痛及改善肩关节主动外展活动范围的短期疗效优于单一使用复方倍他米松注射治疗。%ObjectiveTo evaluate the effectiveness of ultrasound-guided (US-guided) subacromial bursa injection of betamethasone combined with hyaluronate for treatment of subacromial bursitis.MethodsA total of 72 patients who were diagnosed as subacromial bursitis by ultrasound and then decided to performed US-guided subacromial bursa injection were randomly divided into two groups. The study group was treated with compound betamethasone suspension followed by sodium hyaluronate, and the control group was treated only with compound betamethasone suspension. Visual analogue score (VAS) and the shoulder active abduction range of motion (AAROM) score

  1. Ação da Betametasona em Ratas Prenhes: Impacto sobre os Níveis de Corticosterona e Glândulas Adrenais Maternas e Fetais Effect of Betamethasone on Pregnant Rats: Impact on Corticosterone Level and Maternal and Fetal Adrenal Glands

    Directory of Open Access Journals (Sweden)

    Eduardo de Souza

    2001-12-01

    Full Text Available Objetivo: a utilização repetitiva do corticóide antenatal objetivando acelerar a maturidade pulmonar fetal tem sido muito empregada no risco de parto prematuro, o que nos motivou a estudar a dosagem de corticosterona no termo e aspectos morfológicos das glândulas adrenais maternas e fetais de ratas albinas submetidas à ação da betametasona na segunda metade da prenhez, para verificar conseqüências dessa terapêutica. Métodos: utilizamos 30 ratas prenhes, distribuídas em 3 grupos numericamente iguais. As do Grupo I receberam betametasona nos dias 11, 12, 18 e 19 da prenhez. As do Grupo II receberam água destilada nesses dias (grupo controle, e as do Grupo III não receberam qualquer medicamento, constituindo grupo controle de estresse. Foram todas sacrificadas no 20º dia de prenhez, quando dosamos a corticosterona no sangue das matrizes e extirpamos as glândulas adrenais maternas e fetais para exame de microscopia óptica. Resultados: a dosagem de corticosterona plasmática foi significantemente menor no grupo tratado com betametasona (4,8 mg/dL, quando comparada aos grupos controles (17,7 e 26,8 mg/dL. À microscopia óptica observou-se intensa vacuolização citoplasmática na zona fasciculada das adrenais maternas e fetais no grupo que utilizou a betametasona, indicando intensa supressão adrenal secundária ao uso do medicamento. Conclusões: o uso repetitivo e prolongado de corticóides, em ratas prenhes, para acelerar a maturidade pulmonar fetal determina supressão adrenal materna e fetal.Purpose: the repetitive use of antenatal corticosteroid therapy for acceleration of fetal lung maturation has been common in cases at risk of preterm delivery. We studied the corticosterone levels at term and the morphologic aspects in the maternal and fetal adrenal glands submitted to the effect of betamethasone in the second half of rat pregnancy in order to verify its consequences. Methods: thirty female pregnant rats were divided into

  2. 腰椎小关节内注射倍他米松治疗腰椎小关节病变所致慢性腰痛%Effects of Injecting Betamethasone to Lumbar Facet Joints on Patients with Chronic Low-Back Pain from the Disfunction of Lumbar Facet Joints

    Institute of Scientific and Technical Information of China (English)

    张光明; 唐坤; 陈俊峰

    2011-01-01

    目的:评估C型臂X光机引导下腰椎小关节内注射倍他米松对腰椎小关节病变所致慢性腰痛的疗效.方法:腰痛时间长于3个月,腰痛症状和体征符合腰椎小关节病变临床表现,经影像学和小关节内注射局麻药诊断性治疗后诊断为腰椎小关节病变的40例患者随机分为小关节注射组(n=20)和消炎镇痛药组(n=20).小关节注射组患者在C型臂X光机引导下行腰椎小关节内注射倍他米松,消炎镇痛药组患者口服双氯芬酸钠.腰痛程度采用视觉模拟评分法(visual analogue scale,VAS)评分.观察时间点定为治疗前(T0)和治疗后3个月(T1).主要观察患者的生命体征和VAS评分.根据治疗过程中VAS改善程度统计疗效(分为显效、有效和无效).结果:治疗后3个月注射组总有效率为92%,消炎镇痛药组总有效率为46%;注射组显效率为74%,消炎镇痛药组显效率为26%.注射组的总有效率和显效率均显著高于消炎镇痛药组(P<0.01).结论:C型臂X光机引导下腰椎小关节内注射倍他米松能有效缓解腰椎小关节病变所致慢性腰痛,疗效优于口服药物治疗.%Objective:To investigate the effects of injecting Betamethasone to lumbar facet joints under the guidance of C-arm X-ray machine on patients with chronic low-back pain from the disfunction of lumbar facet joints. Methods: A total of 40 patients with low-back pain from the disfunction of lumbar facet joints more than 3 months were enrolled in this study. The patients were randomly divided into 2 groups(n = 20, each). The injection group received the injecting Betamethasone to lumbar facet joints under the guidance of C-arm X-ray machine; while the medcine group received taking diclofenac sodium. The vital signs and visual analogue scale were recorded before the treatment(T0) and 3 months after the treatment(Ti ). The effects of treatment were evaluated according to the changes of visual analogue scale (VAS) and were divided into

  3. 玻璃酸钠联合复方倍他米松治疗创伤性膝关节滑膜炎临床疗效分析%Clinical Efficacy Analysis on Sodium Hyaluronate Combined with Compound Betamethasone in Treatment of Traumatic Synovitis of Knee Joint

    Institute of Scientific and Technical Information of China (English)

    牛树真

    2012-01-01

    目的 观察玻璃酸钠联合复方倍他米松膝关节腔内注射方法对创伤性膝关节滑膜炎的临床治疗效果.方法 76例创伤性膝关节滑膜炎患者随机分为两组,试验组患者进行每周1次,连续5周膝关节腔内注射,第1、3周同时注射玻璃酸钠和复方倍他米松(非糖皮质激素禁忌证患者)两种药物,2、4、5周,仅注射玻璃酸钠,而对照组仅给予玻璃酸钠膝关节腔内注射,每周1次,连续5周.观察治疗前后膝关节疼痛、肿胀、关节积液程度.结果 试验组在膝关节疼痛的缓解和膝关节功能的改善方面均优于对照组.结论 玻璃酸钠联合复方倍他米松膝关节腔内注射是治疗创伤性膝关节滑膜炎安全、有效的方法,尤其适合早、中期的创伤性膝关节滑膜炎患者,是一种值得推广的方法.%Objective To observe the clinical efficacy of sodium hyaluronate combined with compound betamethasone on the treatment of traumatic synovitis of knee joint under the method of knee articular cavity injection. Methods 76 cases of traumatic synovitis of knee joint were randomly divided into two groups, the test group patients were given knee articular cavity injection once a week for 5 weeks, and sodium hyaluronate and compound betamethasone were given simultaneously during the 1st and 3rd week, only sodium hyaluronate was given during the 2nd, 4th and 5th week. Whereas the control group only received knee articular cavity injection of sodium hyaluronate once a week for 5 weeks. Observed the knee joint pain, swelling and joint effusion before and after treatment. Results The relief of knee joint pain and improvement of knee joint function in test group were better than those in control group. Conclusion Sodium hyaluronate combined with compound betamethasone by knee articular cavity injection is a safe and effective method for the treatment of traumatic synovitis of knee joint, especially for the patients with early or medium

  4. The influence research of antenatal Betamethasone or Dexamethasone on neurological development of preterm children%产前应用倍他米松或地塞米松对早产儿神经发育的影响研究

    Institute of Scientific and Technical Information of China (English)

    黄柏枝; 麦润婵

    2012-01-01

    Objective To investigate the influence of antenatal Betamethasone or Dexamethasone on neurological development of preterm children. Methods 200 cases of premature infants of 28-34 weeks admitted to our hospital from January 2008 to January 2011 were selected, all the infants were divided into two groups according to the prenatal application of Betamethasone or Dexamethasone of mother, 100 cases of control group with no Betamitted orDesamethasone treat- ment; 100 cases of control group with Betamethasone or Dexamethasone treatment for 1-2 courses; two groups of preterm children were all given symptomatic and supportive treatment after born. And preterm children were detected with mental development index (MDI) and psychomotor development index (PDI) in the 3, 6, 12 months after born. Results The average gestational age in preterm children of the observation group was (34.73 ?.01) weeks, which of the control group was (34.59?.98) weeks, there was no significant difference (P > 0.05); the physical indicators of birth weight, length, head circumference, chest circumference of preterm children in observation group compared with control group, the difference was not significant different (P > 0.05); incidence of preterm children suffocation, HIE and intracranial hemorrhage of observation group compared with the control group, the difference was not significant (P > 0.05); the Brazelton score of the first day compared with control group, the difference was not significant (P > 0.05); Brazelton score of the fifth day of observation group was significantly higher than control group (P < 0.05); mental development index and psychomotor development index in 3, 6 and 12 months of observation group was significantly higher than control group (P < 0.05). Conclusion The prenatal Betamethasone or Dexamethasone treatment of pregnant women may promote neurological development in preterm children, and improve brain function.%目的 探讨产前应用倍他米松或地塞米松治疗

  5. Effect of betamethasone and diclofenac sodium on serum and tissue concentration of amoxicillin: in vivo study in rats Efeito da betametasona e do diclofenaco sódico na concentração sérica e tecidual da amoxicilina: estudo in vivo em ratos

    Directory of Open Access Journals (Sweden)

    Thales Rocha Mattos Filho

    2006-10-01

    Full Text Available OBJECTIVE: Antimicrobial agents in combination with anti-inflammatory drugs have been usually prescribed in both Medicine and Dentistry. However, few scientific reports support this clinical practice. The aim of this study was to evaluate the effect of betamethasone and diclofenac sodium on serum and tissue concentration of amoxicillin in rats. METHODS: Four polyurethane sponges were implanted in the back skin of 48 rats. After seven days the animals were divided into 6 groups (n=8. Group 1: amoxicillin (25 mg/kg; G2: diclofenac sodium (2.5 mg/kg; G3: betamethasone (0.1 mg/kg; G4: diclofenac sodium and amoxicillin; G5: betamethasone and amoxicillin; and G6: 0.9% sodium chloride solution (1.0 mL - control group. All drugs were administered in a single dose. After 90 minutes, the granulomatous tissues of each animal were surgically removed and weighed. Blood was collected from cervical plexus, centrifuged and 10µL of serum was placed on paper discs. In order to estimate amoxicillin concentration, serum and granulomatous tissues were separately submitted to microbiological assay, which used 10(8cfu/mL of Staphylococcus aureus ATCC 25923 (penicillin-susceptible strain. After incubation (18 hours, 37ºC the inhibition zones were measured and compared to a regression curve. RESULTS: No inhibition zones were observed for groups 2, 3 and 6. Tissue and serum concentrations of both G1 (4.14µg/g and 2.06µg/mL, respectively and G5 (3.87µg/g and 1.70µg/mL, respectively showed statistically significant differences (Kruskal-Wallis, p0.05. CONCLUSION: Considering single doses, betamethasone did not interfere with amoxicillin levels but diclofenac sodium reduced both tissue and serum levels of amoxicillin in rats.OBJETIVO: A prescrição de antimicrobianos associados a antiinflamatórios é uma prática comum em odontologia, embora na maioria das vezes não haja justificativa para tal conduta. O objetivo deste trabalho foi avaliar, em um estudo in vivo em

  6. Intraarticular injection of sodium hyaluronate plus nerve and pain block with betamethasone in treatment of periarthritis of shoulder%玻璃酸钠关节腔内注射结合倍他米松神经及痛点阻滞治疗肩关节周围炎

    Institute of Scientific and Technical Information of China (English)

    罗芳; 申颖; 刘延青; 王恩真; 王保国

    2005-01-01

    BACKGROUND: Very satisfactory clinical effects have been achieved in treatment of osteoarthritis of knee with intraarticular injection of sodium hyaluronate (SH) allied with steroid hormones for nerve block. How will such allied treatment be used for periarthritis of shoulder?OBJECTIVE: To probe into the improvement of pain and joint function in periarthritis of shoulder treated with integration of intraarticular injection of SH with nerve and pain block with betamethasone.DESIGN: Self-control was designed before and after experiment.SETTING: Beijing Tiantan Hospital, Capital University of Medical Sciences PARTICIPANTS: Twenty patients with periarthritis of shoulder were included, aged from 40 to 65 years from Pain Clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences from January to October 2004.METHODS: Integration of intraarticular injection of SH with nerve and pain block with betamethasone was applied to treat 20 cases of periarthritis of shoulder and the record was done before treatment and 1in which, "no any pain sensation" was 0 score, "unable to bear pain with imagination" was 10 scores. Pain score was recorded during quiet involved. 4 scores indicated being impossible completely, 3 scores indicate being possible with help, 2 scores indicate being possibled reluctantly and mostly feeling inconvenient, 1 score indicated being possible reluctantly without inconvenience and 0 score indicated being possible as healthy person.of daily life activity.RESULTS: According to practical management and analysis, 20 cases enment compared with that before treatment [(4.34±1.33),(8.27±1.37)scores,compared with that before treatment [(4.73±1.31), (8.49±1.35)scores,ment compared with that before treatment [ ( 1.10 ±0.74), (3.30 ±0.48 )scores, P < 0.01]. CONCLUSION: Integration of intraarticular injection of SH with nerve and pain block with betamethasone treats effectively periarthritis of shoulder, without remarkably harmful

  7. Clinical effect of Compound Betamethasone and Triamcinolone Acetonide Acetate in treating alopecia areata by local injection%局部注射复方倍他米松和醋酸曲安奈德治疗斑秃的疗效观察

    Institute of Scientific and Technical Information of China (English)

    尹伟欣; 李旭阳; 尹光文; 秦玉翰

    2012-01-01

    目的 比较局部注射复方倍他米松注射液和醋酸曲安奈德注射液治疗斑秃的临床疗效及不良反应.方法 182例斑秃患者随机分为治疗组和对照组各91例,治疗组采用复方倍他米松注射液1ml加2%利多卡因2ml,0.2ml/cm2局部注射,每4周1次,连续3次,对照组采用醋酸曲安奈德注射液1ml加2%利多卡因2ml,0.2ml/cm2局部注射,每周1次,连续3周,治疗组和对照组均同时口服维生素B6片(20mg,3次/d),谷维素片(20mg,3次/d),分别观察治疗后第4、8、12周的临床疗效及不良反应.结果 治疗第4周时治疗组和对照组有效率分别为17.58%和30.77%,P<0.05;第8周时治疗组和对照组有效率分别为46.15%和53.85%,P>0.05;第12周时治疗组和对照组有效率分别为83.52%和70.33%,P<0.05.结论 局部注射糖皮质激素治疗斑秃疗效确切,早期醋酸曲安奈德组疗效高于复方倍他米松组,但后期复方倍他米松组疗效高于醋酸曲安奈德组.%Objective To compare the clinical potency and untoward reactions of compound betamethasone and triamcinolone acetonide acetate in treating alopecia areata by local injection. Methods Totally 182 patients with alopecia areata were randomly divided into treatment group (n = 91) and control group ( n = 91) , using compound betamethasone ( 1 ml and 2ml of 2% lidocaine, 0.2ml/cm2) for treatment group by local injection, once per 4 weeks for 3 times directly. The control group were locally injected with triamcinolone acetonide acetate (1ml and 2ml of 2% lidocaine, 0. 2ml/cm2) , once a week for 3 times directly, then observed the clinical potency and untoward reactions at 4th.,8th., 12th weeks respectively. All the patients were received VitaminB6 20 mg and oryzanol 20 mg, po, tid. Results At the 4th week, the effective power of treatment group and control group was 17. 58% and 30.77% (P >0.05) , significant differences were found among the tow groups. At the 8th week, the effective

  8. OCULAR MICROBIAL POPULATION AS A 2-1 BETAMETHASONE DISSODIC FOSPHATE AND DISSODIC FOSPHATE/ACETATE DEXAMETHASONE MONITOR IN SWINE CORNEA TRANSPLANTED DOGS ESTUDO DA MICROBIOTA OCULAR COMO MONITOR DO 2-1 FOSFATO DISSÓDICO DE BETAMETASONA E DO FOSFATO DISSÓDICO/ACETATO DE DEXAMETASONA, EM CÃES QUE RECEBERAM TRANSPLANTES COM CÓRNEAS DE SUÍNOS

    Directory of Open Access Journals (Sweden)

    Nilo Sérgio Troncoso Chaves

    2007-09-01

    Full Text Available

    Ten mixed breed dogs, with a 10 kg average weight, were selected at Centro de Zoonoses de Goiânia. After being examined and considered healthy, the dogs were enumerated from 11 to 20 on their collars. Each animal had swine cornea implanted into the left eye. The swine cornea was obtained at Casa de Banha Caçula, a slaughterhouse, and conserved in a humid chamber during a maximum 6 hour period. Before surgery, each animal received 4 mg dissodic fosphate/acetate of dexamethasone IM and one drop of betamethasone dissodic fosphate and gentamycin sulphate. This medication was kept until euthanasia. Each dog had a superior fornix sample collected, the sample was immersed in 0.1% peptonized water, so that tests for aerobic bacteria and fungus could be realized. Each test was repeated with samples collected on days 7, 14, 21 and 28, after graft, and compared with those from day 0. The 12.8% Staphylococcus epidermidis on initial samples was caused by contamination during collection because it wasn’t found on the 28th day samples. This fact suggests that, although corticosteroids had caused systemic imunocellular supression, they didn’t make easier the bacterial development into the grafted eye.

    KEY-WORDS: Microbial population; corticosteroids; xenotranplants; cornea; canine; swine.

    Foram utilizados dez cães, sem raça definida, com peso médio de 10kg, selecionados no Centro de Zoonoses da Prefeitura de Goiânia. Após examinados e considerados sadios, foram numerados de 11 a 20 na respectiva coleira. Cada cão, a seu tempo, teve implantada no olho esquerdo córnea de suíno, este abatido no frigorífico Casa de Banha Caçula. A córnea foi conservada em câmara úmida pelo

  9. EYE CLINICAL STUDY IN SWINE CORNEA IMPLANT DOGS TREATED WITH 2-1 BETAMETHASONE DISSODIC FOSPHATE AND DISSODIC FOSPHATED/ACETATE DEXAMETHASONE ESTUDO CLÍNICO NOS OLHOS DOS CÃES, TRATADOS COM 2-1 FOSFATO DISSÓDICO DE BETAMETASONA E FOSFATO DISSÓDICO/ACETATO DE DEXAMETASONA, QUE RECEBERAM IMPLANTES COM CÓRNEAS DE SUÍNOS

    Directory of Open Access Journals (Sweden)

    Nilo Sérgio Troncoso Chaves

    2007-09-01

    Full Text Available

    Ten mixed breed dogs, with a 10 kg average weight, were selected at Centro de Zoonoses de Goiânia. After being examined and considered healthy the dogs were enumerated from 11 to 20 on their collars. Each animal had swine cornea implanted into the left eye. The swine cornea was obtained at Casa de Banha Caçula, a slaughterhouse, and conserved in humid chamber for a maximum 6 hour period. Before surgery, each animal received 4 mg dissodic fosphate/acetate dexamethasone IM and was instilled one drop of betamethasone dissodic fosphate and one drop of gentamicin sulphate, maintaining the ocular medication 4 times/day and the intramuscular medication once a week, until euthanasia. After xenografts being realized, each cornea was examined every 7 days using direct ophthalmoscope to analyse transparency, vessels new formation, episcleral and conjunctival vessels reaction, cornea thickness, depth and presence or absence of deposits into the anterior chamber. On day 7 clinical evaluation, all cornea xenotransplant eyes (100% had lost transparency (++,+++, there was episcleral vessels reaction (P, anterior chamber depth was preserved (N, there wasn’t edema, as well as deposits (A on anterior chamber. On day 14, with the loss of two corneas by “self-trauma”, the other dogs had their implanted corneas (80% completely opaque (+++, with important ciliary reaction (P, edema (A; however, the anterior chamber integrity was preserved (N, without presence of deposits (A. With three more dogs euthanized between days 14 and 21, due to corticosteroids side-effects, the remaining dogs (50% preserved their implants with the day 14 alterations until the end of this experience.

    Foram utilizados 10 cães, sem ra

  10. Drug: D00244 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available methasone (JP16/USP/INN) Betamethasone D00244 Betamethasone (JP16/USP/INN) Betamethasone D00244 Betamethasone (JP16/USP/INN) Inflamma...tory Bowel Disease Agents Glucocorticoids Betamethasone

  11. ESTUDO HISTOPATÓLOGICO NAS CÓRNEAS DOS CÃES TRATADOS COM 2-1 FOSFATO DISSÓDICO DE BETAMETASONA E FOSFATO DISSÓDICO/ACETATO DE DEXAMETASONA, QUE RECEBERAM TRASPLANTES COM CÓRNEAS DE SUÍNOS HISTOPHATOLOGICAL STUDY IN CORNEAS OF DOGS, TREATED WITH 2-1 DISSODIC FOSPHATE OF BETAMETHASONE AND DISSODIC FOSPHATED/ACETATE OF DEXAMETHASONE, THAT HAD RECEIVED IMPLANTATION OF SWINE CORNEAS

    Directory of Open Access Journals (Sweden)

    Luiz Antônio Franco da Silva

    2007-09-01

    Full Text Available

    Foram utilizados 10 cães, sem raça definida, com peso médio de 10kg, examinados e considerados sadios. Cada cão, a seu tempo, teve implantada no olho esquerdo córnea de suíno, conservada em câmara úmida pelo período máximo de seis horas. Cada animal antes da cirurgia recebeu 4 mg de fosfato dissódico/acetato de dexametasona, por via intramuscular, e uma gota de fosfato dissódico de betametasona/sulfato de gentamicina colírio. Conservou-se a medicação ocular 4 vezes/dia e a intramuscular semanalmente, até o sacrifício do cão. Cada qual foi sacrificado por processo indolor (thiopental sódico + cloreto de succinilcolina e teve o olho que recebeu implante com córnea de suíno enucleado. Foi injetado formol 10% na câmara do vítreo e a córnea foi removida com aba escleral, tratada e corada com hematoxilina-eosina. Foram analisadas as seguintes áreas: enxerto, áreas adjacentes receptoras e observadas as várias alterações.

    PALAVRAS-CHAVE: Histopatologia; corticosteróides; xenotransplantes; córnea; canino; suíno.

    Ten dogs, with no definitive breed, average weight of 10 kg, were in this research. After being examined and considered healthy they received numbers, from 11 to 20 in their collars. Each dog received implantation, in the left eye, of swine cornea, obtained at Casa de Banha Caçula, a slaughterhouse, and maintained in wet chamber for six hours at most. Before surgery, each animal received 4 mg of dissodic phosphate/acetate dexamethasone IM and, once a week one drop of dissodic phosphate betamethasone and gentamicin sulphate, four times a day, until the 28th day. when the animals were sacrificed through painless process (Thiopental sodic

  12. Effects of intra-amniotic lipopolysaccharide and maternal betamethasone on brain inflammation in fetal sheep

    NARCIS (Netherlands)

    E. Kuypers (Elke); R.K. Jellema (Reint); D.R.M.G. Ophelders (Daan); J. Dudink (Jeroen); M. Nikiforou (Maria); T.G.A.M. Wolfs (Tim); I. Nitsos (Ilias); J.J. Pillow (Jane); G.R. Polglase (Graeme); M.W. Kemp (Matthew); M. Saito (Masatoshi); J.P. Newnham (John); A.H. Jobe (Alan); S.G. Kallapur (Suhas); B.W. Kramer (Boris)

    2013-01-01

    textabstractRationale: Chorioamnionitis and antenatal glucocorticoids are common exposures for preterm infants and can affect the fetal brain, contributing to cognitive and motor deficits in preterm infants. The effects of antenatal glucocorticoids on the brain in the setting of chorioamnionitis are

  13. 21 CFR 524.1044d - Gentamicin sulfate, betamethasone valerate ointment.

    Science.gov (United States)

    2010-04-01

    ... treatment of acute and chronic canine otitis externa and canine infected superficial lesions caused by bacteria sensitive to gentamicin. (2)(i) For the treatment of acute and chronic canine otitis externa...

  14. Magnesium Sulfate and Betamethasone Reduce NUR77 Expression in a Preterm Labor Mouse Model

    Science.gov (United States)

    2016-06-29

    neurologic injury. MgSO4, however, prevents cerebral palsy in only 1 in 40 women who receive it. Understanding the cellular responses to MgSO4/BMTZ...could allow for more effective treatments. Nur77 is a nuclear receptor implicated in apoptosis and immune responses- processes that occur in

  15. Olanzapine and Betamethasone Are Effective for the Treatment of Nausea and Vomiting due to Metastatic Brain Tumors of Rectal Cancer

    Directory of Open Access Journals (Sweden)

    M. Suzuki

    2014-01-01

    Full Text Available Brain lesions originating from metastasis of colorectal cancer represent 3-5% of all brain metastases and are relatively rare. Of all distant metastases of colorectal cancer, those to the liver are detected in 22-29% of cases, while those to the lungs are detected in 8-18% of cases. In contrast, brain metastasis is quite rare, with a reported incidence ranging from 0.4 to 1.8%. Treatments for metastatic brain tumors include surgery, radiotherapy, chemotherapy and supportive care with steroids, etc. Untreated patients exhibit a median survival of only approximately 1 month. The choice of treatment for brain metastasis depends on the number of lesions, the patient's general condition, nerve findings and presence of other metastatic lesions. We herein report the case of a 78-year-old male who presented with brain metastases originating from rectal carcinoma. He suffered from nausea, vomiting, anorexia and vertigo during body movement. He received antiemetics, glycerol and whole brain radiation therapy; however, these treatments proved ineffective. Olanzapine therapy was started at a dose of 1.25 mg every night. The persistent nausea disappeared the next day, and the frequency of vomiting subsequently decreased. The patient was able to consume solid food. Olanzapine is an antipsychotic that has recently been used as palliative therapy for refractory nausea and vomiting in patients receiving chemotherapy. We consider that olanzapine was helpful as a means of supportive care for the treatment of nausea and vomiting due to brain metastasis.

  16. Drug: D01637 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available LAMMATORY AGENTS A07EA Corticosteroids acting locally A07EA04 Betamethasone D0163...T OF HEMORRHOIDS AND ANAL FISSURES FOR TOPICAL USE C05AA Corticosteroids C05AA05 Betamethasone D01637 Betame...ICOSTEROIDS, PLAIN D07AC Corticosteroids, potent (group III) D07AC01 Betamethason...e D01637 Betamethasone dipropionate (JP16/USP) D07X CORTICOSTEROIDS, OTHER COMBINATIONS D07XC Corticosteroids...R NASAL PREPARATIONS FOR TOPICAL USE R01AD Corticosteroids R01AD06 Betamethasone

  17. Drug: D04796 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D04796 Mixture, Drug Fradiomycin sulfate - betamethasone valerate mixt; Betnevate N...renocorticotropic hormone mixtures D04796 Fradiomycin sulfate - betamethasone valerate mixt PubChem: 17398165 ...

  18. Prospective audit showing improved patient-assessed skin toxicity with use of betamethasone cream for those at high risk of radiation dermatitis.

    Science.gov (United States)

    Erridge, Sara C; McCabe, Marie; Porter, Mandy K; Simpson, Patricia; Stillie, Alison L

    2016-10-01

    This audit was conducted before and after introduction of a risk-based skincare policy with prophylactic steroids recommended for those at high risk. Comparison of the two cohorts confirmed results seen in trials with significant reduction in redness, itch, discomfort, sleep disturbance, and use of analgesia with the addition of steroids.

  19. Short- and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Østergaard, Mikkel; Ejbjerg, Bo;

    2012-01-01

    by Kaplan-Meier plots of the joint injection survival (ie, the time between injection and renewed flare). Potential predictors of joint injection survival were tested.RESULTS: 1373 Unique joints (ankles, elbows, knees, metacarpophalangeal (MCP), metatarsophalangeal, proximal interphalangeal (PIP), shoulders...

  20. Pre-injection of hyaluronic acid does not affect the systemic effects of intra-articular depot betamethasone injection at the knee joint.

    Science.gov (United States)

    Habib, George; Khatib, Muhamad; Sakas, Fahed; Artul, Suheil; Jabaly-Habib, Haneen

    2017-01-01

    Intra-articular injection (IAI) of both hyaluronic acid (HA) and depot-steroid preparations had the advantage of quick and prolonged favorable effects on pain relief among patients with symptomatic osteoarthritis of the knee (OAK). The effect of IAI of HA on the systemic effects of the intra-articular steroids had not been investigated. Non-selected patients attending the rheumatology clinic with symptomatic OAK who failed NSAIDS and physical therapy were offered an IAI of HA at the knee joint followed 20 min later by an IAI of 1 ml of Celestone Chronodose at the same joint (group 1). Morning serum levels of cortisol were obtained just prior to the IAI and 1, 2 and 8 days later. Demographic, clinical, and laboratory parameters were obtained also from all the patients. Age- and sex-matched group of patients from the same clinic were recruited as a control group (group 2). Mean baseline serum cortisol levels in group 1 was 381 ± 154 mmol/l vs. 376 ± 119 in group 2 (p = 0.954). Morning serum cortisol levels at day 1 and day 2 were 24 ± 6 and 22 ± 6 mmol/l, respectively, in group 1 patients vs. 27 ± 5.8 (p = 0.214) and 25 ± 5.6 mmol/l (p = 0.200), respectively, in group 2. These levels were significantly lower than baseline levels in each group. Morning serum cortisol levels at day 8 in group 1 and group 2 were 349 ± 128 and 314 ± 99 mmol/l, respectively (p = 0.419). Pre-injection of HA at the knee joint did not affect the systemic effect on the hypothalamic-pituitary-adrenal axis of IAI of Celestone Chronodose.

  1. Kojic acid vis-a-vis its combinations with hydroquinone and betamethasone valerate in melasma: A randomized, single blind, comparative study of efficacy and safety

    Directory of Open Access Journals (Sweden)

    Kirti S Deo

    2013-01-01

    Strict photoprotection and use of a SPF 15 sunscreen was advised during the day. Patients were evaluated every 2 weeks and a fall in MASI score was calculated at the end of the study period of 12 weeks by the same investigator. Results: The response was compared according to percentage decrease in MASI score. Efficacy was evaluated among the groups at the end of 3 months using bivariate analysis and calculated by using the paired ′t′ test. The clinical efficacy of group B was the highest followed closely by group D and group A, that of group C being the lowest. Conclusion: Kojic acid in synergy with hydroquinone is a superior depigmenting agent as compared with other combinations.

  2. Drug: D01357 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available NFLAMMATORY AGENTS A07EA Corticosteroids acting locally A07EA04 Betamethasone D01...OF HEMORRHOIDS AND ANAL FISSURES FOR TOPICAL USE C05AA Corticosteroids C05AA05 Betamethasone D01357 Betameth...ROIDS, PLAIN D07AC Corticosteroids, potent (group III) D07AC01 Betamethasone D013...57 Betamethasone valerate (JP16/USP) D07X CORTICOSTEROIDS, OTHER COMBINATIONS D07XC Corticosteroids, potent,...NS FOR TOPICAL USE R01AD Corticosteroids R01AD06 Betamethasone D01357 Betamethaso

  3. Drug: D02286 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available ANAL FISSURES FOR TOPICAL USE C05AA Corticosteroids C05AA05 Betamethasone D02286 Betamethasone benzoate (US...OSTEROIDS, PLAIN D07AC Corticosteroids, potent (group III) D07AC01 Betamethasone D02286 Betamethasone benzoa...te (USP) D07X CORTICOSTEROIDS, OTHER COMBINATIONS D07XC Corticosteroids, potent, other combinations D07XC01 ...M R01 NASAL PREPARATIONS R01A DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE R01AD Corticosteroids...MATORY AGENTS S01BA Corticosteroids, plain S01BA06 Betamethasone D02286 Betametha

  4. Drug: D02032 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available ALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS A07E INTESTINAL ANTIINFLAMMATORY AGENTS A07EA Corticosteroids...SURES FOR TOPICAL USE C05AA Corticosteroids C05AA05 Betamethasone D02032 Betamethasone butyrate propionate (...JAN) D DERMATOLOGICALS D07 CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS D07A CORTICOSTEROIDS, PLAIN D07AC Corticosteroids...rate propionate (JAN) D07X CORTICOSTEROIDS, OTHER COMBINATIONS D07XC Corticosteroids, potent, other combinat...FOR TOPICAL USE R01AD Corticosteroids R01AD06 Betamethasone D02032 Betamethasone

  5. Drug: D01402 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available TIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS A07E INTESTINAL ANTIINFLAMMATORY AGENTS A07EA Corticosteroids...SSURES FOR TOPICAL USE C05AA Corticosteroids C05AA05 Betamethasone D01402 Betamethasone acetate (JAN/USP) D ...OIDS, PLAIN D07AC Corticosteroids, potent (group III) D07AC01 Betamethasone D01402 Betamethasone acetate (JA...N/USP) D07X CORTICOSTEROIDS, OTHER COMBINATIONS D07XC Corticosteroids, potent, other combinations D07XC01 Be...YSTEM R01 NASAL PREPARATIONS R01A DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE R01AD Corticosteroids

  6. Experimental research on anti-inflammatory and analgesic effects of betamethasone and chloramphenicol cream%倍他米松氯霉素霜抗炎镇痛作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    杨军炎; 吴彦; 盛国荣

    2008-01-01

    目的: 考察倍他米松氯霉素霜镇痛、抗炎消肿的功效.方法: 采用热板法与电刺激法两种致痛动物模型和二甲苯对小鼠腹部皮肤毛细血管通透性的影响与角叉菜胶对大鼠足跖肿胀的影响两种炎症动物模型,对倍他米松氯霉素霜的保护作用和治疗效果作了研究,并与肤乐乳膏进行了对比试验.结果: 倍他米松氯霉素霜能提高热板法致痛模型的痛阈,减少电刺激致痛的发生率,抑制毛细血管的通透性,减少炎性肿胀,显示了良好的镇痛与抗炎作用,并呈现明显的量效关系;在相同剂量下,镇痛作用显著优于肤乐乳膏(P<0.01),抗炎作用优于肤乐乳膏(P<0.05).结论: 倍他米松氯霉素霜能改善皮肤疾病的疼痛和水肿渗出症状,为临床应用提供了实验依据.

  7. Determination of betamethasone sodium phosphate injection by polarimetry%旋光法快速测定倍他米松磷酸钠注射液的含量

    Institute of Scientific and Technical Information of China (English)

    邱颖妲

    2004-01-01

    目的:建立倍他米松磷酸钠注射液的含量测定方法.方法:以水为溶剂,采用旋光度测定法测定.结果:倍他米松磷酸钠在0.5~10 mg/ml浓度范围内与旋光度值呈良好线性关系,回归方程为:C=10.881 4×α-0.097 9(r=0.999 5),平均回收率:99.4%,RSD=1.01%.结论:该方法简便,快速,准确.

  8. Drug: D04447 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available 6 ANTIHISTAMINES FOR SYSTEMIC USE R06A ANTIHISTAMINES FOR SYSTEMIC USE R06AB Substituted alkylamines R06AB54 Chlorphenamine, combinat...ions D04447 Betamethasone - d-chlorpheniramine maleate mixt PubChem: 17398108 ...

  9. Liposome surface charge influence on skin penetration behaviour.

    Science.gov (United States)

    Gillet, A; Compère, P; Lecomte, F; Hubert, P; Ducat, E; Evrard, B; Piel, G

    2011-06-15

    Vesicular systems have shown their ability to increase dermal and transdermal drug delivery. Their mechanism of drug transport into and through the skin has been investigated but remains a much debated question. Several researchers have outlined that drug penetration can be influenced by modifying the surface charge of liposomes. In the present work we study the influence of particle surface charge on skin penetration. The final purpose is the development of a carrier system which is able to enhance the skin delivery of two model drugs, betamethasone and betamethasone dipropionate. Liposomes were characterised by their size, morphology, zeta potential, encapsulation efficiency and stability. Ex vivo diffusion studies using Franz diffusion cells were performed. Confocal microscopy was performed to visualise the penetration of fluorescently labelled liposomes into the skin. This study showed the potential of negatively charged liposomes to enhance the skin penetration of betamethasone and betamethasone dipropionate.

  10. Short-term chemical pretreatment cannot replace curettage in photodynamic therapy

    DEFF Research Database (Denmark)

    Nissen, Christoffer V; Wiegell, Stine Regin; Philipsen, Peter Alshede

    2016-01-01

    pretreatment with curettage and two combination ointments containing calcipotriol/betamethasone and salicylic acid/betamethasone affect PpIX fluorescence after the application of methyl aminolevulinate MAL and 5-aminolevulinic acid (BF-200 ALA). METHODS: Four fields on the forearms of 30 healthy volunteers...... were pretreated with curettage or short-term application of calcipotriol/betamethasone or salicylic acid/betamethasone for 20 min. Two fields were not pretreated, thus serving as reference. After pretreatment, MAL or BF-200 ALA was applied for 24 h, and PpIX fluorescence was measured hourly from 1 to 5...... h and after 18, 21 and 24 h. RESULTS: Curettage significantly enhanced PpIX fluorescence for MAL from 1 to 21 h (P salicylic acid...

  11. Drug: D04246 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available S01C ANTIINFLAMMATORY AGENTS AND ANTIINFECTIVES IN COMBINATION S01CA Corticosteroids and antiinfectives in c...D ANTIINFECTIVES IN COMBINATION S03CA Corticosteroids and antiinfectives in combination S03CA06 Betamethason

  12. A double-blind randomised clinical trial of the treatment of otitis externa using topical steroid alone versus topical steroid-antibiotic therapy.

    Science.gov (United States)

    Abelardo, E; Pope, L; Rajkumar, K; Greenwood, R; Nunez, D A

    2009-01-01

    The objective of the study was to determine if the addition of topical antibiotic increases the efficacy of topical steroid in controlling otitis externa. A double-blind randomised controlled trial was performed from February 2003 to April 2005 in an otolaryngology emergency clinic (acute urban teaching hospital) in the United Kingdom. Patients were followed up for 2 weeks. Forty-five adults with otitis externa based on the presence of oedema, discharge or debris in the outer ear canal were recruited. The patients were randomised to one of the two treatment groups, namely using betamethasone sodium phosphate 0.1% (Vista-Methasone) or betamethasone sodium phosphate 0.1% with neomycin sulphate 0.5% (Vista-Methasone N), and were instructed to use the trial medication at three drops three times a day for 2 weeks. Subjects' visual analogue symptom scores (blockage, pain, discharge, and itching) for otitis externa pre-treatment (day 0) and post-treatment (day 15), percentage changes in visual analogue symptom scores as a result of treatment, proportion of patients whose symptom scores failed to improve or deteriorated on treatment were analysed. The two experimental arms demonstrated statistically similar presenting symptom scores at recruitment (mean symptom scores of 19.2 for betamethasone group and 28.7 for betamethasone-neomycin group). The mean symptom score change in response to treatment was 82.8 and 47.8% in the betamethasone-neomycin and betamethasone-alone groups, respectively. There was no statistically significant difference between the groups in median percentage symptom score change in response to treatment. All patients in the betamethasone-neomycin group showed symptom improvement but in the betamethasone alone group, five patients got worse (Fishers exact, P = 0.05). Topical antibiotic-steroid combination therapy is superior to steroid-alone treatment for symptomatic control of otitis externa.

  13. Chitosan-collagen compound betamethasone gel enhanced peripheral nerval regeneration in rats%应用几丁糖-胶原-复方倍他米松缓释凝胶促进周围神经再生实验研究

    Institute of Scientific and Technical Information of China (English)

    陈维波; 兰丽琴; 缪道一; 胡冬蕊; 朱其

    2012-01-01

    目的 评价修复周围神经损伤后,神经吻合口局部应用几丁糖-胶原-复方倍他米松缓释凝胶抑制瘢痕组织增生、促进神经再生的效果.方法 45只成年雄性SD大鼠切断右侧胫神经后采用神经外膜缝合法进行修复,然后随机为3组:单纯神经缝合组,单纯缝合+几丁糖-胶原组,单纯缝合+几丁糖-胶原-复方倍他米松组,每组15只.分别于术后4,8,12周行大体观察和神经电生理检查,术后12周行组织学检测和计算机图像分析.结果 单纯缝合+几丁糖-胶原-复方倍他米松组大鼠神经吻合口局部瘢痕组织增生和粘连程度较其他两组明显减轻,再生神经纤维较直,排列结构较整齐;12周时电生理检查示复合肌肉动作电位波幅最大[(6.2±2.1) mV],图像分析示远端神经轴突平均直径最长[(3.40±0.28) μm],有髓神经纤维再生率最高(95%±4%),与其他两组比较差异均有统计学意义(均P<0.05).结论 几丁糖-胶原-复方倍他米松凝胶能有效防止周围神经损伤修复后局部瘢痕组织增生和粘连,促进神经再生和功能恢复.

  14. ESTUDO DO LEUCOGRAMA COMO MONITOR DO 2-1 FOSFATO DISSÓDICO DE BETAMETASONA DO FOSFATO DISSÓDICO/ACETATO DE DEXAMETASONA, EM CÃES QUE RECEBERAM TRANSPLANTES COM CÓRNEAS DE SUÍNOS WHITE BLOOD COUNT AS A 2-1 BETAMETHASONE DISSODIC FOSFHATE AND DEXAMETHASONE DISSODIC FOSPHATE/ACETATE MONITOR IN SWINE CORNEA TRANSPLANTED DOGS

    Directory of Open Access Journals (Sweden)

    Larissa Franco de Araújo

    2007-09-01

    Full Text Available

    Foram utilizados dez cães, sem raça definida, com peso médio de 10kg, selecionados no Centro de Zoonoses de Goiânia. Após serem examinados e considerados sadios, foram numerados de 11 a 20 na respectiva coleira. Cada animal, a seu tempo, teve implantada no olho esquerdo córnea de suíno, este abatido no frigorífico Casa de Banha Caçula. A córnea foi conservada em câmara úmida pelo período máximo de seis horas. Cada cão recebeu, antes da cirurgia, 4mg por via intramuscular de fosfato dissódico/acetato de dexametasona e uma gota de sulfato de gentamicina/fosfato dissódico de betametasona. Foi conservado o uso da medicação ocular 4 vezes/dia e a intramuscular semanalmente, até o sacrifício do cão. Cada animal teve uma amostra de sangue colhida no dia 0, antes da cirurgia, uma no 14° e outra no 28° dia, para o estudo do leucograma, como monitor dos corticosteróides. Nas dez amostras colhidas no dia 0, 80% não apresentaram alterações, já 10% apresentaram leucocitose com neutrofilia e 10% não foram analisadas. Como três animais foram sacrificados no intervalo do 14° ao 21° dia, estas amostras (40%, foram analisadas e comparadas com aquelas do tempo 0. Cinco animais (50% tiveram suas amostras examinadas no 28° dia. Tanto no 14° como no 28° dia encontraram-se 100% de neutrofilia, 100% de eosinopenia e 44,4% de linfocitopenia, num sinal clássico de supressão imunocelular.

    PALAVRAS-CHAVE: Corticosteróides; xenotransplantes; córnea; canino; suíno.

    Ten mixed breed dogs, with a 10 kg average weight were selected at Centro de Zoonoses de Goiânia. After being examined and considered healthy, the dogs were enumerated from 11 to 20 on their collars. Each animal had swine cornea implanted into the left eye. The swine cornea was obtained at Casa de Banha Caçula, a slaughterhouse, and conserved in a humid chamber during a maximum 6 hour period. Each animal received 4 mg dissodic fosphate/acetate dexamethasone IM and was instilled one drop of gentamycin sulphate/betametbasone dissodic fosphate, maintaining ocular medication 4 times/day and intramuscular medication once a week until euthanasia. Each animal had blood samples collected on day 0, before surgery, and on day 14 and 28 to analyse white blood count as a monitor of corticosteroids, imunocellular supressor drugs. From ten blood samples collected on day 0, 80% didn’t present any alterations, 10% presented leukocytosis with neutrophilia and 10% weren’t submitted to analysis. Due to the fact that three animals had been euthanized between days 14 and 21, these samples (40%, were analyzed and compared with these collected on day 0. Five animals (50% had their samples examined on day 28. On both days 14 and 28, there were 100% neutrophilia, 100% eosinophilia and 44.4% lymphocytopenia, indicating imunocellular supression.

    KEY-WORDS: Corticosteroids; xenotransplants; cornea; canine; swine.

  15. Behavioural assessment of pain in commercial turkeys (Meleagris gallopavo) with foot pad dermatitis.

    Science.gov (United States)

    Sinclair, A; Weber Wyneken, C; Veldkamp, T; Vinco, L J; Hocking, P M

    2015-01-01

    Two experiments were conducted to investigate the differences in susceptibility to foot pad dermatitis (FPD) of two medium-heavy lines of turkeys, and whether FPD is painful, by detailed analysis of behaviour in birds with and without analgesic treatment (betamethasone). Turkeys housed on dry litter in the first experiment generally had more frequent bouts of different behaviours that were of shorter duration than birds on wet litter. T-patterns (behavioural sequences) were more frequent, varied and complex on dry than on wet litter. Betamethasone-injected birds of line B, but not breed A, had shorter resting and longer standing durations on wet litter than saline-injected birds. In the second experiment, turkeys on wet litter given saline stood less and rested more than all other treatment groups, suggesting that they experienced pain that was alleviated in birds receiving betamethasone. Turkeys on dry litter had more frequent, varied and complex patterns of behaviour than turkeys on wet litter and birds kept on intermediate litter wetness. Betamethasone provision increased pattern variety regardless of litter treatment. Turkeys with low FPD scores transferred to wet litter and given saline injections had a longer total duration of resting and shorter duration of standing compared to betamethasone-treated birds. Low FPD birds transferred to wet litter had a similar number of patterns and total pattern occurrence as high FPD birds transferred to dry litter. Betamethasone increased pattern variety and frequency compared to saline injections whereas overall pattern complexity was similar. It was concluded that wet litter affects the behaviour of turkey poults independently of FPD and that betamethasone may also change the behaviour of turkeys. There was some evidence from analgesic treatment and T-pattern analyses that FPD was painful. However, there was no evidence of differences in susceptibility to FPD of the two commercial hybrids.

  16. Can "steroid switching" improve steroid-induced musical hallucinations in a patient with terminal cancer?

    Science.gov (United States)

    Kanemura, Seitetsu; Tanimukai, Hitoshi; Tsuneto, Satoru

    2010-12-01

    The patient was a 57-year-old woman with malignant pleural mesothelioma. She had a past history of anxiety neurosis but not had any history of otological diseases. On admission to our hospice (day 1), she complained of dyspnea and wheezing associated with the progression of her underlying disease. After we started oral betamethasone (2 mg/d), dyspnea was alleviated and the frequency of wheezing was reduced. On day 3, she began to experience musical hallucinations that were manifested in opera/piano concert music and a child's voice. The episodes of musical hallucinations occurred approximately 10 times a day and disappeared spontaneously within several minutes. She had not experienced these symptoms before. We reduced the dose of betamethasone to 1 mg/d, but the musical hallucinations continued. Then on day 11, we switched betamethasone (1 mg/d) to prednisolone (10 mg/d) and we then gradually tapered off prednisolone. The frequency of musical hallucinations decreased and she ceased to experience musical hallucinations on day 29. However, on day 40, her dyspnea was aggravated again, so we started treatment with prednisolone (5 mg/d). Dyspnea was alleviated and no musical hallucinations occurred. On Day 51, dyspnea was worsened and we switched prednisolone to betamethasone (4 mg/d), which she hoped to use. The betamethasone alleviated the dyspnea but she developed musical hallucinations that were similar to the previous episodes. The musical hallucinations disappeared spontaneously 4-5 days later without changing the betamethasone. Musical hallucinations never occurred thereafter. She later died due to the exacerbation of disease.

  17. Aggravation of fatigue by steroid therapy in terminally ill patients with cancer.

    Science.gov (United States)

    Matsuo, Naoki; Yomiya, Kinomi

    2014-05-01

    Steroids are commonly used for fatigue relief in terminally ill cancer patients. However, steroid-induced adverse effects including depression, myopathy, and hyperglycemia may contribute to fatigue. We report our experiences with aggravation of fatigue with steroid use in three cases. Case 1 was a 65-year-old man with advanced gastric cancer. He was started on betamethasone (2 mg/d) for fatigue, but the fatigue worsened due to steroid-induced depression. Discontinuation of steroids and initiation of an antidepressant ameliorated the fatigue. Case 2 was a 68-year-old man with advanced lung cancer. He complained of fatigue. Betamethasone (1 mg/d) was started and alleviated the fatigue. However, when the betamethasone dose was increased to 2 mg/d, the fatigue, with muscle weakness and myalgia, worsened due to steroid-induced myopathy. We therefore switched from betamethasone (2 mg/d) to prednisolone (10 mg /d). The fatigue resolved and the patient returned to his previous condition. Case 3 was a 73-year-old man with recurrent bile duct cancer. He also had diabetes mellitus. He developed fatigue, anorexia and fever. We started betamethasone (1.5 mg/d) for these symptoms, but the fatigue and anorexia worsened due to steroid-induced hyperglycemia. Blood glucose rose to 532 mg/dL. Therefore, insulin therapy was started, and the dose of betamethasone was reduced to 0.5 mg/d. His glucose level decreased to less than 320 mg/dL and he recovered from the fatigue while achieving moderate oral intake. In conclusion, the possibility of steroid-induced secondary fatigue in terminally ill cancer patients should be taken into consideration.

  18. Periarticular and generalised bone loss in patients with early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Jensen, T W; Hansen, M S; Hørslev-Petersen, Kim;

    2014-01-01

    )). PATIENTS AND METHODS: A hundred and sixty patients with early, active rheumatoid arthritis (RA) received methotrexate, intra-articular betamethasone and ciclosporin /placebo-ciclosporin. Patients with Z-score ≤0 also started alendronate 10 mg/day. BMD of the hand (digital x-ray radiogrammetry (DXR......OBJECTIVES: The aims of this study were to investigate the influence of alendronate and intra-articular betamethasone treatment on bone mineral density (BMD) changes in hand, lumbar spine and femoral neck during 1 year of a treat-to-target study (Cyclosporine, Methotrexate, Steroid in RA (CIMESTRA...

  19. High-risk pregnancy in a woman with Marfan syndrome, a bicuspid aortic valve, and a dilated aortic sinus

    DEFF Research Database (Denmark)

    Groth, Kristian Ambjørn; Greisen, Jacob Raben; Nielsen, Birgitte Bruun;

    2015-01-01

    /day) to reduce blood pressure and was admitted for bed rest from week 30. Her aortic diameter was assessed by echocardiography every 2nd week and remained unchanged. She was treated with betamethason at week 26 and the child was born by a caesarean section in week 35. The post-operative course was uneventful....

  20. Behavioural assessment of pain in commercial turkeys (Meleagris gallopavo) with foot pad dermatitis

    NARCIS (Netherlands)

    Sinclair, A.; Weber Wyneken, C.; Veldkamp, T.; Vinco, L.J.; Hocking, P.M.

    2015-01-01

    Two experiments were conducted to investigate the differences in susceptibility to foot pad dermatitis (FPD) of two medium-heavy lines of turkeys, and whether FPD is painful, by detailed analysis of behaviour in birds with and without analgesic treatment (betamethasone). Turkeys housed on dry lit

  1. Drug: D00972 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D00972 Drug Betamethasone sodium phosphate (JP16/USP); Celestone (TN) C22H28FO8P. 2...ethasone sodium phosphate (JP16/USP) CAS: 151-73-5 PubChem: 7848035 DrugBank: DB00443 LigandBox: D00972 NIKK

  2. Antenatal corticosteroid therapy : short-term effects on fetal behaviour and haemodynamics

    NARCIS (Netherlands)

    Mulder, E. J. H.; de Heus, R.; Visser, G. H. A.

    2009-01-01

    Antenatal corticosteroid therapy to enhance fetal lung maturity in threatened preterm delivery has a number of non-pulmonary side-effects, both beneficial and undesirable. This review focuses on the short-term (transient) effects of betamethasone and dexamethasone on aspects of fetal circulation and

  3. Histopathological comparison of topical therapy modalities for acute radiation proctitis in an experimental rat model

    Institute of Scientific and Technical Information of China (English)

    Cagatay Korkut; Oktar Asoglu; Murat Aksoy; Yersu Kapran; Hatice Bilge; Nese Kiremit-Korkut; Mesut Parlak

    2006-01-01

    AIM: To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin. METHODS: A total of 120 rats were used. Four groups (n = 30) were analyzed with one group for each of the following applied therapy modalities: control, mesalazine, formalin, betamethasone, and misoprostol. A single fraction of 17.5 Gy was delivered to each rat. The rats in control group rats were given saline, and the rats in the other three groups received appropriate enemas twice a day beginning on the first day after the irradiation until the day of euthanasia. On d 5, 10, and 15, ten rats from each group were euthanized and a pathologist who was unaware of treatment assignment examined the rectums using a scoring system. RESULTS: The histopathologic scores for surface epithelium, glands (crypts) and lamina propria stroma of the rectums reached their maximum level on d 10. The control and formalin groups had the highest and mesalazine had the lowest, respectively on d 10. On the 15th d, mesalazine, betamethasone, and misoprostol had the lowest scores of betamethasone. CONCLUSION: Mesalazine, betamethasone, and misoprostol are the best topical agents for radiation proctitis and formalin has an inflammatory effect and should not be used.

  4. Effects of topical corticosteroid and tacrolimus on ceramides and irritancy to sodium lauryl sulphate in healthy skin.

    Science.gov (United States)

    Jungersted, Jakob Mutanu; Høgh, Julie K; Hellegren, Lars I; Jemec, Gregor B E; Agner, Tove

    2011-05-01

    The skin barrier, located in the stratum corneum, is influenced mainly by the lipid and protein composition of this layer. In eczematous diseases impairment of the skin barrier is thought to be of prime importance. Topical anti-inflammatory drugs and emollients are the most widely used eczema treatments. The aim of this study was to examine the effects of topically applied corticosteroid, tacrolimus and emollient on stratum corneum lipids and barrier parameters. Nineteen healthy volunteers participated in the study. Both forearms of the subjects were divided into four areas, which were treated twice daily for one week with betamethasone, tacrolimus, emollient, or left untreated, respectively. After one week each area was challenged with a 24 h sodium lauryl sulphate patch test. The lipids were collected using the cyanoacrylate method and evaluated by high performance thin layer chromatography. For evaluation of the skin barrier, transepidermal water loss, erythema and electrical capacitance were measured. The ceramide/cholesterol ratio was increased in betamethasone- (p = 0.008) and tacrolimus-treated (p = 0.025) skin compared with emollient-treated skin. No differences in ceramide subgroups were found between treatment regimes. Pretreatment with betamethasone (p = 0.01) or with tacrolimus (p = 0.001) causes a decreased inflammatory response to sodium lauryl sulphate compared with emollient. In conclusion, treatment with betamethasone and tacrolimus has a positive effect on the ceramide/cholesterol ratio and susceptibility to irritant reaction compared with an emollient.

  5. Audio spectrum analysis of umbilical artery Doppler ultrasound signals applied to a clinical material.

    Science.gov (United States)

    Thuring, Ann; Brännström, K Jonas; Jansson, Tomas; Maršál, Karel

    2014-12-01

    Analysis of umbilical artery flow velocity waveforms characterized by pulsatility index (PI) is used to evaluate fetoplacental circulation in high-risk pregnancies. However, an experienced sonographer may be able to further differentiate between various timbres of Doppler audio signals. Recently, we have developed a method for objective audio signal characterization; the method has been tested in an animal model. In the present pilot study, the method was for the first time applied to human pregnancies. Doppler umbilical artery velocimetry was performed in 13 preterm fetuses before and after two doses of 12 mg betamethasone. The auditory measure defined by the frequency band where the spectral energy had dropped 15 dB from its maximum level (MAXpeak-15 dB ), increased two days after betamethasone administration (p = 0.001) parallel with a less pronounced decrease in PI (p = 0.04). The new auditory parameter MAXpeak-15 dB reflected the changes more sensitively than the PI did.

  6. Consequences of low birth weight, maternal illiteracy and poor access to medical care in rural India: infantile iatrogenic Cushing syndrome.

    Science.gov (United States)

    Karande, Sunil

    2015-08-21

    Home delivery, low birth weight babies and maternal illiteracy among the poor in rural India are frequent. The rural poor prefer to seek healthcare from private providers, most of whom have no formal medical training and buy medicines from private pharmacies without a prescription owing to a weakly regulated environment. This report is of a 4-month-old baby from a remote village in northern India, who presented with exogenous Cushing syndrome. This baby was a full-term low birth weight home delivery. As the baby was not growing well, treatment was started at 1 month by a private doctor with betamethasone drops The mother on her own volition continued giving the betamethasone drops by buying the medicine over the counter from a private pharmacy. This case highlights the gaps in essential health services in rural India and the steps being taken to improve the situation.

  7. Necrobiosis Lipoidica : A Case Without Diabetes And Review Of Literature

    Directory of Open Access Journals (Sweden)

    Biswas Nibir

    2002-01-01

    Full Text Available Necrobiosis lipoidica, a disorder initially thought to be a complication of diabetes, may also occur in non-diabetics. A 55 year old woman with histologically confirmed necrobiosis lipoidica, who did not have diabetes on presentation or during subsequent follow up, is reported. A good response to topical clobetasol propionate followed by betamethasone dipropionate was noted. A brief review of the literature has been included.

  8. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2011-06-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  9. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2012-02-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  10. Alterations in circulatory and renal angiotensin-converting enzyme and angiotensin-converting enzyme 2 in fetal programmed hypertension.

    Science.gov (United States)

    Shaltout, Hossam A; Figueroa, Jorge P; Rose, James C; Diz, Debra I; Chappell, Mark C

    2009-02-01

    Antenatal betamethasone treatment is a widely accepted therapy to accelerate lung development and improve survival in preterm infants. However, there are reports that infants who receive antenatal glucocorticoids exhibit higher systolic blood pressure in their early adolescent years. We have developed an experimental model of programming whereby the offspring of pregnant sheep administered clinically relevant doses of betamethasone exhibit elevated blood pressure. We tested the hypothesis as to whether alterations in angiotensin-converting enzyme (ACE), ACE2, and neprilysin in serum, urine, and proximal tubules are associated with this increase in mean arterial pressure. Male sheep were administered betamethasone (2 doses of 0.17 mg/kg, 24 hours apart) or vehicle at the 80th day of gestation and delivered at term. Sheep were instrumented at adulthood (1.8 years) for direct conscious recording of mean arterial pressure. Serum and urine were collected and proximal tubules isolated from the renal cortex. Betamethasone-treated animals had elevated mean arterial pressure (97+/-3 versus 83+/-2 mm Hg; P<0.05) and a 25% increase in serum ACE activity (48.4+/-7.0 versus 36.0+/-2.7 fmol/mL per minute) but a 40% reduction in serum ACE2 activity (18.8+/-1.2 versus 31.4+/-4.4 fmol/mL per minute). In isolated proximal tubules, ACE2 activity and expression were 50% lower in the treated sheep with no significant change in ACE or neprilysin activities. We conclude that antenatal steroid treatment results in the chronic alteration of ACE and ACE2 in the circulatory and tubular compartments, which may contribute to the higher blood pressure in this model of fetal programming-induced hypertension.

  11. Effect of Maternal Steroid on Developing Diaphragm Integrity

    OpenAIRE

    Yong Song; Demmer, Denise L.; Pinniger, Gavin J.; Tina Lavin; MacMillan, Mia V.; Pillow, Jane J.; Anthony J Bakker

    2014-01-01

    Antenatal steroids reduce the severity of initial respiratory distress of premature newborn babies but may have an adverse impact on other body organs. The study aimed to examine the effect of maternal steroids on postnatal respiratory muscle function during development and elucidate the mechanisms underlying the potential myopathy in newborn rats. Pregnant rats were treated with intramuscular injections of 0.5 mg/kg betamethasone 7 d and 3 d before birth. Newborn diaphragms were dissected fo...

  12. Glucocorticoid hypersensitivity as a rare but potentially fatal side effect of paediatric asthma treatment: a case report

    Directory of Open Access Journals (Sweden)

    Lehmann Sylvia

    2008-06-01

    Full Text Available Abstract Introduction Immediate-type hypersensitivity to glucocorticosteroids is rare but well known among allergists. Surprisingly, very few reports of glucocorticosteroid hypersensitivity in children exist although glucocorticosteroid treatment is particularly common in this age group. Case presentation We report the case of a 2-year-old boy who developed generalized urticaria, facial angio-oedema, nausea and severe dyspnoea after intravenous application of prednisolone-21-hydrogen succinate. Skin prick testing with prednisolone-21-hydrogen succinate elicited a positive result; no reactions were observed to prednisone, betamethasone or dexamethasone. While fluorescence enzyme immunoassay analysis revealed no specific IgE antibodies against prednisolone-21-hydrogen succinate, CD63-based basophil activation testing with the culprit drug prednisolone-21-hydrogen succinate was positive. In contrast, additional incubation of basophils with prednisone, betamethasone and dexamethasone did not elicit any significant response. Hence, we performed an oral provocation test with betamethasone and a titrated intravenous dexamethasone challenge. As both drugs were tolerated without any complications they were recommended for future treatment. Conclusion In a child with confirmed immediate-type hypersensitivity to glucocorticosteroids, it is still not possible to predict which glucocorticosteroid might be tolerated by solely relying on clinical history or results of skin and in vitro testing. Therefore, incremental glucocorticosteroid challenges under standardized clinical conditions remain necessary in order to facilitate a patient-tailored emergency treatment and to avoid severe reactions to glucocorticosteroids in these patients.

  13. Topical royal jelly alleviates symptoms of pruritus in a murine model of allergic contact dermatitis

    Directory of Open Access Journals (Sweden)

    Katsunori Yamaura

    2013-01-01

    Full Text Available Background: Royal jelly is widely used as a health tonic, especially in Asia. Royal jelly is commonly used in cosmetics as well as in dietary supplements and beverages. Little is known, however, about the pharmacologic efficacy of topical royal jelly. Therefore, we investigated the antipruritic activity of topical royal jelly on chronic pruritus in experimental allergic contact dermatitis in mice. Materials and Methods: Hairless mice (HOS: HR-1, with chronic allergic contact dermatitis induced by 5 weeks of repeated application of 2,4,6-trinitro-1-chlorobenzene (TNCB to the entire back skin were treated topically with royal jelly (0.01% or 1% for 5 weeks after sensitization with TNCB. The effects of royal jelly on pruritus and inflammation were evaluated by measurement of scratching behavior and skin inflammation score, respectively. Results: Repeated application of TNCB to the back skin of mice elicited frequent scratching behavior immediately and 24h after challenge. Topical royal jelly (0.01% or 1% and betamethasone (0.01% significantly ameliorated this chronic pruritus throughout the experimental period. The level of nerve growth factor mRNA in back skin was increased in the mice with dermatitis and reduced by betamethasone, but not by royal jelly. Conclusion: The inhibitory effect of royal jelly on chronic pruritus may occur through different mechanisms from those of betamethasone. Topical application of royal jelly, as used in cosmetics, might be beneficial for the alleviation of chronic pruritus.

  14. Effect of maternal steroid on developing diaphragm integrity.

    Directory of Open Access Journals (Sweden)

    Yong Song

    Full Text Available Antenatal steroids reduce the severity of initial respiratory distress of premature newborn babies but may have an adverse impact on other body organs. The study aimed to examine the effect of maternal steroids on postnatal respiratory muscle function during development and elucidate the mechanisms underlying the potential myopathy in newborn rats. Pregnant rats were treated with intramuscular injections of 0.5 mg/kg betamethasone 7 d and 3 d before birth. Newborn diaphragms were dissected for assessment of contractile function at 2 d, 7 d or 21 d postnatal age (PNA, compared with age-matched controls. The expression of myosin heavy chain (MHC isoforms and atrophy-related genes and activity of intracellular molecular signalling were measured using quantitative PCR and/or Western blot. With advancing PNA, neonatal MHC gene expression decreased progressively while MHC IIb and IIx isoforms increased. Protein metabolic signalling showed high baseline activity at 2 d PNA, and significantly declined at 7 d and 21 d. Antenatal administration of betamethasone significantly decreased diaphragm force production, fatigue resistance, total fast fibre content and anabolic signalling activity (Akt and 4E-BP1 in 21 d diaphragm. These responses were not observed in 2 d or 7 d postnatal diaphragm. Results demonstrate that maternal betamethasone treatment causes postnatal diaphragmatic dysfunction at 21 d PNA, which is attributed to MHC II protein loss and impairment of the anabolic signalling pathway. Developmental modifications in MHC fibre composition and protein signalling account for the age-specific diaphragm dysfunction.

  15. Skin penetration behaviour of liposomes as a function of their composition.

    Science.gov (United States)

    Gillet, A; Lecomte, F; Hubert, P; Ducat, E; Evrard, B; Piel, G

    2011-09-01

    Deformable liposomes have been developed and evaluated as a novel topical and transdermal delivery system. Their mechanism of drug transport into and through the skin has been investigated but remains a much debated question. The present study concerns ex vivo diffusion experiments using pig ear skin in order to explain the penetration mechanism of classical and deformable liposomes. Classical and deformable vesicles containing betamethasone in the aqueous compartment through the use of cyclodextrin inclusion complexes were compared to vesicles encapsulating betamethasone in their lipid bilayer. Deformable liposomes contained sodium deoxycholate as the edge activator. Liposomes were characterised by their diameter, encapsulation efficiency, deformability, stability (in terms of change in diameter) and release of encapsulated drug. Ex vivo diffusion studies using Franz diffusion cells were performed. Confocal microscopy was performed to visualise the penetration of fluorescently labelled liposomes into the skin. This study showed that liposomes do not stay intact when they penetrate the deepest layers of the skin. Betamethasone is released from the vesicles after which free drug molecules can diffuse through the stratum corneum and partition into the viable skin tissue.

  16. Antenatal and postnatal corticosteroid and resuscitation induced lung injury in preterm sheep

    Directory of Open Access Journals (Sweden)

    Kallapur Suhas G

    2009-12-01

    Full Text Available Abstract Background Initiation of ventilation using high tidal volumes in preterm lambs causes lung injury and inflammation. Antenatal corticosteroids mature the lungs of preterm infants and postnatal corticosteroids are used to treat bronchopulmonary dysplasia. Objective To test if antenatal or postnatal corticosteroids would decrease resuscitation induced lung injury. Methods 129 d gestational age lambs (n = 5-8/gp; term = 150 d were operatively delivered and ventilated after exposure to either 1 no medication, 2 antenatal maternal IM Betamethasone 0.5 mg/kg 24 h prior to delivery, 3 0.5 mg/kg Dexamethasone IV at delivery or 4 Cortisol 2 mg/kg IV at delivery. Lambs then were ventilated with no PEEP and escalating tidal volumes (VT to 15 mL/kg for 15 min and then given surfactant. The lambs were ventilated with VT 8 mL/kg and PEEP 5 cmH20 for 2 h 45 min. Results High VT ventilation caused a deterioration of lung physiology, lung inflammation and injury. Antenatal betamethasone improved ventilation, decreased inflammatory cytokine mRNA expression and alveolar protein leak, but did not prevent neutrophil influx. Postnatal dexamethasone decreased pro-inflammatory cytokine expression, but had no beneficial effect on ventilation, and postnatal cortisol had no effect. Ventilation increased liver serum amyloid mRNA expression, which was unaffected by corticosteroids. Conclusions Antenatal betamethasone decreased lung injury without decreasing lung inflammatory cells or systemic acute phase responses. Postnatal dexamethasone or cortisol, at the doses tested, did not have important effects on lung function or injury, suggesting that corticosteroids given at birth will not decrease resuscitation mediated injury.

  17. Cytotoxicity of five fluoroquinolone and two nonsteroidal anti-inflammatory benzalkonium chloride-free ophthalmic solutions in four corneoconjunctival cell lines

    Science.gov (United States)

    Ayaki, Masahiko; Iwasawa, Atsuo; Soda, Mitsutaka; Yaguchi, Shigeo; Koide, Ryohei

    2010-01-01

    Purpose: Epithelial disorders after eye surgery can result in visual deterioration and patient discomfort. Such disorders may be caused by drug toxicity. In the present study, we evaluated the toxicity of ophthalmic solutions, with or without benzalkonium chloride (BAK) as the preservative, used for postoperative care. Methods: A range of commercially available antibiotic and anti-inflammatory ophthalmic solutions used postoperatively (ie, levofloxacin, moxifloxacin, gatifloxacin, norfloxacin, tosufloxacin, dibekacin, cefmenoxime, diclofenac, bromfenac, pranoprofen, betamethasone, and fluoromethorone) were assessed in three corneal cell lines and one conjunctival cell line. All antibiotic solutions were BAK free. Cell viability was determined with the 3-(4,5-dimethyl-2 thiazoyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay after cells had been exposed to the drugs for 48 h. The effects of preservatives on cell viability were also determined. Toxicity was compared using the cell viability score (CVS). Results: Based on results of the MTT assay and CVS, the order of cell viability after exposure to the antibiotic solutions was cefmenoxime ≥ tosufloxicin ≥ dibekacin ≥ levofloxacin ≥ norfloxacin = gatifloxacin = moxifloxacin. For the anti-inflammatory solutions, the order of cell viability was betamethasonebetamethasone + fradiomycin > preservative-free diclofenac ≥ preservative-free bromfenac >> 0.02% fluoromethorone ≥ 0.1% fluoromethorone = diclofenac + preservative = bromfenac + preservative = pranoprofen. The anti-inflammatory drugs were more toxic than the antibiotics. The toxicity of antibiotic drugs against ocular surface cells was dependent on the pharmaceutical components of the solution, whereas that of the anti-inflammatory drugs was dependent on both the pharmaceutical components and the preservatives. Conclusion: Postoperative drug-induced epitheliopathy may be caused primarily by anti-inflammatory drugs. CVS is useful in comparing the

  18. Sensitivity of different areas of the flexor aspect of the human forearm to corticosteroid-induced skin blanching.

    Science.gov (United States)

    Meyer, E; Smith, E W; Haigh, J M

    1992-10-01

    The intensity of corticosteroid-induced blanching has been found to vary at different areas of the flexor aspect of the human forearm. A retrospective analysis of 38,880 observations of skin blanching in 56 volunteers was conducted to assess the sensitivity of forearm skin to betamethasone 17-valerate. The mid-forearm appears to be more sensitive to the blanching response than do the areas close to the wrist or elbow. These results indicate that each preparation under evaluation should be applied to several sites along the forearm when using the human skin blanching assay in order to obtain an accurate comparative assessment of corticosteroid release from topical delivery vehicles.

  19. Modificaciones hemodinámicas y metabólicas maternas secundarias al uso de betametasona para la maduración pulmonar fetal

    Directory of Open Access Journals (Sweden)

    Keibis Jiménez-Castillejo

    2013-09-01

    Full Text Available El objetivo de la investigación fue determinar las modificaciones hemodinámicas y metabólicas maternas secundarias al uso de betametasona para la maduración pulmonar fetal. Se realizó una investigación de tipo explicativa, prospectiva y longitudinal con un diseño cuasi-experimental y una muestra no probabilística intencional de 106 pacientes que acudieron a la consulta pre-natal de alto riesgo del Hospital Central “Dr. Urquinaona". Una vez seleccionadas las pacientes se le administró inyecciones intramusculares de betametasona (12 mg por dos días consecutivos. El valor de presión arterial sistólica presentó un leve aumento luego de la segunda medición y la tercera medición (p = ns. La presión arterial diastólica presentó aumento significativo durante la segunda medición y un nuevo aumento significativo en la tercera medición (p < 0,05. Se observaron aumentos significativos en el valor promedio de la frecuencia cardiaca luego de la segunda y tercera medición de betametasona (p < 0,05. No se encontraron modificaciones significativas en las concentraciones de glicemia, sodio y potasio entre las tres mediciones (p = ns. Se concluye que el uso de betametasona para inducir la maduración pulmonar fetal produce modificaciones hemodinámicas maternas acompañados de cambios metabólicos transitorios. Hemodynamical and metabolic modifications secondary to betamethasone use for fetal lung maturity Abstract The objective of research was to determine maternal hemodynamic and metabolic modifications secondary to the use of betamethasone for fetal lung maturation. An explicative, prospective and longitudinal research was done with a quasi-experimental design and intentional non probabilistic sample of 106 patients who assisted to High Risk Antenatal Consult at Hospital Central “Dr. Urquinaona". Once patients were selected, two intramuscular injections of betamethasone (12 mg were administered for two consecutive days. Systolic blood

  20. XXIV World Allergy Congress 2015

    OpenAIRE

    Lee, Heung-Man; Park, Il-Ho; Shin, Jae-Min; Zeher, Margit; Matsui, Katsuhiko; Tamai, Saki; Ikeda, Reiko; Suri, Drsushil; Suri, Dranu; Arani, Marzieh Heidarzadeh; Lubis, Azwin; Endaryanto, Anang; Koga, Shinichiro; Tsuzuki, Yasunobu; Jin, Shan

    2016-01-01

    Table of Contents A1 Pirfenidone inhibits TGF-b1-induced extracellular matrix production in nasal polyp-derived fibroblasts Jae-Min Shin, Heung-Man Lee, Il-Ho Park A2 The efficacy of a 2-week course of oral steroid in the treatment of chronic spontaneous urticaria refractory to antihistamines Hyun-Sun Yoon, Gyeong Yul Park A3 The altered distribution of follicular t helper cells may predict a more pronounced clinical course of primary sjögren’s syndrome Margit Zeher A4 Betamethasone suppresse...

  1. HELLP syndrome

    Directory of Open Access Journals (Sweden)

    Dilek Acar

    2014-08-01

    Suggested treatment modality consists, stabilization of blood pressure and magnesium sulfate infusion. Then evaluation of fetal status and planning delivery method and time if maternal status remains unstable. If prognosis seems favorable without urgent delivery and fetus can benefit from it, a course of betamethasone can be given to fetuses between 24 and 34 weeks of gestational age. The only and definite treatment of HELLP syndrome is delivering the baby. Suggested benefits of steroid therapy and other experimental treatments are still to be proven effective by large randomized controlled trials. [Archives Medical Review Journal 2014; 23(4.000: 735-760

  2. Corticosteroid contact allergy: an EECDRG multicentre study

    DEFF Research Database (Denmark)

    Dooms-Goossens, A; Andersen, Klaus Ejner; Brandäo, F M;

    1996-01-01

    This article describes the results of an EECDRG multicentre study on contact allergy to corticosteroids. A total of 7238 patients were investigated: 6238 in 13 centres in the course of 1993, and 1000 patients in 1 centre in 1993 and 1994. The 5 corticosteroids tested were budesonide 0.1% pet......., betamethasone-17-valerate 1% pet., clobetasol-17-propionate 1% pet., hydrocortisone-17-butyrate 1% eth., and tixocortol-21-pivalate 1% pet.; 189 (2.6%) gave a positive patchtest reaction (+, ++, + + +) to at least 1 of the corticosteroids. The data regarding the corticosteroid-sensitive patients, as well...

  3. Synthesis of 21-Thioureido or 21-Ureidocorticosteroids as NOS Inhibitors

    Institute of Scientific and Technical Information of China (English)

    PENG Jiu-He; HAN Chong; LI Bing-Jie; CHENG Jin-Pei

    2003-01-01

    @@ Aryl or alkyl thioureas are known as NOS inhibitors, [1~ 4] in this paper we reported the synthesis of 21-thioureido or 21-ureidocorticosteroids as potential NOS inhibitors. The title compounds were prepared from primary 21aminocorticosteroids and in vivo generated aryl isothiocynates. For comparison, 21-ureidocorticoids were synthesized in a similar way. Scheme 1 shows the preparation of 21-thioureido and 21-ureidoprednisolone. Other corticosteroids' 2 1-thioureido or ureido derivatives, such as hydrocortisone' s, methylprednisolne' s, dexamethasone' s, betamethasone' s, RS' s, cortisone' s and prednisone' s, were also prepared. Preliminary pharmacology evaluation showed that they possessed NOS inhibiting activities.

  4. Prophylactic treatment with a potent corticosteroid cream ameliorates radiodermatitis, independent of radiation schedule

    DEFF Research Database (Denmark)

    Ulff, Eva; Maroti, Marianne; Serup, Jörgen;

    2016-01-01

    schedules as well as for anatomical sites, skin type, breast size and BMI. Patients treated the irradiated area during the radiation period and two weeks following cessation of radiation. RESULTS: Patients receiving hypofraction RT developed less skin reactions than those treated with conventional RT...... in patients with breast cancer receiving adjuvant radiotherapy (RT) after surgery. In total, 202 patients were randomized to betamethasone-17-valerate cream or Essex® cream, a moisturizer. Treatment was assessed by RTOG clinical scoring. Patients' symptoms were recorded. The analyses were stratified for RT....... Treatment with a potent steroid resulted in clinically and statistically significantly less skin reactions (p

  5. Commercial glucocorticoid formulations and skin dryness. Could it be caused by the vehicle?

    Science.gov (United States)

    Korting, H C; Kerscher, M; Vieluf, D; Mehringer, L; Megele, M; Braun-Falco, O

    1991-01-01

    Eczema craquelé can be induced by repeated open application of a topical glucocorticoid, viz. 0.05% clobetasole 17-propionate cream. This might not be invariably due to the active component. Comparison of the skin surface roughness as assessed by profilometry and as expressed by RZDIN showed a decrease after repeated open application of 0.1% betamethasone 17-valerate cream and 0.25% prednicarbate cream, but an increase following the vehicle of the latter preparation. Thus commercial oil-in-water emulsion preparations seem to be potentially injurious to human skin, though this may be masked when a glucocorticoid is added.

  6. Neurosyphilis Mimicking Ramsay Hunt Syndrome.

    Science.gov (United States)

    Maeda, Tadashi; Yoshizawa, Sadako; Hirayama, Takehisa; Saga, Tomoo; Tateda, Kazuhiro; Urita, Yoshihisa

    2015-01-01

    A 36-year-old man presented with facial nerve palsy, hearing loss, vertigo and headache. He was initially diagnosed with Ramsay Hunt syndrome and treated with a systemic steroid and valaciclovir; however, his symptoms deteriorated. Serum rapid plasma reagin (RPR) and treponema pallidum hemagglutination tests were positive. Cerebrospinal fluid analysis revealed an elevated white blood cell count and positive RPR, confirming the diagnosis of neurosyphilis. Penicillin G (PCG) was administered, and his facial nerve function and headache improved. However, left-side hearing loss worsened temporarily, which was assumed to be a Jarisch-Herxheimer reaction. Betamethasone was administered along with PCG, and he recovered completely.

  7. Sdz asm 981.

    Science.gov (United States)

    Wellington, K; Spencer, C M

    2000-12-01

    SDZ ASM 981 is an anti-inflammatory macrolactam which binds with high affinity to macrophilin-12. The resulting complex inhibits calcineurin, thus blocking the synthesis of inflammatory cytokines. Twice daily application of topical SDZ ASM 981 1% cream was effective in the treatment of atopic dermatitis in adults and children in clinical trials. Summarised results from 260 patients with atopic dermatitis indicate that the efficacy of SDZ ASM 981 is dose dependent. The highest concentration evaluated (1% cream) was not as effective as betamethasone valerate 1% cream in this 3-week trial. The efficacy of SDZ ASM 981 and clobetasol ointments, used under occlusion, did not differ significantly in 10 patients with chronic psoriasis. Likewise, SDZ ASM 981 0.6% and betamethasone valerate 1% creams were similarly effective in 66 patients with allergic contact dermatitis. Concentrations of SDZ ASM 981 in the blood during topical treatment were invariably below 2.1 microg/L. Oral SDZ ASM 981 20mg or 30mg twice daily were effective in a dose dependent manner in the reduction of psoriasis in adults with no evidence of adverse effects. SDZ ASM 981 was well tolerated in the available trials, exhibiting no potential for systemic adverse reactions and no atrophogenic potential, a problem commonly associated with corticosteroid treatment.

  8. Recurrent Psoriasis After Introduction of Belatacept in 2 Kidney Transplant Recipients.

    Science.gov (United States)

    Cicora, Federico; Roberti, Javier

    2016-06-01

    Organ transplant recipients may have skin diseases as a result of immunosuppression, but psoriasis is reported infrequently. This skin condition may be induced by immunosuppression imbalance. We present 2 cases of recurrent psoriasis in 2 kidney transplant patients with belatacept-based immunosuppressive regimens. Two years after transplant, upon suspicion of calcineurin inhibitor neurotoxicity in the first patient, tacrolimus was replaced with belatacept. The patient's neurological signs resolved but the patient presented with skin lesions compatible with psoriatic plaques, successfully treated with betamethasone dipropionate and hydrocortisone. The second patient had a history of obesity and dyslipidemia, left foot amputation, and psoriasis. He received a kidney transplant, and maintenance immunosuppression included prednisone, mycophenolate mofetil, and belatacept. At posttransplant month 15, the patient presented with cutaneous erythematosus, maculopapular, and desquamative lesions compatible with psoriasis, treated with betamethasone dipropionate. The belatacept-based immunosuppressive regimens were maintained and psoriasis resolved. Psoriasis is a potential complication in kidney recipients that may recur when belatacept is used and/or tacrolimus is withdrawn as it could have happened in the first patient. The characteristics of the second case may suggest that belatacept might not have been the inciting agent. Good results were obtained with topical treatment.

  9. Determination by high-performance liquid chromatography of phenylbutazone in samples of plasma from fighting bulls.

    Science.gov (United States)

    Marti, M I González; Sánchez, González C I; Jiménez, Hernández; Cachán, García; Castro, de Cabo M J; Cuadrado, A L Garzón

    2002-03-25

    The purpose of this study was to investigate the possible presence of phenylbutazone in plasma samples from fighting bulls killed in 2nd and 3rd category bullrings in the province of Salamanca (Spain) in 1998, 1999 and 2000. For quantitative and qualitative determination, a high-performance liquid chromatograph was used, equipped with a photodiode-array detector and setting wavelengths at 240, 254 and 284 nm. The mobile phase optimized for the simultaneous detection of dexamethasone, betamethasone, flunixin and phenylbutazone, was 0.01 M acetic acid pH 3 in methanol (35:65 v/v) at a flow rate of 1 ml/min. Plasma samples were deproteinized with 400 microl of acetonitrile and 20 microl of the supernatant were injected directly into the chromatographic system equipped with a Lichrospher 60 RP select B column and guard column. For the quantitative analysis, standard calibration curves were made in a concentration range between 0.25 and 30 microg/ml, using betamethasone as internal standard. The retention time of phenylbutazone was 8.7 +/- 0.2 min and recovery was 83%. The detection and quantification limits were 0.016 and 0.029, respectively for A=240 nm. The study results show that 17 of the 74 samples analyzed in 1998, 18 of those from 1999 and 10 of those from 2000 were positive for phenylbutazone.

  10. The Effect of Dexmedetomidine on Lumbar Epidural Injection for Failed Back Surgery Syndrome

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    Ashraf Eskandr

    2016-01-01

    Full Text Available Purpose. Failed back surgery syndrome is a chronic pain condition requiring rapid, effective, and efficient management. This study evaluates the effect of adding dexmedetomidine to lumbar epidural steroids in patients with failed back surgery syndrome. Methods. Fifty patients suffering from failed back surgery syndrome were randomly assigned to one of two groups, receiving an epidural injection of 20 mL of either a mixture of betamethasone (14 mg and bupivacaine 0.5 mg (group C or a mixture of betamethasone (14 mg, bupivacaine 0.5 mg, and dexmedetomidine (0.5 μg/kg (group D adjusted to the volume with normal saline. The effect was evaluated using visual analogue scale (VAS, analgesic requirement, and Oswestry disability index 2 weeks, 4 weeks, 8 weeks, and 12 weeks after injection. Results. VAS and ibuprofen consumption showed a significant reduction in group D. The Oswestry disability index was significantly improved in group D. There were no records of hypotension, bradycardia, sedation, or hypoxemia in both groups. Conclusion. The present study demonstrated potential safe and effective usage of adding dexmedetomidine to epidural steroid to control pain in patients with failed back surgery syndrome.

  11. The effect of immunosuppressants on experimental infection with Fasciola hepatica.

    Science.gov (United States)

    Corba, J; Spaldonová, R

    1975-01-01

    Results are presented on the effect of immunosuppressive substances such as chlorambucil, cyclophosphamide, azathioprine, amethopterine and a cortizone derivate of betamethasone, on the development of Fasciola hepatica in the rat. The suppression of the immune response of the host to immunosuppressants was reflected in an earlier start of migration of the flukes to the common bile duct, and in an earlier onset of egg production as compared with that in the controls. Of the substances employed, cyclophosphamide and betamethasone were the most effective ones within the period from week 2--6 p.i., which is the time during which the migration of the flukes in the liver parenchyma is highest. Pathological changes in the liver of the animals were less marked than those of the infected controls. Evidence was obtained on an increased pathogenicity of infective larval flukes causing a higher mortality of the hosts in comparison with that of the control animals. On the other hand, the administration of immunosuppressants did neither influence the total number of developed flukes nor the appearance of eosinophilia in the peripheral blood of the treated animals.

  12. Disrupted secretory activation of the mammary gland after antenatal glucocorticoid treatment in sheep.

    Science.gov (United States)

    Henderson, Jennifer J; Hartmann, Peter E; Moss, Timothy J M; Doherty, Dorota A; Newnham, John P

    2008-11-01

    Antenatal glucocorticoids are administered to women at risk of preterm delivery to prevent neonatal respiratory morbidity. The effects of exogenous glucocorticoids on the development of lactation are unknown. This study investigated the effects of a single dose of antenatal glucocorticoids on secretory activation in sheep before and after parturition. Pregnant ewes (N=36) were randomised to receive either medroxyprogesterone acetate (MPA) at 118 days of pregnancy and betamethasone at 125 days (BETA group), MPA at 118 days and saline at 125 days (MPA group) or saline at 118 and 125 days (SALINE group). The concentration of lactose, progesterone, cortisol and prolactin in maternal plasma was measured during pregnancy. After term parturition, the concentration of lactose in milk and maternal plasma was measured daily for 5 days. Lambs were weighed at birth and at 5 days of age; milk volume was measured on day 5. The concentration of lactose in maternal plasma increased significantly after betamethasone administration, corresponding to a fall in plasma progesterone. No changes in lactose were observed in MPA or SALINE ewes. Transient decreases in cortisol and increases in prolactin were observed in the BETA group, but not in either the MPA or SALINE group. After parturition, BETA ewes experienced reduced milk yield and lamb weight gain, and delayed increases in milk lactose levels compared with MPA and saline controls. This study demonstrated that, in sheep, antenatal glucocorticoid administration disrupted secretory activation, causing precocious mammary secretion before parturition and compromising postpartum milk production and lamb growth.

  13. Chylothorax in dermatomyositis complicated with interstitial pneumonia.

    Science.gov (United States)

    Isoda, Kentaro; Kiboshi, Takao; Shoda, Takeshi

    2016-11-24

    Chylothorax is a disease in which chyle leaks and accumulates in the thoracic cavity. Interstitial pneumonia and pneumomediastinum are common thoracic manifestations of dermatomyositis, but chylothorax complicated with dermatomyositis is not reported. We report a case of dermatomyositis with interstitial pneumonia complicated by chylothorax. A 77-year-old woman was diagnosed as dermatomyositis with Gottron's papules, skin ulcers, anti-MDA5 antibody and rapid progressive interstitial pneumonia. Treatment with betamethasone, tacrolimus and intravenous high-dose cyclophosphamide was initiated, and her skin symptoms and interstitial pneumonia improved once. However, right-sided chylothorax began to accumulate and gradually increase, and at the same time, her interstitial pneumonia began to exacerbate, and skin ulcers began to reappear on her fingers and auricles. Although her chylothorax improved by fasting and parenteral nutrition, she died due to further exacerbations of dermatomyositis and interstitial pneumonia in spite of steroid pulse therapy, increase in the betamethasone dosage, additional intravenous high-dose cyclophosphamide and plasma pheresis. An autopsy showed no lesions such as malignant tumors in the thoracic cavity. This is the first report of chylothorax complicated by dermatomyositis with interstitial pneumonia.

  14. Short-term glucocorticoid administration in patients with protracted and chronic gout arthritis. Part 2 — comparison of different medication forms efficacy

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    A A Fedorova

    2008-01-01

    Full Text Available Objective. To compare efficacy of different glucocorticoid (GC medication forms in protracted and chronic gout arthritis. Material and methods. 59 pts with tophaceous gout (crystal-verified diagnosis and arthritis of three and more joints lasting more than a months in spite of treatment with sufficient doses of nonsteroidal anti-inflammatory drugs were included. Median age of pts was 56 [48;63], median disease duration — 15,2 years [7,4;20], median swollen joint count at the examination — 8 [5; 11]. The patients were randomized into 2 groups. Methylprednisolone (MP 500 mg/day iv during 2 days and placebo im once was administered in one of them, betamethasone (BM 7 mg im once and placebo iv twice — in the other. Results. Number of pts with full resolution of arthritis, recurrent exacerbation, insufficient arthritis resolution or clinically insignificant response was comparable in both groups. More rapid decrease of pain at moving was achieved during the first 2-3 days after GC administration in pts with full resolution of arthritis (p=0,03 in group receiving MP in comparison with BM. At day 14 joint damage measures did not differ between groups. Conclusion. Efficacy of short-term glucocorticoid administration does not depend on mode of administration and GC medication form (methylprednisolone 500 mg/day iv during 2 days or betamethasone 7 mg im once.

  15. Effects of perineural steroid injections on median nerve conduction during the carpal tunnel release

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    Stepić Nenad

    2008-01-01

    Full Text Available Background/Aim. The treatment outcome of the median nerve compressive neuropathy in the carpal zone due to carpal tunnel syndrome (CTS is represented by recovering the nerves sensibility, conductivity, condition and strength. Perineural application of betamethasone during the surgical decompression might result in faster recovery of compressed median nerve's conduction speed. Methods. In this study 40 patients with CTS were randomly divided in the two groups. In the first group (n = 20 we performed the surgical decompression of the median nerve by the open release of the carpal tunnel, and in the second group (n = 20 we applicated a perineural injection of 1 ml of betamethason immediately after the surgical decompression. We performed the electrodiagnostic (ED examinations 7, 30 and 90 days after the surgery, and measured the conduction speed of the median nerve in the carpal tunnel zone and the sensitivity conduction speed of the median nerve. Results. Significant differences in examined ED respective variable values in different time intervals were obtained. At the final measurements, 90 days after the surgical procedure, both groups evidenced a full recovery of the conduction speed in the carpal tunnel with statistically significant better results in the second group of the patients (t = -2.116; p = 0.043. Conclusion. Intraoperative application of the corticosteroid injection during the surgical decompression results in faster regaining of conduction speed of the median nerve.

  16. Cytotoxicity of five fluoroquinolone and two nonsteroidal anti-inflammatory benzalkonium chloride-free ophthalmic solutions in four corneoconjunctival cell lines

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    Masahiko Ayaki

    2010-09-01

    Full Text Available Masahiko Ayaki1, Atsuo Iwasawa2, Mitsutaka Soda3, Shigeo Yaguchi3, Ryohei Koide41Department of Ophthalmology, Saitama National Hospital, Saitama, Japan; 2Department of Clinical Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan; 3Department of Ophthalmology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan; 4Department of Ophthalmology, Showa University School of Medicine, Tokyo, JapanPurpose: Epithelial disorders after eye surgery can result in visual deterioration and patient discomfort. Such disorders may be caused by drug toxicity. In the present study, we evaluated the toxicity of ophthalmic solutions, with or without benzalkonium chloride (BAK as the preservative, used for postoperative care.Methods: A range of commercially available antibiotic and anti-inflammatory ophthalmic solutions used postoperatively (ie, levofloxacin, moxifloxacin, gatifloxacin, norfloxacin, tosufloxacin, dibekacin, cefmenoxime, diclofenac, bromfenac, pranoprofen, betamethasone, and fluoromethorone were assessed in three corneal cell lines and one conjunctival cell line. All antibiotic solutions were BAK free. Cell viability was determined with the 3-(4,5-dimethyl-2 thiazoyl-2,5-diphenyl-2H-tetrazolium bromide (MTT assay after cells had been exposed to the drugs for 48 h. The effects of preservatives on cell viability were also determined. Toxicity was compared using the cell viability score (CVS.Results: Based on results of the MTT assay and CVS, the order of cell viability after exposure to the antibiotic solutions was cefmenoxime ≥ tosufloxicin ≥ dibekacin ≥ levofloxacin ≥ norfloxacin = gatifloxacin = moxifloxacin. For the anti-inflammatory solutions, the order of cell viability was betamethasonebetamethasone + fradiomycin > preservative-free diclofenac ≥ preservative-free bromfenac >> 0.02% fluoromethorone ≥ 0.1% fluoromethorone = diclofenac + preservative = bromfenac + preservative = pranoprofen. The anti

  17. Monochromatic excimer light versus combination of topical steroid with vitamin D3 analogue in the treatment of nonsegmental vitiligo: a randomized blinded comparative study.

    Science.gov (United States)

    Abdel Latif, Azmy Ahmed; Ibrahim, Shady Mahmoud Attia

    2015-01-01

    Vitiligo is a difficult disease to treat, socially stigmatizing its patients. Monochromatic excimer light (MEL) was developed for use in dermatology and adapted for the treatment of vitiligo. Comparing the efficacy of MEL versus topical combination therapy of vitamin D3 analogue and steroid in the treatment of nonsegmental vitiligo. Forty-four patients with localized and stable nonsegmental vitiligo participated in the present study. In each patient, two lesions were selected and divided randomly into two groups, group A was treated with daily topical combination of calcipotriol and betamethasone and group B was treated with biweekly sessions of MEL for 3 months. Efficacy based on repigmentation percentages were blindly evaluated by two independent physicians and patient's satisfaction. There was significant improvement in both treatment modalities at the end of the study, but without significant differences in both groups. There was a significant difference between both groups regarding the onset of repigmentation (p-value vitiligo.

  18. Frecuencia cardiaca y movimientos fetales posterior a la administracion de betametasona para maduración pulmonar fetal

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    Yolima Ruiz Lopez

    2013-05-01

    Full Text Available El objetivo de la investigación fue demostrar las modificaciones de la frecuencia cardiaca y los movimientos fetales producidas por la administración de betametasona para maduración pulmonar fetal. Se realizó una investigación de tipo explicativa, prospectiva y longitudinal con un diseño cuasi-experimental y una muestra no probabilística de 106 gestantes entre 24 y 34 semanas, con diagnóstico de amenaza de parto pretérmino tratadas con betametasona (12 mg intramuscular cada 24 horas por dos dosis que acudieron al Hospital Central “Dr. Urquinaona”. Se evaluaron los movimientos fetales y frecuencia cardiaca materna y fetal. No se encontraron diferencias significativas en la frecuencia cardiaca materna comparado con los valores iniciales (p = ns. Se observó que el valor inicial de la frecuencia cardiaca fetal fue de 135,1±9,7 latidos por minuto para aumentar luego a 137,2±8,9 latidos por minuto (p = ns para presentar un nuevo aumento hasta (142,9±9,9 latidos por minuto que fue significativo comparado con los valores iniciales (p < 0,05. Se observó una disminución significativa de movimientos fetales medidos en 30 minutos después de la primera inyección (23,1±6,0 movimientos comparado con 14,8±7,0 movimientos, para aumentar después de la segunda inyección pero aun presentando valores significativamente más bajos comparado con los valores iniciales (20,0 ±6,7 movimientos; p < 0,05. Se concluye que la administración de betametasona para maduración pulmonar fetal produce incremento significativo en la frecuencia cardiaca y reducción marcada de los movimientos fetales. Abstract Fetal heart rate and movements after betamethasone administration for fetal lung maturity The objective of research was to demonstrate fetal heart rate and movements modifications by the use of betamethasone for fetal lung maturity. An explicative, prospective and longitudinal research was done with a quasi-experimental design and a non

  19. Possible cross-sensitivity between sertraline and paroxetine in a panic disorder patient

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    Khairkar Praveen

    2010-01-01

    Full Text Available Cross-sensitivity due to paroxetine and sertraline, the SSRIs, is rarely reported in the literature. We report an adverse drug reaction to paroxetine and sertraline in a patient of panic disorder, who initially developed a maculopapular, erythematous, pruritic rash in the third week with sertraline 50 mg/day. The rash resolved within 2 days of its discontinuation and oral supplementation of diphenhydramine and betamethasone. 10 days following discontinuation of sertraline, the patient was shifted on sustain release paroxetine 12.5 mg/day when another skin reaction with the same appearance and distribution appeared on day 4 of it, suggesting a possibility of cross-sensitivity, a drug class effect. This case report intends to improve the awareness among clinicians to use caution when choosing an alternative SSRIs.

  20. Intratympanic steroid prevents long-term spiral ganglion neuron loss in experimental meningitis

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Brandt, C.T.; Lund, S.P.;

    2010-01-01

    , and distortion product otoacoustic emissions showed significant hearing loss at the low frequencies in animals treated with intratympanic steroid compared with animals treated with systemic saline (p test). However, intratympanic steroid significantly increased the number of viable neurons...... in the spiral ganglion compared with both intratympanic and systemic saline (p = 0.0082 and p = 0.0089; Mann-Whitney test). Histology revealed fibrosis of the tympanic membrane and cavity in steroid-treated animals, which plausibly caused the low-frequency hearing loss. Conclusion: Intratympanic betamethasone...... treatment prevents long-term spiral ganglion neuron loss in experimental pneumococcal meningitis. This finding is clinically relevant in relation to postmeningitic hearing rehabilitation by cochlear implantation. However, the drug instillation in the middle ear induced local fibrosis and a concurrent low...

  1. A combination therapy to treat second-degree anti-Ro/La-related congenital heart block: a strategy to avoid stable third-degree heart block?

    Science.gov (United States)

    Ruffatti, A; Milanesi, O; Chiandetti, L; Cerutti, A; Gervasi, M T; De Silvestro, G; Pengo, V; Punzi, L

    2012-05-01

    While mainly based on the use of fluorinated steroids, there is no standard management of anti-Ro/La-related congenital heart block (CHB). This is a report concerning two consecutive cases of anti-Ro/La-related second-degree block treated with betamethasone (4 mg/day), weekly plasmapheresis, and intravenous immunoglobulins (IVIGs; 1 g/kg) administered every 15 days, a therapy that was begun shortly after CHB was detected and continued until delivery. The newborns were also treated with IVIG (1 g/kg) soon after birth and continued fortnightly until the anti-Ro/La antibody levels became undetectable. In both cases second-degree AV block reverted to a stable sinus rhythm with a first-degree atrioventricular (AV) block. Moreover, there was no recurrence of CHB when therapy was suspended, as confirmed by a 29 month and an eight month follow-up, respectively.

  2. Rapidly Regressive Unilateral Fetal Pleural Effusion

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    Tuncay Yuce

    2015-03-01

    Full Text Available Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case we treated a women at 32th weeks of gestation. Her pregnancy was complicated with fetal pleural effusion and polyhydramniosis. A therapeutic thoracocentesis was planned and she received two courses of betamethasone prior to procedure. On the day of planned procedure, a substantial regression of pleural effusion was observed and procedure was postponed. During her antenatal follow-up a complete regression of pleural effusion was observed. After delivery pleural effusion did not relapse. These findings hint there may be a role of antenatal steroids in treatment of fetal pleural effusion, which is known to be resistant to treatment modalities both during antenatal and postnatal period. [Cukurova Med J 2015; 40(Suppl 1: 25-28

  3. Kontaktallergi over for lokalsteroid. Kontaktallergi over for kortikosteroider blandt konsekutivt testede eksempatienter

    DEFF Research Database (Denmark)

    Vestergaard, L; Andersen, Klaus Ejner

    1997-01-01

    eczematous skin disease, who do not improve or deteriorate during topical corticosteroid therapy, contact allergy to these drugs should be suspected and relevant patch tests should be performed to sort out concomitant reactions. Future treatment with corticosteroids must take into account possible cross......We studied the frequency of contact dermatitis to corticosteroids in consecutive eczema patients and the relevance of positive patch test reactions. Of 2,742 patients patch tested at the Dermatology Clinic at Odense University Hospital between June 1991 and December 1995, 65 patients (47 women...... steroid allergens, and 17 had a positive reaction to at least one of these (2.6%). Budesonide allergy was most often encountered, followed by hydrocortisone, tixocortol pivalate and hydrocortisone-17-butyrate. Betamethasone valerate, triamcinolone acetonide and clobetasol propionate rarely caused contact...

  4. [Update of the topical treatment of psoriasis].

    Science.gov (United States)

    Carrascosa, J M; Vanaclocha, F; Borrego, L; Fernández-López, E; Fuertes, A; Rodríguez-Fernández-Freire, L; Zulaica, A; Tuneu, A; Caballé, G; Colomé, E; Bordas, X; Hernanz, J M; Brufau, C; Herrera, E

    2009-04-01

    Topical therapy continues to be one of the pillars of psoriasis management. Topical corticosteroids and vitamin D analogs are the drugs of choice during the induction phase, and vitamin D analogs continue to be drugs of choice for maintenance therapy. Tazarotene and dithranol are suitable options in patients with certain, specific characteristics. The calcineurin inhibitors can be considered to be second-line treatment for psoriasis of the face and flexures. The efficacy and safety of the fixed-dose combination of betamethasone and calcipotriol in the induction phase is greater than that of either drug alone. The combination of corticosteroids with salicylic acid achieves better results than corticosteroids in monotherapy. None of the drugs evaluated stands out over the others in all clinical situations, and their use must therefore be individualized in each patient and adjusted according to the course of the disease.

  5. Carbamzepine-induced toxic epidermal necrolysis

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    Nithyananda K Chowta

    2011-01-01

    Full Text Available Toxic epidermal necrolysis (TEN, also known as Lyell′s syndrome, is a widespread life-threatening mucocutaneous disease where there is extensive detachment of the skin and mucous membrane. Many factors involved in the etiology of TEN including adverse drug reactions. Here we are reporting a case of toxic epidermal necrolysis in an adult male patient after receiving carbamazepine in a 38 year old male. On the18th day of carbamazepine, patient developed blisters which first appeared on the trunk, chest and arms. The erythematous rash was covering almost all over the body with epidermal detachment of 70% body surface area. There was loss of eye lashes, congestion of conjunctiva with mucopurulent discharge and exposure keratitis. The clinical impression was TEN induced by carbamazepine. Carbamazepine was stopped immediately. He was treated with high dose intravenous betamethasone and systemic and topical antibiotics. After one month, the progression of the skin lesions halted and he was discharged.

  6. Fusidic acid in dermatology

    DEFF Research Database (Denmark)

    Schöfer, Helmut; Simonsen, Lene

    1995-01-01

    Studies on the clinical efficacy of fusidic acid in skin and soft-tissue infections (SSTIs), notably those due to Staphylococcus aureus, are reviewed. Oral fusidic acid (tablets dosed at 250 mg twice daily, or a suspension for paediatric use at 20 mg/kg/day given as two daily doses) has shown good...... efficacy and tolerability. Similarly, plain fusidic acid cream or ointment used two or three times daily in SSTIs such as impetigo are clinically and bacteriologically effective, with minimal adverse events. Combination formulations of fusidic acid with 1% hydrocortisone or 0.1% betamethasone achieve...... excellent results in infected eczema by addressing both inflammation and infection. A new lipid-rich combination formulation provides an extra moisturizing effect. Development of resistance to fusidic acid has remained generally low or short-lived and can be minimized by restricting therapy to no more than...

  7. Release of Steroids from Plastibase Semisolid Bases

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    D.Hassan-Zadeh S.Kararayar

    1991-07-01

    Full Text Available The present research is carried out in order to study the possibility of replacing the classic semisolid bases in steroidal commercial products with Plastibase."nAs regard to its high lipophilic properties, the plastibase alone is not a suitable base for hydrocortisone acetate and f.luocinolone acetonide. Addition of 5 and 7.5% of Propylene glycol to plastibase can increase the rate of drug release from vehicle. This change in drug release is related to decrease in drug-vehicle interaction and consequently increasing its partition coefficient. It seems that these considerations can be applied to betamethasone and clobetasole ointments, which are the most utilized in Iranian commerce .

  8. Effects of Topical Corticosteroid and Tacrolimus on Ceramides and Irritancy to Sodium Lauryl Sulphate in Healthy Skin

    DEFF Research Database (Denmark)

    Jungersted, Jakob Mutanu; Høgh, Julie Kaae; Hellgren, Lars

    2011-01-01

    The skin barrier, located in the stratum corneum, is influenced mainly by the lipid and protein composition of this layer. In eczematous diseases impairment of the skin barrier is thought to be of prime importance. Topical anti-inflammatory drugs and emollients are the most widely used eczema....... For evaluation of the skin barrier, transepidermal water loss, erythema and electrical capacitance were measured. The ceramide/cholesterol ratio was increased in betamethasone- (p = 0.008) and tacrolimus-treated (p = 0.025) skin compared with emollient-treated skin. No differences in ceramide subgroups were...... treatments. The aim of this study was to examine the effects of topically applied corticosteroid, tacrolimus and emollient on stratum corneum lipids and barrier parameters. Nineteen healthy volunteers participated in the study. Both forearms of the subjects were divided into four areas, which were treated...

  9. Effects of topical corticosteroid and tacrolimus on ceramides and irritancy to sodium lauryl sulphate in healthy skin

    DEFF Research Database (Denmark)

    Jungersted, Jakob Mutanu; Høgh, Julie Kaae; Hellegren, Lars I

    2011-01-01

    The skin barrier, located in the stratum corneum, is influenced mainly by the lipid and protein composition of this layer. In eczematous diseases impairment of the skin barrier is thought to be of prime importance. Topical anti-inflammatory drugs and emollients are the most widely used eczema....... For evaluation of the skin barrier, transepidermal water loss, erythema and electrical capacitance were measured. The ceramide/cholesterol ratio was increased in betamethasone- (p¿=¿0.008) and tacrolimus-treated (p¿=¿0.025) skin compared with emollient-treated skin. No differences in ceramide subgroups were...... treatments. The aim of this study was to examine the effects of topically applied corticosteroid, tacrolimus and emollient on stratum corneum lipids and barrier parameters. Nineteen healthy volunteers participated in the study. Both forearms of the subjects were divided into four areas, which were treated...

  10. FIXED DRUG ERUPTION DUE TO METRONIDAZOLE: REVIEW OF LITERATURE AND A CASE REPORT

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    Wahlang JB

    2012-03-01

    Full Text Available Fixed drug eruption (FDE is common type of drug eruption seen in skin clinics. FDE usually occurs within hours of administration of the offending agent. Most commonly implicated are sulphonamides, salicylates, oxyphenbutazones, tetracycline, dapsone, chlordiazepoxide, barbiturates, phenolphthalein, morphine, codeine,quinine and derivatives, phenacetin, erythromycin, griseofulvin, mebendazole, meprobamate etc. We hereby report a case of fixed drug eruption on glans penis due to metronidazole, a nitroimidazole-derivative clinically indicated in trichomoniasis, amebiasis, giardiasis, anaerobic and mixed antibacterial infections. A patientadministered metronidazole IV developed erythematous superficial non-tender ulceration over the glans penis on the second day of treatment with Inj. Metronidazole. A provisional diagnosis of metronidazole induced fixed drug eruption was made, metronidazole inj. was stopped and the patient was managed with Tab. Prednisolone30mg/day tapered over 10 days and Fusidic acid+Betamethasone cream.

  11. Dexamethasone and diclofenac confirmation by LC-MS-MS as herbal product adulterants

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    Lourdes Garza-Ocañas

    2013-09-01

    Full Text Available Objective. To confirm the presence of dexamethasone and diclofenac as adulterants of an herbal product. Materials and methods. For identificaction and confirmation of drugs a method of instrumental analysis by liquid chromatography coupled with high pressure tandem mass spectrometry was used. Results. The presence of dexamethasone and diclofenac was confirmed in samples of 11 bottles of Reumofan Plus obtained from patients and/or physicians. The methodology used, allowed separation of stereoisomers dexamethasone and betamethasone, the relative abundances of product ions 237.2 and 279.2 m / z spectrally differentiate the compounds. Conclusions. The presence of dexamethasone and diclofenac was confirmed in samples of a product marketed as “100% natural” obtained from patients and / or physicians in a period from January to December, 2011.

  12. Glucocorticoid-induced fetal programming alters the functional complement of angiotensin receptor subtypes within the kidney.

    Science.gov (United States)

    Gwathmey, TanYa M; Shaltout, Hossam A; Rose, James C; Diz, Debra I; Chappell, Mark C

    2011-03-01

    We examined the impact of fetal programming on the functional responses of renal angiotensin receptors. Fetal sheep were exposed in utero to betamethasone (BMX; 0.17 mg/kg) or control (CON) at 80 to 81 days gestation with full-term delivery. Renal nuclear and plasma membrane fractions were isolated from sheep age 1.0 to 1.5 years for receptor binding and fluorescence detection of reactive oxygen species (ROS) or nitric oxide (NO). Mean arterial blood pressure and blood pressure variability were significantly higher in the BMX-exposed adult offspring versus CON sheep. The proportion of nuclear AT(1) receptors sensitive to losartan was 2-fold higher (67 ± 6% vs 27 ± 9%; Pprogramming.

  13. Spectral domain optical coherence tomography study of pearl-like lesions in the anterior chamber

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    Soliman W

    2012-06-01

    Full Text Available Wael Soliman*, Ehab I Wasfi*, Omar M AliDepartment of Ophthalmology, Assiut University Hospital, Assiut University, Assiut, Egypt*These authors contributed equally to this workAim: To study the morphological pattern of pearl-like lesions in the anterior chambers of children before and after management using anterior segment spectral domain optical coherence tomography (SD-OCT.Patients and methods: This was a prospective, observational cross-sectional study of patients presenting with peculiar pearl-like lesions in the anterior chamber of their eyes. 1 mL of betamethasone sodium phosphate (2 mg/mL and betamethasone dipropionate (5 mg/mL was injected subconjunctivally. Follow-ups of all patients were conducted for a period of 6 weeks. Anterior segment imaging was done using SD-OCT and also photo slit lamp before and after management.Results: Twelve eyes of 12 patients were included in this study. These patients presented with pearl-like lesions in the anterior chamber with signs of anterior uveitis. There was no history of ocular injury or tuberculosis in any patients. Six weeks after subconjunctival steroid injection, all patients achieved mean best-corrected visual acuity, which changed from 0.2 (range 0.1–0.4 to 0.5 (range 0.4–0.8, and the severity of iritis decreased. SD-OCT showed that the lesions at presentation appeared as a globular noncystic mass attached to the back of the cornea, encroaching on the angle of the eye, and attached to the anterior surface of the iris at some points.Conclusion: SD-OCT for imaging the anterior segment allowed us to exclude the cystic nature of this pearly lesion. Some similarities may exist between these pearly lesions and superficial phlyctenular keratitis, which may support the immunological and inflammatory origin of these lesions.Keywords: pearl-like lesions, anterior chamber, phlycten, anterior segment OCT

  14. Effects of repeated prenatal glucocorticoid exposure on long-term potentiation in the juvenile guinea-pig hippocampus.

    Science.gov (United States)

    Setiawan, Elaine; Jackson, Michael F; MacDonald, John F; Matthews, Stephen G

    2007-06-15

    Synthetic glucocorticoids (sGCs) are routinely used to treat women at risk of preterm labour to promote fetal lung maturation. There is now strong evidence that exposure to excess glucocorticoid during periods of rapid brain development has permanent consequences for endocrine function and behaviour in the offspring. Prenatal exposure to sGC alters the expression of N-methyl-D-aspartate receptor (NMDA-R) subunits in the fetal and neonatal hippocampus. Given the integral role of the NMDA-R in synaptic plasticity, we hypothesized that prenatal sGC exposure will have effects on hippocampal long-term potentiation (LTP) after birth. Further, this may occur in either the presence or absence of elevated cortisol concentrations, in vitro. Pregnant guinea-pigs were injected with betamethasone (Beta, 1 mg kg(-1)) or vehicle on gestational days (gd) 40, 41, 50, 51, 60 and 61 (term approximately 70 days), a regimen comparable to that given to pregnant women. On postnatal day 21, LTP was examined at Schaffer collateral synapses in the CA1 region of hippocampal slices prepared from juvenile animals exposed to betamethasone or vehicle, in utero. Subsequently, the acute glucocorticoid receptor (GR)- and mineralocorticoid receptor (MR)-dependent effects of cortisol (0.1-10 microM; bath applied 30 min before LTP induction) were examined. There was no effect of prenatal sGC treatment on LTP under basal conditions. The application of 10 microM cortisol depressed excitatory synaptic transmission in all treatment groups regardless of sex. Similarly, LTP was depressed by 10 microM cortisol in all groups, with the exception of Beta-exposed females, in which LTP was unaltered. Hippocampal MR and GR protein levels were increased in Beta-exposed females, but not in any other prenatal treatment group. This study reveals sex-specific effects of prenatal exposure to sGC on LTP in the presence of elevated cortisol, a situation that would occur in vivo during stress.

  15. Management of chronic hemophilic synovitis in children by phonophoresis

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    Saraf S

    2005-01-01

    Full Text Available Background: Physical cascades in hemophilia like hemarthrosis and its sequelae like chronic synovitis can be managed better by repeated factor transfusions or radiotherapy or injectable rifampicin, however, the non-availability and high cost of these modalities of therapy prompted us to look into other innovative methods, which could be effective and economical. Methods: Drug induced pulse ultrasound therapy (phonophoresis using Betamethasone ointment was used in patients of chronic hemophilic synovitis on alternate day for an average duration of six minutes. Ten to 15 such sittings were given during the course of treatment. The objective parameters for the evaluation of results included changes in the degree of swelling, range of movements, frequency of joint bleed and joint tenderness. Subjective assessment was the grading of response by the patient viz. significant, moderate or poor. Results: The study included 21 patients of synovitis knee (24 knees in children of 6-15 yrs. As per Caviglia classification, four knees were graded gr. I, thirteen as gr. II and seven as gr. III. There was significant reduction in the joint swelling. The range of movements also increased satisfactorily with decrease in the frequency of joint bleed in the follow up. Results were adjudged as good in nine, fair in nine and poor in six; response being better in grade I and grade II. Conclusion: Low dose pulse ultrasound does not produce heat, rather changes permeability of membrane, and reduces pain and hematoma. The introduction of local steroidal drug with ultrasound further helps in the colloidochemical action. Phonophoresis relies on perturbation of the tissues encouraging absorption of the drug. Phonophoresis using betamethasone showed significantly good results in short term follow up in chronic hemophilic synovitis of knee. This modality of treatment can be valuable in developing countries where factor replacement is a problem and other modalities of

  16. A case of radial keratoneuritis in non-Acanthamoeba keratitis

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    Mutoh T

    2012-09-01

    Full Text Available Tetsuya Mutoh, Yukihiro Matsumoto, Makoto ChikudaDepartment of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanAbstract: A case of non-Acanthamoeba keratitis with radial keratoneuritis, which is thought to be pathognomonic for Acanthamoeba keratitis, is reported. A healthy 32-year-old woman with a history of frequent replacement of her contact lenses due to wear was examined at Dokkyo Medical University Koshigaya Hospital (Saitama, Japan and found to have a slight corneal opacity that was accompanied by radial keratoneuritis. Based on both the patient’s clinical findings and past history, the presence of Acanthamoeba keratitis was highly suspected. However, direct light microscopy of corneal scrapings stained by the Parker ink–potassium hydroxide method only found Acanthamoeba-type material in the specimen collected at her initial visit. In all other specimens collected from the patient, no Acanthamoeba was found either when using the same method or when performing cultures of the surgical debridement of the corneal lesion. In addition, topical antifungal eye drops, systemic antifungal drugs, and surgical debridement were also not effective in this case. Since a precise diagnosis could not be made, the patient was treated with topical 0.1% betamethasone sodium, which ultimately resulted in a dramatic improvement of her corneal inflammation. At 23 days after initiation of topical administration of 0.1% betamethasone sodium, visual acuity was 20/250, with a slight corneal opacity noted at the original site of infection. The outcome of the current case suggests that radial keratoneuritis is not always pathognomonic for Acanthamoeba keratitis.Keywords: radial keratoneuritis, non-Acanthamoeba keratitis, topical corticosteroid

  17. Kelch-like ECT2-interacting protein KLEIP regulates late-stage pulmonary maturation via Hif-2α in mice

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    Nicole Woik

    2014-06-01

    Full Text Available Respiratory distress syndrome (RDS caused by preterm delivery is a major clinical problem with limited mechanistic insight. Late-stage embryonic lung development is driven by hypoxia and the hypoxia-inducible transcription factors Hif-1α and Hif-2α, which act as important regulators for lung development. Expression of the BTB-and kelch-domain-containing (BTB-kelch protein KLEIP (Kelch-like ECT2-interacting protein; also named Klhl20 is controlled by two hypoxia response elements, and KLEIP regulates stabilization and transcriptional activation of Hif-2α. Based on the available data, we hypothesized an essential role for KLEIP in murine lung development and function. Therefore, we have performed a functional, histological, mechanistic and interventional study in embryonic and neonatal KLEIP−/− mice. Here, we show that about half of the KLEIP−/− neonates die due to respiratory failure that is caused by insufficient aeration, reduced septal thinning, reduced glycogenolysis, type II pneumocyte immaturity and reduced surfactant production. Expression analyses in embryonic day (E 18.5 lungs identified KLEIP in lung capillaries, and showed strongly reduced mRNA and protein levels for Hif-2α and VEGF; such reduced levels are associated with embryonic endothelial cell apoptosis and lung bleedings. Betamethasone injection in pregnant females prevented respiratory failure in KLEIP−/− neonates, normalized lung maturation, vascularization, aeration and function, and increased neonatal Hif-2α expression. Thus, the experimental study shows that respiratory failure in KLEIP−/− neonates is determined by insufficient angiocrine Hif-2α–VEGF signaling and that betamethasone activates this newly identified signaling cascade in late-stage embryonic lung development.

  18. [Effect of anti-inflammatory drugs, alone and combined with ofloxacin, on the respiratory burst of human polymorphonuclear leukocytes].

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    Cabrera, E; Velert, M M; Orero, A; Martínez, P; Cantón, E

    2001-06-01

    The antibacterial activity of polymorphonuclear leukocytes (PMNs) is based on the production of superoxide anion and H(2)O(2) in the respiratory burst and can be impaired in different ways. The combination of an antibacterial agent and an antiinflammatory drug is quite common in immunodepressed patients whose respiratory burst of PMN could be impaired. In this study we examine in vitro the effect of pretreating (35 degrees C for 30 min) PMNs with the antiinflammatory drugs dexamethasone (0.4, 4 and 40 microgram/ml), methylprednisolone (0.37, 3.7 and 37 microgram/ ml), hydrocortisone (0.048, 0.48 and 4.8 microgram/ml), betamethasone (0.1, 1, 5 and 10 mg/ml), phenylbutazone (1000 microgram/ml) and acetylsalicylic acid (25, 250, 2500 microgram/ml) alone, and combined with 10 mg/ml of ofloxacin on the respiratory burst. Superoxide anion was measured by the cytochrome c reduction microtechnique and H(2)O(2) by phenol red. The antiinflammatory drugs alone decreased the production of H(2)O(2) (except dexamethasone and methylprednisolone) and superoxide anion (except betamethasone) from 15-45%, depending on the antiinflammatory drug and concentration, while ofloxacin increased the production of superoxide anion (20.2 +/- 6.7%). The combination of antiinflammatory drugs with ofloxacin neutralizes the inhibitory effect of the former on the respiratory burst of PMNs. It is therefore important to know the effect of drugs on the respiratory burst in order to choose those that have the same therapeutic effect without interfering with PMN functions.

  19. MACROSCOPIC ANALYSES OF THE EFFECTS OF HYALURONATES AND CORTICOSTEROIDS ON INDUCED OSTEOARTHRITIS IN RABBITS’ KNEES

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    Albano, Mauro Batista; Vidigal, Leandro; de Oliveira, Marcello Zaia; Namba, Mario Massatomo; da Silva, João Luiz Vieira; de Assis Pereira Filho, Francisco; Barbosa, Marcio Alves; da Silva, Elias Marcelo Batista

    2015-01-01

    Objective: To evaluate the effects of intra-articular injections of corticosteroids, native hyaluronic acid and branched-chain hyaluronic acid in experimentally-induced osteoarthrosis. Methods: 44 rabbits underwent anterior cruciate ligament resection and were then divided into four groups of eleven. Group 1: one intra-articular injection of saline solution per week, for three weeks; Group 2: three injections (one per week) of native hyaluronic acid; Group 3: three injections (one per week) of branched-chain hyaluronic acid; Group 4: two injections of betamethasone with an interval of three weeks. The cartilage of the tibial plateaus was evaluated macroscopically twelve weeks after surgery. Changes to the joint surface were graded as follows: Grade 0: smooth joint surface without relief changes; Grade 1: rough surface without any depressions; Grade 2: similar to grade 1, but with depressions on the joint surface; and Grade 3: subchondral bone exposure. The statistical analysis consisted of the use of Student's t test, chi-square test and analysis of variance (ANOVA). The significance level used was 5%. Results: A statistical difference was found between the control group and the three study groups 2, 3, 4 in relation to the development and severity of arthrosis. However, there was no difference between the groups regarding the drugs studied. Conclusion: A similar degree of attenuation of the osteoarthrosis process in the rabbits’ knees was found with the use of intra-articular injections of low-molecular-weight and high-molecular-weight glycosaminoglycans, and the corticosteroid betamethasone, compared with placebo. PMID:27022552

  20. Partitioning of anti-inflammatory steroid drugs into phosphatidylcholine and phosphatidylcholine-cholesterol small unilamellar vesicles as studied by second-derivative spectrophotometry.

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    Takegami, Shigehiko; Kitamura, Keisuke; Funakoshi, Takako; Kitade, Tatsuya

    2008-05-01

    The partition coefficients (Kps) of six anti-inflammatory steroid drugs, dexamethasone (DMS), betamethasone (BMS), triamcinolone acetonide (TCLA), fluocinolone acetonide (FCLA), betamethasone 17,21-dipropionate (BMSDP), and clobetasole propionate (CBSP), for phosphatidylcholine (PC), and PC-cholesterol small unilamellar vesicles (SUVs) were determined by a second-derivative spectrophotometric method. The Kp values were obtained with a relative standard deviation of below 10% and the following order was observed: BMS< or =DMS

  1. Use of real time continuous glucose monitoring and intravenous insulin in type 1 diabetic mothers to prevent respiratory distress and hypoglycaemia in infants

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    Passaro Patrizia

    2008-07-01

    Full Text Available Abstract Background Pregnancy in Type 1 diabetic patients is a precarious condition, both for mother and fetus with increased the risk of prematurity and, immediately after delivery with risk of respiratory distress syndrome and hypoglycaemia in newborns. A strict control and monitoring of diabetes throughout pregnancy is important in reducing the impact of the disease on the fetus and newborn. In recent years many new technologies have been introduced to ameliorate diabetes monitoring, where the last is the Real-time Continuous Glucose Monitoring System (RT-CGMS. Methods In the last three years, 72 h continuous glucose monitoring system (RT-CGMS (Medtronic, CA was performed in 18 pregnant women with Type 1 diabetes in two moments of pregnancy: during treatment with betamethasone to prevent respiratory distress and during delivery. In both cases insulin was administered intravenous and the dose was changed on the basis of glycaemia. Results The results present the use of this new technique during two topics moments of pregnancy of type 1 diabetes patients when is very important intensively to monitor diabetes and to obtain the well being of the fetus. No infant experimented hypoglycaemia or respiratory distress syndrome at the moment and in the first hours after the birth. Conclusion We wish to stress the importance reducing glycaemia during administration of betamethasone and during labor. It is conceivable that the scarce attention paid to monitoring glucose levels in diabetic mothers during labor in gynaecological world may be due to the difficulty in glucose monitoring with the devices until now available. Hopefully, our anecdotal account may prompt improvements with RT-CGMS, and may lead to a better approach to the problem, thereby changing the prognosis of infants born to diabetic mothers.

  2. Doppler obstétrico posterior al uso de Betametasona para la maduración pulmonar fetal

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    Keibis Jiménez Castillejo

    2014-04-01

    Full Text Available El objetivo de la investigación fue determinar las modificaciones del Doppler obstétrico posterior al uso de betametasona para la maduración pulmonar fetal. Se realizó una investigación de tipo explicativa, prospectiva y longitudinal con un diseño cuasi-experimental y una muestra no probabilística intencional de 106 pacientes que acudieron a la consulta Pre-natal de Alto Riesgo del Hospital Central “Dr. Urquinaona". Una vez seleccionadas las pacientes se les administró inyecciones intramusculares de betametasona (12 mg/día por dos días consecutivos. Se realizaron las mediciones de índice de pulsatilidad e índice de resistencia en las arterias uterinas, umbilical y cerebral media fetal. No se encontraron diferencias estadísticamente significativas entre las determinaciones del índice de pulsatilidad y de resistencia de las arterias uterinas (p = ns. Se observaron disminuciones significativas en el índice de pulsatilidad y de resistencia de la arteria umbilical en la segunda y tercera medición al compararla con la medición inicial (p < 0,05. Se encontraron disminuciones en el índice de pulsatilidad de la arteria cerebral media fetal en ambos periodos de estudio comparado con los valores iniciales y solo se observó una disminución significativa del índice de resistencia en la segunda medición (p < 0,05. Se concluye que el uso de betametasona para la maduración pulmonar fetal produce modificaciones en la evaluación Doppler de las arterias umbilical y cerebral media fetal. Obstetric doppler after use of Betamethasone for fetal lung maturation Abstract The objective of research was to determine modifications of obstetric Doppler after to fetal lung maturation. An explicative, prospective and longitudinal research was done with a quasi-experimental design and an intentional non probabilistic sample of 106 patients who assisted to High Risk Antenatal Consult at Hospital Central “Dr. Urquinaona". Once patients were selected

  3. Current regimen of pulse therapy for pemphigus: Minor modifications, improved results

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    Pasricha J

    2008-01-01

    Full Text Available Background: If administered properly, dexamethasone cyclophosphamide pulse (DCP therapy has the potential to effect lifelong recovery from pemphigus. Aims: The objective of this paper is to highlight various parameters of DCP therapy and also, to report the effects of a few modifications in the regimen. Methods: An analysis of 123 patients treated with the DCP/DP regimen over a period of five years (1998 to 2002 is presented here. Seventeen patients who did not start/continue the treatment and three patients who died during the treatment have been excluded from the analysis. Twenty patients who had not yet started families were given only dexamethasone pulses (DPs while 103 patients received DCPs. Low dose (50 mg/day cyclophosphamide was used as in the standard regimen. The three modifications introduced into the regimen were: (1 an additional daily dose of oral betamethasone sufficient to control the disease activity during phase I, which was progressively tapered off completely as the patient recovered, (2 use of systemic antibiotics if the patient had skin lesions, and oral anti-candida drugs if the patient had oral ulcers until complete healing, and (3 insistence on thorough cleaning of the skin and scalp with a normal soap and shampoo, and proper maintenance of oral hygiene in spite of skin/mucosal lesions. The regimen consisted of DCP/DP repeated in exactly 28-day cycles, along with 50 mg cyclophosphamide per day, insistence on completing the treatment and avoiding irregular pulses in all patients. The number of DCPs/DPs during phase I varied in different patients depending upon the dose of betamethasone used and the rate of recovery, but phase II (nine DCPs/DPs in exactly 28-day cycles along with 50 mg cyclophosphamide per day and phase III (only 50 mg cyclophosphamide per day was fixed at nine months each. This was followed by posttreatment follow-up (phase IV. Results: At present, all the patients are in complete remission. The

  4. Efficacy of intravitreal dexamethasone implant for prostaglandin-induced refractory pseudophakic cystoid macular edema: case report and review of the literature

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    Sacchi M

    2014-07-01

    Full Text Available Matteo Sacchi, Edoardo Villani, Francesca Gilardoni, Paolo Nucci University Eye Clinic, San Giuseppe Hospital, University of Milan, Milan, Italy Background: Macular edema is a known complication even after uneventful cataract surgery. The chronic use of prostaglandin analogs is a risk factor for the development of pseudophakic cystoid macular edema (CME. Nonsteroidal anti-inflammatory drugs (NSAIDs are considered first-line therapy but refractory postsurgical CME represents a therapeutic challenge, as there is not an evidence-based treatment.Objective: To report the use of a single implant of intravitreal dexamethasone for tafluprost-associated pseudophakic CME refractory to NSAIDs and to sub-Tenon’s corticosteroid injections.Case report: A 64-year-old female with ocular hypertension treated with tafluprost experienced decreased vision (visual acuity 20/60 and metamorphopsia 2 months after uneventful cataract extraction. Spectral domain optical coherence tomography (SD-OCT revealed CME. After 1 month of topical and oral NSAIDs, CME was still evident on SD-OCT (visual acuity 20/50. Two sub-Tenon’s betamethasone injections were performed at a 2-week interval. As CME was still present, 2 months after the diagnosis of CME (visual acuity 20/40, the patient underwent a single dexamethasone intravitreal implant. One month later, macular appearance was normal, and visual acuity increased to 20/30. This result was maintained throughout the 6 months of follow-up.Conclusion: In this report, a single implant of intravitreal dexamethasone successfully treated pseudophakic CME associated with the use of prostaglandin analogs unresponsive to NSAIDs and sub-Tenon’s betamethasone. The results of this report need to be corroborated by powered, prospective, randomized trials. The need for repeated treatments as well as the retreatment interval in patients requiring more than a single injection are issues still needing further investigations. Keywords

  5. A STUDY OF COMPARATIVE EFFEICIENCY OF ORAL MINI PULSE THERAPY VERSUS ORAL ACITRET IN IN GENARALISED LICHEN PLANUS

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    Guru Prasad

    2015-10-01

    Full Text Available BACKGROUND: Lichen planus is a chronic inflammatory disease that effects skin, mucous membranes, hair and nails. There are several drugs both topical and systemic for the treatment of lichen planus. AIMS AND OBJECTIVES: Present study was done to compare the efficacy between oral mini pulse therapy with betamethasone and with acetretin in the management of generalised lichen planus. MATERIALS AND METHODS: The study was carried out on patients who were clinically diagnosed as generalised lichen plan us, attending the outpatient department of dermatology, venereology and leprosy, King George hospital, affiliated to Andhra medical college, Vis h akhapatnam from November 2011 to December 2012. A total of 60 patients were included in study and divided into two equal groups. Group1 patients were treated with 0.1 mg/kg of oral betamethasone given on 2 consecutive days in a week till 8 weeks and tapered. Group 2 patients were treated with 0.5 mg/kg of acetretin for 8 weeks and tapered. INCLUSION CRITERIA: All pa tients of age group in between 11 - 60 years , of either sex, suffering f rom lichen planus of duration > 3 months, and women in group 2 who were in reproductive age group on two methods of contraception were included. EXCLUSION CRITERIA: Pregnant and lactating women, in Group 1: patients suffering from diabetes, hypertension, peptic ulcer disease, renal, hepatic, heart disease or tuberculosis, in Group 2: patients with abnormal lipid profile, diabetes, hypertension, renal, liver or heart disease were excluded. RESULTS: out of 60 patients enrolled in study, 2 patients from group 1 and 5 patients from group 2 were dropped from study and results were concluded. Majority of patients were in age group of 31 - 60 (78.3% with male to female ratio of 2.1:1.Group 1 patient s at the end of 8 weeks response was seen in 92.8%, with relapse rate of 15.38% after 6 months of follow up. Group 2 patients at end of 8 weeks response was seen in 72 % with relapse

  6. [The current views of the treatment of diffuse external otitis].

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    Fedorova, O V; Shadrin, G B

    2016-01-01

    The objective of the present study was to evaluate the clinical effectiveness and safety of the local application of triderm for the treatment of diffuse external otitis. The study included 68 patients presenting with bacterial and fungal diffuse external otitis. The treatment in the form of local empiric therapy was continued till the results of microbiological treatment became apparent. The beneficial outcome achieved in 91.2% of the patients was clinically manifest as the regression of the inflammatory process in the external auditory meatus. No complications, such as ototoxic events, either local or systemic allergic reactions, were documented. The authors substantiate the possibility of the application of the medication under consideration for the treatment of diffuse external otitis based on the knowledge of the mechanism of the actin of its constituent components, viz. betamethasone, dipropionate, gentamicin sulfate, and clotrimazole, taking into account the occurrence of the most common causative agents of diffuse external otitis. It is concluded that triderm is a safe medication for the local application and, probably, for the initial empiric therapy of diffuse external otitis to be continued till the results of the microbiological treatment become apparent.

  7. Iatrogenic Cushing syndrome caused by ocular glucocorticoids in a child.

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    Messina, Maria Francesca; Valenzise, Mariella; Aversa, Salvatore; Arrigo, Teresa; De Luca, Filippo

    2009-01-01

    A boy aged 7.6 years presented to our Unit of Paediatric Endocrinology for evaluation of obesity. Progressive weight gain (10 kg) started 6 months earlier after an accidental penetrating orbital injury on the right eye. During this period the child has been treated with oral betamethasone (0.5 mg/day) for 1 month and dexamethasone 2% ocular drops (2 hourly by day) for 6 months. Physical examination showed he was 113.5 cm in height (-1.5 SD), weight 36.0 kg, blood pressure 110/90 mmHg (90th centile), body mass index 28 (+5 SD), truncal obesity, buffalo hump, "moon-face", increased lanugo hair and supraclavicular fullness. Endocrinological work-up revealed undetectable levels of basal adrenocorticotropic hormone (ACTH), basal and ACTH-stimulated cortisol and 24 h urine excretion cortisol, confirming the diagnosis of iatrogenic Cushing syndrome. The abrupt withdrawal of ocular glucocorticoids by the parents evoked two adrenal crises; 4 months later the patient recovered. In conclusion, we would alert doctors that every formulation of glucocorticoids, no ocular drops excluded, can determine severe systemic side effects and iatrogenic Cushing syndrome.

  8. [Treatment of severe Rhesus erythroblastosis].

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    Bichler, A; Frisch, H

    1977-01-01

    Report about the management of cases of severe Rhesus erythroblastosis. One case is specially discussed because of it's actuality. This was a patient with severe Rh-sensitization (OOD at 450 mm from the beginning of the 30th week of gestation in zone III according to Liley). Because of the haemolytic disease and the chronic fetal distress the Caesarean section was already performed in the 32nd week of gestation after Betamethason treatment of the mother. The Lecithin-Sphingomyelin (L/S) ratio in the amniotic fluid as a criterium of fetal lung maturity raised almost twicefold (from 0.9 to 1.6) after Cortison treatment. The intensive care (assisted ventilation with PEEP, correction of the acidosis and transfusion of packed red cells) of the severely anaemic (Hb 3.5 g%, Hk 15 vol.%) and hydropic newborn was already started in the delivery room. The newborn developed no RDS and was discharged healthy. With reference to this and other cases the management of severe Rh-sensitization before the 34th week of gestation is discussed. Premature infants are mainly susceptable to the development of a Respiratory Distress syndrome (RDS). After antepartum Cortison treatment for prevention of an RDS the date of confinement should be arranged earlier. The value of an early Caesarian section after antepartum Glucocorticoid treatment as compared to the application of intrauterine transfusions in cases of severe erythroblastosis is discussed. It is also reported about recent methods of treatment of severe conditions of hydrops fetalis.

  9. Nodular scabies: a classical case report in an adolescent boy.

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    Ramachandra Reddy, Damodara; Ramachandra Reddy, Prathap

    2015-09-01

    This case report presents a classical case of nodular scabies in a 12 year boy who complained of itching for 20-21 days before presentation to the hospital. Application of Betnovate ointment (Betamethasone valerate 0.1 %) before presentation to the hospital had provided only 2-3 days of relief from itching. Dermatological examination revealed skin colored to erythematous papule of 3-4 mm on the body with predilection for web space of fingers and flexural areas and nodules on the scrotum and groin. Based on this, clinical diagnosis of scabies with nodular scabies was made on the child. The scraping obtained from the web-space of the child showed mite under the light microscope, which confirms the diagnosis. Treatment with topical permethrin 5 % lotion resulted in 50-70 % subsidence of itching within a day, and improvement in impetigo lesions of his father in 5 days. However, the scrotal and groin nodular lesion of the child persisted with severe itching. Treatment with topical steroid and tacrolimus 0.1 % ointment did not show much improvement. Intralesional injection of triamcinolone (5 mg/ml) on the nodule resulted in 30-40 % subsidence in itching and 50-60 % reduction in the size of the lesion over 2-3 weeks.

  10. A case of anterior ischemic optic neuropathy associated with uveitis

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    Sugahara M

    2013-05-01

    Full Text Available Michitaka Sugahara, Takayuki Fujimoto, Kyoko Shidara, Kenji Inoue, Masato Wakakura Inouye Eye Hospital, Tokyo, Japan Introduction: Here, we describe a patient who presented with anterior ischemic optic neuropathy (AION and subsequently developed uveitis. Case: A 69-year-old man was referred to our hospital and initially presented with best-corrected visual acuities (BCVA of 20/40 (right eye and 20/1000 (left eye and relative afferent pupillary defect. Slit-lamp examination revealed no signs of ocular inflammation in either eye. Fundus examination revealed left-eye swelling and a pale superior optic disc, and Goldmann perimetry revealed left-eye inferior hemianopia. The patient was diagnosed with nonarteritic AION in the left eye. One week later, the patient returned to the hospital because of vision loss. The BCVA of the left eye was so poor that the patient could only count fingers. Slit-lamp examination revealed 1+ cells in the anterior chamber and the anterior vitreous in both eyes. Funduscopic examination revealed vasculitis and exudates in both eyes. The patient was diagnosed with bilateral panuveitis, and treatment with topical betamethasone was started. No other physical findings resulting from other autoimmune or infectious diseases were found. No additional treatments were administered, and optic disc edema in the left eye improved, and the retinal exudates disappeared in 3 months. The patient's BCVA improved after cataract surgery was performed. Conclusion: Panuveitis most likely manifests after the development of AION. Keywords: anterior ischemic optic neuropathy, uveitis

  11. Synthesis of lab-in-a-pipette-tip extraction using hydrophilic nano-sized dummy molecularly imprinted polymer for purification and analysis of prednisolone.

    Science.gov (United States)

    Arabi, Maryam; Ghaedi, Mehrorang; Ostovan, Abbas; Wang, Shaobin

    2016-10-15

    A novel pipette-tip based on nano-sized dummy molecularly imprinted polymer (PT-DMIP) assisted by ultrasonication for the effective enrichment and analysis of prednisolone from urine samples was developed. The PT-DMIP cartridge was prepared by packing the dummy molecularly imprinted polymer at the tip of the micropipette. The polymerization used betamethasone (BM) as the dummy template, 3-aminopropyltrimethoxysilane (APTMS) as the functionalized monomer, tetraethyl orthosilicate (TEOS) as the cross-linker and aluminum ion (Al(3+)) as a dopant to produce Lewis acid sites in the silica matrix for metal coordinative interactions with the analyte. Compared to conventional solid phase extraction (SPE), the PT-DMIP is cost-effective, fast, and easy to handle, while the system is very approachable and reduces the consumption of toxic organic solvent. HPLC-UV analysis revealed successful applicability of the sorbent for highly efficient extraction of perdnisolone from urine matrices. The extraction recovery was investigated and optimum conditions were obtained using central composite design. Good linearity for prednisolone in the range of 0.22-220μgL(-1) with regression coefficients of 0.99 reveals high applicability of the method for trace analysis. Under the optimized conditions, the recoveries are 89.0-96.1 with relative standard deviations (RSD) of less than 9.0%.

  12. Treatment of phimosis with topical steroids and foreskin anatomy

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    Tatiana C. Marques

    2005-08-01

    Full Text Available OBJECTIVES: To correlate topical steroidal treatment of stenosed foreskin with the different degrees of glans exposure and the length of time the ointment is applied. MATERIALS AND METHODS: We studied 95 patients with phimosis, divided according to the degree of foreskin retraction. Group A presented no foreskin retraction, group B presented exposure of only the urethral meatus, group C presented exposure of half of the glans, and group D presented exposure of the glans, which was incomplete because of preputial adherences to the coronal sulcus. Patients were submitted to application of 0.05% betamethasone ointment on the distal aspect of the prepuce twice daily for a minimum of 30 days and a maximum of 4 months. RESULTS: Of 95 patients, 10 (10.52% abandoned the treatment and 15 patients in groups C and D were excluded from the study. Among the remaining 70 patients, only 4 patients (5.7% in group A did not obtain adequate glans exposure after treatment. In group A (38 patients, fully retractable foreskins were obtained in 19 patients (50% after 1 month of treatment. In group B (28 patients, fully retractable foreskins were obtained in 18 patients (64.2% after 1 month. CONCLUSIONS: Treatment was successful in 94.2% of patients, irrespective of the type of foreskin anatomy. The improvement may require several months of treatment. Patients with impossibility of urethral meatus exposure present around 10% treatment failure.

  13. Multiple Antenatal Dexamethasone Treatment Alters Brain Vessel Differentiation in Newborn Mouse Pups.

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    Winfried Neuhaus

    Full Text Available Antenatal steroid treatment decreases morbidity and mortality in premature infants through the maturation of lung tissue, which enables sufficient breathing performance. However, clinical and animal studies have shown that repeated doses of glucocorticoids such as dexamethasone and betamethasone lead to long-term adverse effects on brain development. Therefore, we established a mouse model for antenatal dexamethasone treatment to investigate the effects of dexamethasone on brain vessel differentiation towards the blood-brain barrier (BBB phenotype, focusing on molecular marker analysis. The major findings were that in total brains on postnatal day (PN 4 triple antenatal dexamethasone treatment significantly downregulated the tight junction protein claudin-5, the endothelial marker Pecam-1/CD31, the glucocorticoid receptor, the NR1 subunit of the N-methyl-D-aspartate receptor, and Abc transporters (Abcb1a, Abcg2 Abcc4. Less pronounced effects were found after single antenatal dexamethasone treatment and in PN10 samples. Comparisons of total brain samples with isolated brain endothelial cells together with the stainings for Pecam-1/CD31 and claudin-5 led to the assumption that the morphology of brain vessels is affected by antenatal dexamethasone treatment at PN4. On the mRNA level markers for angiogenesis, the sonic hedgehog and the Wnt pathway were downregulated in PN4 samples, suggesting fundamental changes in brain vascularization and/or differentiation. In conclusion, we provided a first comprehensive molecular basis for the adverse effects of multiple antenatal dexamethasone treatment on brain vessel differentiation.

  14. Effect of the systemic versus inhalatory administration of synthetic glucocorticoids on the urinary steroid profile as studied by gas chromatography-mass spectrometry

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    Mazzarino, Monica [Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti 1, 00197 Rome (Italy); Rossi, Francesca [Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti 1, 00197 Rome (Italy); Giacomelli, Laura [Dipartimento di Scienze Chirurgiche, Universita La Sapienza, Viale Regina Elena 324, 00161 Rome (Italy); Botre, Francesco [Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti 1, 00197 Rome (Italy) and Dipartimento CGMIA, Universita La Sapienza, Via del Castro Laurenziano 9, 00161 Rome (Italy)]. E-mail: francesco.botre@uniroma1.it

    2006-02-10

    This paper presents a gas chromatography-mass spectrometry (GC-MS) study carried out on human urine to verify whether the administration of glucocorticoids can affect the urinary steroid profile, and especially the levels of endogenous glucocorticoids, androgens and their main metabolites. Betamethasone and beclomethasone, administered either systemically (per os or i.m.) or locally (by inhalation) have been studied. The determination of the urinary levels of endogenous glucocorticoids and androgens was carried out by GC-MS in electron impact ionization mode. Data were evaluated taking into account the baseline individual variability, and compared with values obtained on a control group. Detectable differences were recorded in the steroids metabolites excretion profiles between men and women. The circadian variability of the steroid profile was the same for both sexes, showing a maximum during the morning hours. After systemic treatment with synthetic glucocorticoids, the relative urinary concentrations of corticosteroids, androgens and of their metabolites were significantly altered, recording a transient decrease of the concentration of cortisol and tetrahydrocortisol and a parallel, although less pronounced, increase of the concentration of testosterone, epitestosterone and related androgenic steroids; while no effects were recorded if the administration was by inhalation.

  15. A Gel Formulation Containing a New Recombinant Form of Manganese Superoxide Dismutase: A Clinical Experience Based on Compassionate Use-Safety of a Case Report

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    Lucia Grumetto

    2016-01-01

    Full Text Available Background. We report a case of bilateral posterior subcapsular cataracts (PSCs in a 24-year-old man with an allergic conjunctivitis history caused by a long-term therapy with glucocorticoids. Case Presentation. The patient showed a visual acuity of 9/10 for both eyes. He followed a therapy with ketotifen and bilastine for four years. During the last six months before our evaluation, he was treated with chloramphenicol and betamethasone, interrupted for onset of cataracts and increased intraocular pressure. We treated him with ophthalmic gel preparation containing a new recombinant form of manganese superoxide dismutase (rMnSOD at a concentration of 12.5 μg/mL, only for the right eye, while left eye was treated with standard protocol of Bendazac-lysine g 0.5. Conclusion. This case report shows the protective effects of rMnSOD versus PSC disease, probably due to the capacity of rMnSOD of countering free radical species.

  16. Occurrence of glucocorticoids discharged from a sewage treatment plant in Japan and the effects of clobetasol propionate exposure on the immune responses of common carp (Cyprinus carpio) to bacterial infection.

    Science.gov (United States)

    Nakayama, Kei; Sato, Kentaro; Shibano, Takazumi; Isobe, Tomohiko; Suzuki, Go; Kitamura, Shin-Ichi

    2016-04-01

    The present study evaluated the environmental risks to common carp (Cyprinus carpio) posed by glucocorticoids present in sewage treatment plant (STP) effluent. To gather information on the seasonal variations in glucocorticoid concentration, the authors sampled the effluent of a Japanese STP every other week for 12 mo. Six of 9 selected glucocorticoids were detected in the effluent, with clobetasol propionate and betamethasone 17-valerate detected at the highest concentrations and frequencies. The present study's results indicated that effluent glucocorticoid concentration may depend on water temperature, which is closely related to the removal efficiency of the STP or to seasonal variations in the public's use of glucocorticoids. In a separate experiment, to clarify whether glucocorticoids in environmental water increase susceptibility to bacterial infection in fish, the authors examined the responses to bacterial infection (Aeromonas veronii) of common carp exposed to clobetasol propionate. Clobetasol propionate exposure did not affect bacterial infection-associated mortality. In fish infected with A. veronii but not exposed to clobetasol propionate, head kidney weight and number of leukocytes in the head kidney were significantly increased (p < 0.05), whereas these effects were not observed in infected fish exposed to clobetasol. This suggests that clobetasol propionate alleviated bacterial infection-associated inflammation. Together, these results indicate that susceptibility to bacterial infection in common carp is not affected by exposure to glucocorticoids at environmentally relevant concentrations.

  17. Evaluation of cutaneous drug reactions in patients visiting out patient departments of Indira Gandhi Government Medical College and Hospital (IGGMC and H, Nagpur

    Directory of Open Access Journals (Sweden)

    Sachin Hiware

    2013-01-01

    Full Text Available Objectives: To detect cutaneous drug reactions through spontaneous reporting system in IGGMCand H, Nagpur and analyze them using standard assessment scales. Materials and Methods: An observational, prospective study was performed in patients attending dermatology OPD of IGGMC and H, Nagpur from 1 st June 05 to 31 st May 09. Patients were examined for cutaneous drug reactions (CDRs by spontaneous Adverse Drug Reaction reporting system. Results: Among 2693 total ADRs reported, 872 (33.04% were CDRs. Antimicrobials (55.5% were the main drugs involved followed by NSAIDs (18.56% and steroids (12.61%. Maculopapular rash (37.73% followed by fixed drug eruption (17.2% and urticaria (14.56% were the most frequently observed CDRs. The common drugs causing CDRs were cotrimoxazole (20.41%, topical steroids (betamethasone, ibuprofen (7.91%, ampicillin (6.54%, diclofenac (4.7% and iron dextran (3.44%. Conclusion : It was observed that commonly used drugs like antibiotics and NSAIDs lead to maximum number of CDRs. Hence strict vigilance is required while using them. This study provides a database of ADRs due to common drugs, which will help clinicians in safe use of these drugs.

  18. Scalp psoriasis.

    Science.gov (United States)

    Kircik, Leon H; Kumar, Sandeep

    2010-08-01

    Psoriasis is a chronic, debilitating disease that commonly involves the scalp. Despite a wide range of therapy options, scalp psoriasis remains difficult to treat, highlighting a long-standing unmet need for the safe and effective treatment of scalp psoriasis. Many topical therapies for scalp psoriasis are also difficult or unpleasant to apply, resulting in decreased adherence and efficacy. In brief, the high level of patient dissatisfaction with currently available treatments for psoriasis supports the need for new, effective and well-tolerated treatment options for scalp psoriasis. This article aims to review the efficacy and safety of new formulations and treatment options available to control scalp psoriasis. For example, a new formulation of calcipotriene/betamethasone scalp solution has a rapid onset of action with once daily dosing that improves compliance. The CalePso study examines the safety profile of otherwise established Clobetasol propionate (CP) shampoo 0.05%, and reports that CP shampoo is safe and efficacious in the long-term management of scalp psoriasis. A new foam formulation of coal tar is shown to be cosmetically acceptable and easier to apply.

  19. A Case of Atypical Mucin Balls Wearing Extended Wear of Silicone Hydrogel Lens for Therapeutic Use

    Directory of Open Access Journals (Sweden)

    Yusuke Matsuzaki

    2013-01-01

    Full Text Available A 25-year-old man visited our hospital showing atopic conjunctivitis and corneal shield ulcer on his left eye. Although eye drops of 0.1% of betamethasone sodium phosphate and 0.1% of hyaluronic acid ophthalmic solution were prescribed, calcific corneal opacities developed. The corrected visual acuity decreased to 6/20 in Snellen chart. After corneal epithelial exfoliation, removal of calcific corneal opacity was scrubbed with MQA soaked in 0.05 M of ethylenediaminetetraacetic acid (EDTA. After washing the eye with 200 mL of physiological saline, a silicon hydrogel lens, PureVision (balafilcon A, was inserted to obtain pain relief for the therapeutic use. At postoperative day 11, mucin balls were found between cornea and contact lens and stained by rose bengal dye. One of them was atypically larger than usual, and the major axis was approximately 1.5 mm. Wearing lens was stopped, and all of mucin balls and corneal staining were disappeared at postoperative day. Little corneal opacity remained, and visual acuity after surgery recovered to 14/20 at five months.

  20. Development and evaluation in vitro and in vivo of injectable hydrolipidic gels with sustained-release properties for the management of articular pathologies such as osteoarthritis.

    Science.gov (United States)

    Réeff, Jonathan; Oprenyeszk, Frederic; Franck, Thierry; Goole, Jonathan; De Vriese, Carine; Serteyn, Didier; Henrotin, Yves; Amighi, Karim

    2015-07-25

    This study aimed to evaluate glycerol monooleate (GMO) as a carrier to develop viscoelastic and injectable sustained-release drug delivery systems. The potential pro- and antioxidant activity of the developed hydrolipidic gels were evaluated by measuring the production of ROS by polymorphonuclear leukocytes (PMNs). In addition, the biocompatibility and effectiveness of two selected gel candidates were evaluated in vivo by evaluating the benefit of a single intraarticular injection of these new treatments in a model of osteoarthritis in rabbits. The in vitro study demonstrated that the carrier F1 did not have a pro-oxidative effect and even protected PMNs against natural auto-activation, regardless of the incorporation of either clonidine chlorhydrate or betamethasone dipropionate. The in vivo study demonstrated that F1 and F1-BDP induced a loss of cartilage quality in comparison to the control and reference groups but that the lesions of cartilage observed were generally mild, with not much full-depth erosion. Moreover, no exacerbating inflammation was observed when considering the synovial membranes and the PGE2 and CRP levels. These results seemed to demonstrate that the sustained-release formulation based on GMO could be well-tolerated after intraarticular injection. Moreover, it could have the potential to prevent inflammatory conditions while sustaining drug activity locally over weeks.

  1. Treatment of mites folliculitis with an ornidazole-based sequential therapy

    Science.gov (United States)

    Luo, Yang; Sun, Yu-Jiao; Zhang, Li; Luan, Xiu-Li

    2016-01-01

    Abstract Objective: Treatment of Demodex infestations is often inadequate and associated with low effective rate. We sought to evaluate the efficacy of an ornidazole-based sequential therapy for mites folliculitis treatment. Methods: Two-hundred patients with mites folliculitis were sequentially treated with either an ornidazole- or metronidazole-based regimen. Sebum cutaneum was extruded from the sebaceous glands of each patient's nose and the presence of Demodex mites were examined by light microscopy. The clinical manifestations of relapse of mites folliculitis were recorded and the subjects were followed up at 2, 4, 8, and 12 weeks post-treatment. Results: Patients treated with the ornidazole-based regimen showed an overall effective rate of 94.0%. Additionally, at the 2, 4, 8, and 12-week follow-up, these patients had significantly lower rates of Demodex mite relapse and new lesion occurrence compared with patients treated with the metronidazole-based regimen (P < 0.05). Conclusion: Sequential therapy using ornidazole, betamethasone, and recombinant bovine basic fibroblast growth factor (rbFGF) gel is highly effective for treating mites folliculitis. PMID:27399141

  2. Formulation considerations in the design of topical, polymeric film-forming systems for sustained drug delivery to the skin.

    Science.gov (United States)

    Frederiksen, Kit; Guy, Richard H; Petersson, Karsten

    2015-04-01

    Polymeric film-forming systems (FFSs) are potential drug delivery systems for topical application to the skin. The FFSs form thin and transparent polymeric films in situ upon solvent evaporation. Their application convenience and cosmetic attributes, superior to conventional semi-solids, may offer improved patient compliance. This study represents the first phase of an investigation into the use of FFSs for prolonged dermal drug delivery. FFS formulations were distinguished based on their ability to sustain the release of betamethasone 17-valerate (BMV) in vitro over 72 h. The effect of film-forming polymer (hydrophilic: hydroxypropyl cellulose (Klucel™ LF); hydrophobic: polymethacrylate copolymers (Eudragit® NE and Eudragit® RS), and polyacrylate copolymer (Dermacryl® 79) was first determined, and then the impact of incorporation of plasticisers (triethyl citrate, tributyl citrate, and dibutyl sebacate) was examined. The Klucel film released a significantly higher amount of BMV than the hydrophobic FFS, 42 versus 4 μg/cm(2), respectively. The release was increased when a plasticiser was incorporated, and with higher enhancement ratios achieved with the more lipophilic plasticisers. In conclusion, the results show that FFSs can sustain drug release (hence representing useful systems for prolonged dermal therapy) and emphasise the importance of the formulation on drug delivery, with the type of polymer being of greatest significance.

  3. Optimization of dispersive liquid-phase microextraction based on solidified floating organic drop combined with high-performance liquid chromatography for the analysis of glucocorticoid residues in food.

    Science.gov (United States)

    Huang, Yuan; Zheng, Zhiqun; Huang, Liying; Yao, Hong; Wu, Xiao Shan; Li, Shaoguang; Lin, Dandan

    2017-05-10

    A rapid, simple, cost-effective dispersive liquid-phase microextraction based on solidified floating organic drop (SFOD-LPME) was developed in this study. Along with high-performance liquid chromatography, we used the developed approach to determine and enrich trace amounts of four glucocorticoids, namely, prednisone, betamethasone, dexamethasone, and cortisone acetate, in animal-derived food. We also investigated and optimized several important parameters that influenced the extraction efficiency of SFOD-LPME. These parameters include the extractant species, volumes of extraction and dispersant solvents, sodium chloride addition, sample pH, extraction time and temperature, and stirring rate. Under optimum experimental conditions, the calibration graph exhibited linearity over the range of 1.2-200.0ng/ml for the four analytes, with a reasonable linearity(r(2): 0.9990-0.9999). The enrichment factor was 142-276, and the detection limits was 0.39-0.46ng/ml (0.078-0.23μg/kg). This method was successfully applied to analyze actual food samples, and good spiked recoveries of over 81.5%-114.3% were obtained.

  4. Detection of contact hypersensitivity to corticosteroids in allergic contact dermatitis patients who do not respond to topical corticosteroids.

    Science.gov (United States)

    Gönül, Müzeyyen; Gül, Ulker

    2005-08-01

    The delayed hypersensitivity development against topical corticosteroids which are used in allergic contact dermatitis (ACD) treatment is an important clinical problem. In our study, 41 ACD patients who did not show any response to topical corticosteroid treatment were patch tested with corticosteroid series and the commercial preparations of corticosteroids and their vehicles. In corticosteroid series, there were budesonide, bethametasone-17-valerate, triamcinolone acetonide, tixocortol pivalate, alclomethasone-17-21-dipropionate, clobetasole-17-propionate, dexamethasone-21-phosphate disodium and hydrocortisone-17-butyrate. We detected positive reaction to corticosteroids in 9 of our cases (22%) (5 single and 4 multiple). The sensitivity was mostly produced by tixocortol pivalate (6 patients). This was followed by triamcinolone acetonide (2 patients) budesonide (2 patients), alclomethasone dipropionate (2 patients), dexamethasone 21 phosphate disodium (2 patients) and betamethasone-17-valerate (1 patient). As a result, it should not be forgotten that the corticosteroids used to treat ACD patients may cause ACD themselves. In ACD patients who did not respond to corticosteroid treatment, routinely applying patch test with corticosteroids should be helpful in directing the treatment.

  5. Fixed drug eruption due to metronidazole: a case report

    Directory of Open Access Journals (Sweden)

    Dr. Maxilline D. Marak

    2014-06-01

    Full Text Available Metronidazole is commonly used for the treatment of amebiasis, giardiasis and trichomonous vaginitis. Its side effects are relatively frequent and unpleasant, but nonserious. It has the potential to cause fixed drug eruption (FDE. Case Presentation: This 10 year male boy presented for the itching in some part of the body including an itchy, erythematous oval lesion over the right side of the lower part of anterior abdominal wall. He developed these problems after intake of metronidazole tablet. He was diagnosed to be a case of FDE due to metronidazole. This case of adverse drug reaction (ADR was “probable” type (Score=7 of reaction based on Naranjo ADR probability scale and severity assessment showed “mild” type (level 2 based on Hartwig et al scale. The offending drug was stopped immediately and managed with deflazacort tablet 12 mg for 10 days and Fusidic acid+Betamethasone cream for topical application. Discussion: FDE due to metronidazole usually occur within 30 min to 8 hours following its administration and mean length of time from drug intake to the onset of symptoms is approximately 2 hr. Tissue damage in FDE results from the preferential activation of intraepidermal CD8+T cells

  6. The Effect of a Universal Cervical Length Screening Program on Antepartum Management and Birth Outcomes

    Science.gov (United States)

    Shainker, Scott A.; Modest, Anna M.; Hacker, Michele R.; Ralston, Steven J.

    2016-01-01

    Objective The objective of this study was to evaluate the effect of a universal cervical length screening program on the incidence of antepartum interventions. Study Design This retrospective cohort study included women delivering ≥ 20 weeks of gestation with singleton pregnancies before and after implementing universal cervical length screening. Antepartum interventions included admission for threatened preterm birth, ≥ 2 cervical length measurements, cervical cerclage, neonatology consultation, betamethasone, antibiotic administration for preterm premature rupture of membranes, and tocolysis. Results There were 1,131 women—506 before the screening program (unexposed) and 625 afterward (exposed). The screening program resulted in significantly more women screened (3.0 vs. 69.9%, p gestation length was significantly longer in the exposed (39.6 weeks [interquartile, IQR: 38.6–40.4] vs. 39.0 weeks [IQR: 38.0–40.0, p < 0.001]); however, preterm delivery incidence was unaffected (9.4 vs. 10.9%, p = 0.43). Remaining neonatal outcomes were similar (all p ≥ 0.14). Conclusion Implementing universal cervical length screening significantly increased the proportion of women undergoing ≥ 1 antepartum intervention. With the exception of a modestly prolonged gestation, other outcomes were unaffected. PMID:27280063

  7. [Stevens-Johnson syndrome plus intrahepatic cholestasis caused by clindamycin or chlorpheniramine].

    Science.gov (United States)

    Sahagún Flores, J E; Soto Ortiz, J A; Tovar Méndez, C E; Cárdenas Ochoa, E C; Hernández Flores, G

    2009-05-15

    A 48-year-old woman was hospitalized with the diagnosis of hepatitis. She presented with symptoms of jaundice, headache, elevated bilirubin, and elevated hepatic enzymes. She related a recent episode of a bronchial infection that was treated during the previous eight days with paracetamol (500mg, 2 doses only), chlorpheniramine, betamethasone and clindamycin. After an initial clinical and laboratorial improvement, she began to complain of pruritus of the palms and soles. Thereafter, vesicles evolving to blisters developed and a deterioration of her general health ensued. Serologies for hepatitis A, B, and C viruses were negative. Intrahepatic cholestasis and Stevens Johnson Syndrome (SJS) were the final diagnosis. The association of the Stevens Johnson Syndrome and intrahepatic cholestasis simultaneously, related to adverse drug reactions, is very rare. The drugs reportedly involved are mainly antibiotics, such as ampicillin, vancomycin, amoxicillin/clavulinic acid and erythromycin. Other drugs involved are non-steroidal anti-inflamatory drugs, such as mefenamic acid, ibuprofen, and sulindac. The reactions can be minor or severe and can even cause death, an outcome that has been reported in patients of all races and ethnic groups, but appears to be more rare in patients of Latin origin. We present a discussion of this case and review the main characteristics of the Stevens Johnson Syndrome.

  8. Detection of synthetic corticosteroids in bovine urine by chemiluminescence high-performance liquid chromatography.

    Science.gov (United States)

    Vázquez, B I; Feás, X; Lolo, M; Fente, C A; Franco, C M; Cepeda, A

    2005-01-01

    The development of a black market of chemical cocktails for illegal growth promotion in food-producing animals includes substances that are potentially dangerous for human health, such as synthetic corticosteroids. The potential presence of these residues in food makes it necessary to develop rapid and sensitive analytical methodologies to detect such substances, preferably in live animals before they arrive at the market. A chemiluminescence (CL) detection method for the determination of four synthetic corticosteroids (prednisolone, betamethasone, dexamethasone and flumethasone) in bovine urine has been developed. The proposed system, which does not need any derivatization procedure, offers an easy method well suited for routine research. Urine samples were homogenized with methanol:water (50:50, v/v) and centrifuged. The upper layer was collected and Strata X cartridges were used for cleaning up. The purified residues were evaporated to dryness and then redissolved in the mobile phase. Analysis of the extracts was performed using high-performance liquid chromatography with chemiluminescence detection, employing luminol as the CL reagent. The recovery curves, obtained at four spiking levels (different for each corticosteroid), showed that recoveries of at least 70% could be obtained for urine. The chemiluminescence detection procedure afforded satisfactory results with respect to sensitivity and the LOD and LOQ, taken as the first point of the regression curve, ranged from 4 ppb to 65 ppb. The maximum mean RSD was below 13% and below 15% for intra- and inter-day assay, respectively, in all cases.

  9. T lymphocytes in the lesional skin and the levels of peripheral blood cytokines in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    İbrahim Kökçam

    2011-03-01

    Full Text Available In the current study, it was aimed to investigate the roles of tissue cellular immunity and serum levels of cytokines in the patients with plaque psoriasis treated with calcipotriol-betamethasone dipropionate.Materials and methods: The study included 20 patients with psoriasis. Peripheral blood and biopsy samples were collected from lesional and normal skins before and after treatment. The results were compared with each other.Results: Immunohistochemical examination revealed significant elevations of CD4+, CD8+ and CD25+ T lymphocytes in the lesional tissues when compared to that in the healthy tissues and post treatment tissue (p0.05. The levels of IL–4, IL–10, TNF-α, IFN-γ and TGF-β1 in serum were not significantly different between before and after treatment periods (p>0.05.Conclusion: Our study demonstrated that there were infiltration of CD4+ and CD8+ cell in the lesional skin and CD8+ T-lymphocytes were the dominant cell types. The improvement of the lesions and significant decreases in CD4+ and CD8+ T-cells in accordance with the treatment strongly support the hypothesis that Th lymphocytes may have prominent roles in the immunopathogenesis of the disease. However, our findings showed that sufficient T-cells still remains in the tissue, which is consistent with the chronic characteristic of the disease, and the topical treatment could not be able to prevent the activation of the disease.

  10. [Topical therapy of balanitis xerotica obliterans in childhood. Long-term clinical results and an overview].

    Science.gov (United States)

    Ebert, A-K; Vogt, T; Rösch, W H

    2007-12-01

    Balanitis xerotica obliterans (BXO) is a chronic and progressive dermatitis of unknown aetiology and incidence. Its management in childhood is controversial. Although in most cases only the prepuce is affected, meatal and urethral involvement may lead to major surgical reconstruction. Therefore complete surgical excision of the affected skin is considered to be mandatory. In case of involvement, incidental histological evidence or a relapse, or when complete removal of the affected skin is not possible, a topical therapy should be implemented. In a retrospective analysis of our study population (13 children) with BXO, relapse rate was lower after topical therapy with tacrolimus (Protopic), a highly selective immune modulator, than after the standard anti-inflammatory therapy with betamethasone. The use of tacrolimus ointment is a safe therapy with no severe side effects. Due to the fact that there are no predictive factors for progression or relapse of BXO, we consider a topical anti-inflammatory therapy is always indicated after any type of surgery for BXO. Follow-up monitoring should be close, so that any relapse can be detected and treated as early as possible.

  11. "For export only" medicines come back to Europe: a RP-LC method for the screening of six glucocorticoids in illegal and counterfeit anti-inflammatory and lightening creams.

    Science.gov (United States)

    Gaudiano, M C; Lucente, D; Antoniella, E; Bertocchi, P; Muleri, N; Manna, L; Bartolomei, M; Alimonti, S; Valvo, L; Rodomonte, A L

    2010-10-10

    "For export only" anti-inflammatory and lightening creams are medicinal products sold in African countries for their skin whitening action. In the last years, Rapid Alerts from European Medicinal Regulatory Agencies evidenced the presence of a large number of illegal and counterfeit anti-inflammatory products advertised for their whitening action on black skin in the European market. These drugs, containing glucocorticoids, are illegally sold in Europe in unauthorized ethno-cosmetics-shops and mainly bought by immigrants. This paper reports a new RP-LC method for the rapid simultaneous screening of six different active ingredients in anti-inflammatory and whitening products (creams, ointment and suspension): betamethasone dipropionate, dexamethasone, fluocinonide, fluocinolone acetonide, clobetasol propionate, methyl-prednisolone acetate. The method was developed and validated in view of its possible application in quality control laboratories, mainly those appointed to the control of illegal/counterfeit medicinal products. The associated measurement uncertainty was calculated from validation data. The method was then applied to the analysis of whitening products obtained from the Italian illegal market.

  12. Topical corticosteroid-induced rosacea-like dermatitis: A clinical study of 110 cases

    Directory of Open Access Journals (Sweden)

    Sanjay K Rathi

    2011-01-01

    Full Text Available Background: Prolonged and continuous use of topical steroids leads to rosacea-like dermatitis with variable clinical presentations. Aims: To study the various clinical presentations of patients with topical corticosteroid-induced rosacea-like dermatitis (TCIRD, who had a history of prolonged and repeated use of topical steroids for reasons other than the known disease entities. Methods: A total of 110 patients were enrolled for the study over a period of 2 years, excluding all those with the known disease entity in which topical steroids were commonly used. Detailed history which also included the source and the type of topical steroid use was taken along with clinical examination. Results: There were 12 males and 98 females with their age ranging from 18 to 54 years. The duration of topical steroid use ranged from 4 months to 20 years. The most common clinical presentation was diffuse erythema of the face. Most of the patients had rebound phenomenon on discontinuation of the steroid. The most common topical steroid used was Betamethasone valerate, which could be due to its easy availability and low cost. Conclusion: Varied clinical presentations are seen with prolonged and continuous use of topical steroids. The treatment of this dermatitis is difficult, requiring complete cessation of the offending steroid, usually done in a tapering fashion.

  13. Anti-inflammatory Actions of Endogenous and Exogenous Interleukin-10 versus Glucocorticoids on Macrophage Functions of the Newly Born

    Science.gov (United States)

    Kasat, Kavita; Patel, Hardik; Predtechenska, Olena; Vancurova, Ivana; Davidson, Dennis

    2014-01-01

    OBJECTIVE To determine whether specific macrophage immune functions of the newly born are insensitive to the actions of therapeutic levels of dexamethasone (DEX), previously measured in infants with bronchopulmonary dysplasia (BPD), compared to betamethasone (BETA) and exogenous or endogenous interleukin-10 (IL-10). STUDY DESIGN Macrophages were differentiated from cord blood monocytes (N=18). A serial dose response (around 10−8M), in vitro study was used to examine the effect of DEX, BETA and IL-10, on pro-inflammatory (PI) cytokine release, phagocytosis and respiratory burst. RESULTS Exogenous IL-10 (10−8M) significantly (p<0.05) inhibited the endotoxin-stimulated release of IL-6, IL-8 and tumor necrosis factor by 63% to 82% with no significant effect by DEX and BETA. There was no inhibition by these 3 agents at 10−8M on phagocytosis and respiratory burst. Inhibition of endogenous IL-10 with a monoclonal antibody significantly raised endotoxin-stimulated cytokine release by at least 4 fold. CONCLUSION Macrophages were relatively insensitive to therapeutic levels of DEX and BETA with regard to PI cytokine release. This study provides rationale for translational, preclinical research using airway instillation of IL-10 for the treatment of BPD. PMID:24526008

  14. Studies on 133Xe wash-out from human skin: quantitative measurements of blood flow in normal and corticosteroid-treated skin.

    Science.gov (United States)

    Kristensen, J K; Wadskov, S

    1977-04-01

    Blood flow was measured by the 133Xe technique in normal and corticosteroid-treated skin. Epicutaneous and intracutaneous methods of tracer application were compared in normal skin. The two labeling methods were equally suitable for measuring cutaneous blood flow provided calculations in both cases were based on a biexponential resolution of the wash-out curve in its cutaneous and subcutaneous components and provided the traumatic hyperemia phase was considered, when intracutaneous application of the tracer was used. Results were invalidated if calculations were based on initial slope of the wash-out curves.Topical application of beta-methasone valerate in a reduction in cutaneous blood flow as measured by the intracutaneous technique with curve resolution, whereas no effect could be demonstrated when calculations were based on the initial slopes of the curves. The 133Xe technique is a simple and reliable method for measuring cutaneous blood flow, which might prove useful in estimations of penetration ability and potency of topical corticosteroids.

  15. Multilayer PVA adsorption onto hydrophobic drug substrates to engineer drug-rich microparticles.

    Science.gov (United States)

    Buttini, F; Soltani, A; Colombo, P; Marriott, C; Jones, S A

    2008-01-01

    Despite the availability of numerous crystal engineering techniques, generating drug-rich microparticles with a predetermined size, morphology and crystallinity still represents a significant challenge. A microparticle manufacturing method has recently been developed that attempts to 'shield' the physicochemical properties of micronised drugs by the application of a microfine polymer coating. The aims of this study were to investigate the nature of the drug-polymer interactions and determine the effects of this manufacturing strategy upon release of the drug from the microparticles. The adsorption of poly(vinyl alcohol) (PVA) on the micronised hydrophobic drug surface was found to reach equilibrium between 23 and 27 h. The Freundlich isotherm model was shown to give the most accurate fit to the experimental data and thus multilayer adsorption was assumed. The adsorptive capacity (1/n) was specific to the substrate and PVA grade. An increase in the PVA (%) hydrolysis value caused 1/n to increase from 0.76 to 1.05 using budesonide and from 0.31 to 0.79 when betamethasone valerate (BMV) was used. Increasing the molecular weight of the adsorbing polymer caused a reduction in the strength of PVA-adsorbate interaction when budesonide was used as the substrate (from 0.76 to 0.59), whereas a three-fold increase (from 0.31 to 0.86) was achieved when the BMV substrate was employed. A proportion of the adsorbed polymer was shown to remain associated with the substrate during the spray-drying process and the polymer coating resulted in a significantly higher (p<0.05, ANOVA) amount of drug release in 60 min (ca. 100%) compared to budesonide alone.

  16. Analysis of chromameter results obtained from corticosteroid-induced skin blanching assay: comparison of visual and chromameter data.

    Science.gov (United States)

    Schwarb, F P; Smith, E W; Haigh, J M; Surber, C

    1999-05-01

    In a Guidance document, the American FDA recommends the use of a Minolta chromameter rather than the human eye for the quantitative assessment of the pharmacodynamic blanching response produced by topical application of corticosteroids. The purpose of this study was to compare the appropriateness of the human eye and two models of chromameter for the estimation of skin blanching, in terms of the quality of the data generated by each method. The corticosteroid-induced skin blanching from four different betamethasone 17-valerate cream formulations was compared in a typical human skin blanching trial. The optimized assay methodology routinely practised in our laboratories was utilized. The blanching responses were assessed visually by three trained, independent observers and recorded by two chromameters (Minolta model CR-200 and model CR-300). The topical availability of the four creams was determined using visual scoring and chromameter measurements. All data were manipulated in such a manner as to produce a blanching response versus time profile from which AUBC analysis could be performed. Good correlation was observed between the visual assessments made by three independent observers. In contrast, moderate correlation was determined between visual, CR-200 and CR-300 measurements. Surprisingly, no direct linear relationship between the AUBCs produced by the two chromameters was observed indicating that the quality of the data obtained from the two instruments may not be equal. This investigation also indicated that the use of the chromameter is not completely objective. Visual scoring and chromameter measurement produce data sets that differ in quality. Each procedure needs to be validated and investigators have to be trained for both visual assessment and the operation of the chromameter, particularly with regard to the manipulation of the measuring head of the instrument.

  17. 内服当归饮子加味联合白斑洗剂治疗外阴白色病变52例%Peroral Chinese angelica decoction combined with external Baiban liquid in the treatment of 56 pa-tients with leukoplakia of the vulva

    Institute of Scientific and Technical Information of China (English)

    周燕媛; 胡红; 任强强

    2015-01-01

    Objective:To assess the efficacy of Chinese angelica decoction combined with external Baiban liquid in the treatment of patients with leukoplakia of the vulva. Methods:One hundred and four patients were divided into the treatment group ( 52 patients) and the control group ( 52 patients) . The patients in the treat-ment group were treated with Chinese angelica decoction combined with external Baiban liquid and those in the control group were treated with vitamin B1, vitamin A and external halide betamethasone. Results:The effec-tive rate in the treatment group was 84.62%, which was higher than that in the control group (67.30%), with a significant difference (P<0.05). Conclusion: Chinese angelica decoction combined with external Baiban liquid is effective in the treatment of leukoplakia of the vulva.%目的::评价内服当归饮子加味联合白斑洗剂治疗外阴白色病变的临床疗效。方法:将104例患者随机分为两组,治疗组(52例)给予中药当归饮子加味内服及白斑洗剂外洗;对照组(52例)予口服维生素 B1、维生素 A及外用卤米松软膏。结果:治疗组总有效率为84.62%高于对照组(67.30%),差异有统计学意义(P<0.05)。结论:中药当归饮子加味联合白斑洗剂外洗治疗外阴白色病变疗效显著。

  18. Antenatal Corticosteroids Alter Insulin Signaling Pathways in Fetal Baboon Skeletal Muscle

    Science.gov (United States)

    BLANCO, Cynthia L.; MOREIRA, Alvaro G.; McGILL, Lisa L.; ANZUETO, Diana G.; NATHANIELSZ, Peter; MUSI, Nicolas

    2015-01-01

    Objective We hypothesize that prenatal exposure to glucocorticoids (GCs) will negatively alter the insulin signal transduction pathway and has differing effects on the fetus according to gestational age at exposure. Methods Twenty-three fetal baboons were delivered from twenty-three healthy, non-diabetic mothers. Twelve preterm (0.67 gestational age) and eleven near term (0.95 gestational age) baboons were euthanized immediately after delivery. Half of the pregnant baboons at each gestation received two doses of intramuscular betamethasone 24-hours apart (170 μg.kg−1) before delivery, while the other half received no intervention. Vastus lateralis muscle was obtained from postnatal animals to measure protein content and gene expression of insulin receptor (IR)-β, IR-β Tyr 1361 phosphorylation (pIR-β), IR substate-1 (IRS-1), IRS-1 tyrosine phosphorylation (pIRS-1), p85 subunit of PI3-kinase (p85), Akt (Protein Kinase B), phospho-Akt Ser473 (pAkt), Akt-1, Akt-2, and glucose transporters (GLUT1 and GLUT4). Results Skeletal muscle from preterm baboons exposed to glucocorticoids had markedly reduced protein content of Akt and Akt-1 (respectively, 73% and 72% from 0.67 gestational age Control, P<0.001); IR-β and pIR-β were decreased (respectively, 94% and 85%, P<0.01) in the muscle of premature GC exposed fetuses, but not in term fetuses. GLUT1 and GLUT4 tended to increase with GC exposure in preterm animals (P=0.09), while GLUT4 increased 6.0 fold in term animals after GC exposure (P<0.05). Conclusion Exposure to a single course of antenatal GCs during fetal life alters the insulin-signaling pathway in fetal muscle in a manner dependent on the stage of gestation. PMID:24756099

  19. Expression of glucocorticoid receptor, mineralocorticoid receptor, and 11beta-hydroxysteroid dehydrogenase 1 and 2 in the fetal and postnatal ovine hippocampus: ontogeny and effects of prenatal glucocorticoid exposure.

    Science.gov (United States)

    Sloboda, Deborah M; Moss, Timothy J M; Li, Shaofu; Matthews, Stephen G; Challis, John R G; Newnham, John P

    2008-05-01

    To determine the expression of glucocorticoid metabolizing and action genes in the hippocampus of fetal, neonatal, and adult sheep. Pregnant ewes (or their fetuses) received intramuscular injections of saline or betamethasone (BETA, 0-5 mg/kg) at 104, 111, 118, and/or 125 days of gestation (dG). Hippocampal tissue was collected prior to (75, 84, and 101 dG), during (109 and 116 dG), or after (121, 132, and 146 dG; 6 and 12 postnatal weeks; 3.5 years of age) saline or BETA injections. Hippocampal glucocorticoid receptor (GR), mineralocorticoid receptor (MR), and 11beta-hydroxysteroid dehydrogenase (11betaHSD)1 and 11betaHSD2 mRNA levels were determined using qRT-PCR. Control animals late in gestation demonstrated a decrease in mRNA encoding GR and 11betaHSD1, whereas 11betaHSD2 was undetectable, consistent with a damping of the negative feedback influence of circulating or locally produced cortisol on the hypothalamic-pituitary-adrenal (HPA) axis. BETA-administration had transient effects on fetal GR and MR, and early in postnatal life (12 weeks of age) 11betaHSD1 mRNA was increased. Hippocampal MR mRNA was elevated in adult offspring exposed to either one or four doses of maternal BETA (Pglucocorticoid negative feedback, facilitating increased preterm HPA activity and parturition. Adult offspring of BETA-treated mothers demonstrated increased MR and 11betaHSD2 mRNA, therefore it appears that exposure of fetus to high levels of synthetic glucocorticoids may have long-lasting effects on the hippocampal expression of HPA-related genes into adulthood.

  20. 强脉冲光联合糖皮质激素皮损内注射治疗异物肉芽肿伴红斑%Treatment of facial wrinkles injection caused foreign body granulomas with postoperative erythemas with IPL plus local steroid injection

    Institute of Scientific and Technical Information of China (English)

    王艳春; 高天文; 刘斌; 马翠玲; 齐显龙; 付俊

    2012-01-01

    Objective: To report a case of Arteeoll caused foreign body granulomas with postoperative erythemas treated with IPL 560 nm intense pulsed light plus local steroid injection. Methods: Betamethasone sodium phosphate was injected into lesion sites, followed by IPL 560 nm intense pulsed light treatment. Results: After three times injections and four times IPL light treatments, the papules and nodules disappeared and skin became smoother with lighter erythema. 6-10 months later, skin appeared normal without recurrence. Conclusion: IPL plus local steroid injection is effective in treating Artecol induced foreign body granulomas and erythemas.%目的:报告1例采用强脉冲光(IPL,波长560 nm)结合局部封闭成功治疗“爱贝芙”注射填充面部除皱术后致异物肉芽肿并发红斑.方法:在患者异物肉芽肿及红斑部位,先采用复方倍他米松注射液局部封闭治疗,随后以IPL治疗红斑.结果:患者局部肉芽肿封闭注射3次,IPL治疗4次后,局部丘疹、结节消退,皮肤平整,面部红斑颜色明显变浅.治疗完成后随访6~10个月,红斑结节已全部消退,未复发.结论:IPL结合封闭治疗该例“爱贝芙”注射填充致异物肉芽肿并发红斑疗效确切.

  1. Efficacy of H, antihistamine, corticosteroids and cyclophosphamide in the treatment of chronic dermographic urticaria

    Directory of Open Access Journals (Sweden)

    Kumar Rajesh

    2002-01-01

    Full Text Available H, antihistamines relieve urticaria by blocking the action of histamine on the target tissue, while demonstration of autoantibodies in the sera of a proportion of the patients having chronic idiopathic urticaria, use of immunosuppressive drugs for the treatment of these patients has acquired the greater rationality. We evaluated the role of corticosteroids and cyclophosphamide in the treatment of chronic dermographic urticaria. Twenty-five patients, 13 males and 12 females, between 18-53 years in age, having chronic dermographic urticaria were taken up for this study. The patients were divided into three groups. Group I patients (n=9 were treated with cetirizine hydrochloride 10 mg per day orally, group II patients (n=7 were treated with betamethasone 2 mg along with cyclophosphamide 50 mg along with cetirizine 10 mg per day for a total period of 4 weeks. The patients were evaluated every week to record the therapeutic response and side effects, and then followed up without treatment for a period of 6 months to look for recurrence of the urticaria, if any. Six patients in group I and all the patients in group II and group III had complete remission while the remaining patients in group I had partial relief. The side effects included drowsiness in 4 patients. All the patients in group II had weight gain, 4 patients had acne and 2 patients developed cushingoid features. Majority of the patients relapsed within 3 days after stopping the treatment. Supplementation of the treatment with oral corticosteroids or cyclophosphamide was more effective in controlling the symptoms as compared to cetirizine alone. But a four weeks supplementation was not adequate for preventing the relapses when the drugs were withdrawn.

  2. [Premature birth in patient with cervix incompetence and history of myasthenia gravis].

    Science.gov (United States)

    Fuentealba, Maximiliano; Troncoso, Miguel; Vallejos, Joaquin; Ponce, Sebastian; Villablanca, Nelson; Melita, Pablo

    2013-09-01

    Cervical incompetence it's a dilatation of the cervix during the third trimester of pregnancy that ends with the interruption of it. The incidence in Chile is about 0.1-2% of the total pregnancies and it's one of the causes of preterm birth. A 34 years old pregnant patient. Timectomized at age 18 to treat her miastenia gravis, previously trated with medication, had 4 previous preterm labours all of them under 25 weeks and vaginal births. All fetuses died postpartum. A cerclage was made during the third, fourth and fifth pregnancies. She didn't present hypertension during the gestation and no cervical diameter under 15mm. Since the fourth gestation the following tests are taken: Antifosfolipidic antibodies, APTT,PT. All the results are either normal or negative. Microbial cultures were negative. No amniocentesis was made. A McDonald cervical cerclage was made during pregnancies number 3, 4 and 5 on the 16th week to delay the labor. Also oral micronized progesterone, on a 400mg/24 hours dosis, was administered to avoid preterm birth. On the 24th week the pharmacological treatment started including Intramuscular Betamethasone, 12 mg/24 hours (2 doses), to induce lung maturity on the fetus. It is thought that the administration of progesterone could have improved the situation of the patient, because it acts as a labour repressants. The use of cerclage could have helped, but the factors that may influence the effectiveness of this method are unknown. Perhaps there is some immunologic factor associated with the miastenia gravis that alters the normal course of pregnancy.

  3. Acute leukemia and pregnancy: a review of management and outcome, 1972-1982.

    Science.gov (United States)

    Catanzarite, V A; Ferguson, J E

    1984-11-01

    Acute leukemia is a rare complication of pregnancy. Previous reviews that covered cases reported before the introduction of effective combination chemotherapy found fewer than 300 reported pregnancies, with a 36-69 per cent perinatal mortality and median maternal survival, from diagnosis, of less than 6 months. Advances in the fields of hematology-oncology, maternal-fetal medicine, and neonatology have resulted in a marked improvement in both perinatal survival statistics, and median maternal survival. Since 1972, there have been 14 pregnancies reported in patients cured of acute lymphocytic leukemia, with 1 early spontaneous abortion and 13 term infants. All mothers survived. There have been 47 reports of pregnancy in association with acute leukemia. In 40 pregnancies in which acute leukemia was treated, there were 5 abortions, 3 perinatal demises, 1 infant "liveborn in grave condition," and 31 surviving infants. Median maternal survival was at least 6, and possibly more than 12 months from delivery. In seven cases in which leukemia was untreated, there were one abortion, two perinatal demises, and four living infants; only one of six mothers survived beyond 6 months. Here, a case of pregnancy complicated by acute promyelocytic leukemia is presented. The mother was aggressively treated with combination chemotherapy. The fetus was closely monitored and delivered following a course of betamethasone at 34 weeks' gestation, and had no neonatal problems. The mother expired 13 months status-post bone marrow transplantation, 16 months after delivery. Cases of pregnancy complicated by acute leukemia reported in the period 1972-1982 are reviewed, and management is discussed in detail. Aggressive hematologic and obstetric management is advocated, and should result in further improvements in fetal and maternal outcome.

  4. Analysis of 21-hydroxy deflazacort in human plasma by UPLC-MS/MS: application to a bioequivalence study in healthy volunteers.

    Science.gov (United States)

    Patel, Daxesh P; Sharma, Primal; Patel, Bhargav M; Sanyal, Mallika; Singhal, Puran; Shrivastav, Pranav S

    2013-11-01

    A sensitive and rapid ultra performance liquid chromatography-tandem mass spectrometric (UPLC-MS/MS) method has been developed for the determination of 21-hydroxy deflazacort in human plasma using betamethasone as the internal standard (IS). After solid-phase extraction from 100 μL human plasma, the analyte and IS were analyzed on Waters Acquity UPLC BEH C18 (50 mm × 2.1 mm, 1.7 μm) column using acetonitrile-4.0mM ammonium formate, pH 3.5 (90:10, v/v) as the mobile phase. The protonated analyte was quantified by selected reaction monitoring in the positive ionization mode by triple quadrupole mass spectrometer. The calibration plots were linear over the concentration range 0.50-500 ng/mL. Intra-batch and inter-batch precision (% CV) and accuracy (%) for five quality control samples ranged within 1.40-4.82% and 98.0-102.0% respectively. The overall mean extraction recovery of 21-hydroxy deflazacort from plasma ranged from 95.3 to 97.3%. Matrix effect was assessed by post-column analyte infusion and the extraction recovery was >95.0% across four quality control levels for the analyte and IS. Stability was evaluated under different conditions like bench top, autosampler, processed sample (at room temperature and in cooling chamber), freeze-thaw and long term stability. The method was applied to support a bioequivalence study of 30 mg deflazacort tablet formulation in 28 healthy subjects. Assay reproducibility was demonstrated by reanalysis of 115 incurred samples.

  5. Purification and properties of a 3 alpha-hydroxysteroid dehydrogenase of rat liver cytosol and its inhibition by anti-inflammatory drugs.

    Science.gov (United States)

    Penning, T M; Mukharji, I; Barrows, S; Talalay, P

    1984-01-01

    An NAD(P)-dependent 3 alpha-hydroxysteroid dehydrogenase (EC 1.1.1.50) was purified to homogeneity from rat liver cytosol, where it is responsible for most if not all of the capacity for the oxidation of androsterone, 1-acenaphthenol and benzenedihydrodiol (trans-1,2-dihydroxycyclohexa-3,5-diene). The dehydrogenase has many properties (substrate specificity, pI, Mr, amino acid composition) in common with the dihydrodiol dehydrogenase (EC 1.3.1.20) purified from the same source [Vogel, Bentley, Platt & Oesch (1980) J. Biol. Chem. 255, 9621-9625]. Since 3 alpha-hydroxysteroids are by far the most efficient substrates, the enzyme is more appropriately designated a 3 alpha-hydroxysteroid dehydrogenase. It also promotes the NAD(P)H-dependent reductions of quinones (e.g. 9,10-phenanthrenequinone, 1,4-benzoquinone), aromatic aldehydes (4-nitrobenzaldehyde) and aromatic ketones (4-nitroacetophenone). The dehydrogenase is not inhibited by dicoumarol, disulfiram, hexobarbital or pyrazole. The mechanism of the powerful inhibition of this enzyme by both non-steroidal and steroidal anti-inflammatory drugs [Penning & Talalay (1983) Proc. Natl. Acad. Sci. U.S.A. 80, 4504-4508] was examined with several substrates. Most non-steroidal anti-inflammatory drugs are competitive inhibitors (e.g. Ki for indomethacin, 0.20 microM for 9,10-phenanthrenequinone reduction at pH 6.0, and 0.835 microM for androsterone oxidation at pH 7.0), except for salicylates, which act non-competitively (e.g. Ki for aspirin, 650 microM for androsterone oxidation). The inhibitory potency of these agents falls sharply as the pH is increased from 6 to 9. Most anti-inflammatory steroids are likewise competitive inhibitors, except for the most potent (betamethasone and dexamethasone), which act non-competitively. The enzyme is inhibited competitively by arachidonic acid and various prostaglandins. PMID:6435601

  6. NONSPECIFIC ANTI-INFLAMMATORY AGENTS. SOME NOTES ON THEIR PRACTICAL APPLICATION, ESPECIALLY IN RHEUMATIC DISORDERS.

    Science.gov (United States)

    BOLAND, E W

    1964-03-01

    A number of acute and chronic inflammatory disorders are amenable to varying degrees of therapeutic control with the administration of nonspecific anti-inflammatory drugs. An evaluation of these suppressive agents in the field of rheumatic diseases and practical suggestions regarding their administration are presented. Eight synthetically modified corticosteroid compounds are available commercially. Each of them exhibits qualitative differences in one or several physiologic actions, each has certain advantages and disadvantages in therapy, and each shares the major deterrent features of corticosteroids. Prednisone, prednisolone, methylprednisolone, fluprednisolone and paramethasone have similar therapeutic indices, and there is little choice between them for the usual rheumatoid patient requiring steroid therapy. Conversely, the therapeutic indices of dexamethasone, betamethasone and triamcinolone are lower than that of prednisolone; they are less desirable for routine use and should be reserved for specially selected cases. Salicylates are preferred to adrenocortical steroids in the treatment of the ordinary patient with acute rheumatic fever. Steroid therapy should be reserved for resistant cases and for those with significant carditis. Salicylates are mainstays for pain relief in rheumatoid arthritis, but with the analgesic doses usually employed their anti-inflammatory action is slight.Phenylbutazone is a highly useful anti-inflammatory agent, especially in management of acute gouty arthritis and ankylosing (rheumatoid) spondylitis; its metabolite, oxyphenylbutazone, does not exhibit clear-cut advantages. Colchicine specifically suppresses acute gouty arthritis. Its analogues, desacetylcolchicine and desacetylthiocolchicine, produce fewer unpleasant gastrointestinal symptoms, but may promote agranulocytosis and alopecia.A number of indole preparations with anti-inflammatory activity have been tested clinically. One of them, indomethacin, has received extensive

  7. Successful treatment of severe pouchitis with rebamipide refractory to antibiotics and corticosteroids: A case report

    Institute of Scientific and Technical Information of China (English)

    Mitsuki Miyata; Toshihiro Konagaya; Shiniti Kakumu; Takeshi Mori

    2006-01-01

    The antibiotics, metronidazole and ciprofloxacin, are the first-line treatment for pouchitis. Patients who do not respond to antibiotics or conventional medications represent a major challenge to therapy. In this report,we have described a successful treatment of severe refractory pouchitis with a novel agent, rebamipide,known to promote epithelial cell regeneration and angiogenesis. A 27-year-old male with ileo-anal pouch surgery presented with worsening anal pain, diarrhea,and abdominal pain. The patient was diagnosed to have pouchitis and was given metronidazole together with betamethasone enema (3.95 mg/dose). However,despite this intensive therapy, the patient did not improve. On endoscopy, ulceration and inflammation were seen in the ileal pouch together with contact bleeding and mucous discharge. The patient was treated with rebamipide enema (150 mg/dose) twice a day for 8 wk without additional drug therapy. Two weeks after the rebamipide therapy, stool frequency started to decrease and fecal hemoglobin became negative at the 4th wk. At the end of the therapy, endoscopy revealed that ulcers in the ileal pouch had healed with no obvious inflammation.The effect of rebamipide enema was dramatic and was maintained throughout the 11-mo follow-up. The patient continued to be in remission. No adverse effects were observed during the treatment or the follow-up period.The sustained response seen in this case with severe and refractory pouchitis indicates that agents, which promote epithelial cell growth, angiogenesis and mucosal tissue regeneration, are potential therapeutic agents for the treatment of refractory colorectal lesions.

  8. Treatment for delayed brain injury after pituitary irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Takashi; Misumi, Shuzoh; Shibasaki, Takashi; Tamura, Masaru; Kunimine, Hideo; Hayakawa, Kazushige; Niibe, Hideo; Miyazaki, Mizuho; Miyagi, Osamu.

    1988-03-01

    Treatment for delayed brain injury after pituitary irradiation is discussed. Six cases with delayed brain injury were treated with a combination of dexamethasone or betamethasone, with heparin, glycerol, dextran 40 and some vasodilators. Two cases with temporal lobe syndrome were treated in the early stages of brain injury for a period of over 12 months were almost completely cured, another two cases with chiasma syndrome were treated in the relatively late stages, showed a partial improvement. One case which was irradiated 120 GY during 13 years did not improve. The final case treated with steroids for a short period also resulted in failure and the patient underwent an operation for the removal of the necrotic mass three years after the radiotherapy. Steroid therapy started in the early stages of brain injury after irradiation for over the 12 months is thought to be effective. Heparin therapy was also effective in one out of three cases, but in one of the cases subarachnoid hemorrhage from a traumatic aneurysm occurred during the therapy. In an acute phase, showing edematous change of the injured brain, the administration of glycerol is also thought to be useful. But the effectiveness of the other medicines containing some vasodilators was obscure or doubtful. We propose the following : (1) A meticulous observation is essential for the patients who received high doses of irradiation to diagnose brain injury in the early reversible stage. (2) Steroids should be given immediately in this reversible stage of brain injury before the irreversible ''necrosis'' occurs. (3) Steroids should be maintained for a long period over 12 months. (4) Heparin therapy is also thought to be effective, but careful precautions to avoid hemorrhagic complications before the therapy should be scheduled. This recommended plan may also be used for the treatment of brain injuries after cranial irradiation for other intracranial tumors.

  9. Glucocorticoid-Induced Fetal Programming Alters the Functional Complement of Angiotensin Receptors Subtypes within the Kidney

    Science.gov (United States)

    Gwathmey, TanYa M.; Shaltout, Hossam A.; Rose, James C.; Diz, Debra I.; Chappell, Mark C.

    2011-01-01

    We examined the impact of fetal programming on the functional responses of renal angiotensin receptors. Fetal sheep were exposed in utero to betamethasone (BMX; 0.17 mg/kg) or control (CON) at 80–81 days gestation with full term delivery. Renal nuclear and plasma membrane fractions were isolated from 1.0–1.5 year old sheep for receptor binding and fluorescence detection of reactive oxygen species (ROS) or nitric oxide (NO). Mean arterial blood pressure and blood pressure variability were significantly higher in the BMX-exposed adult offspring versus control (CON) sheep. The proportion of nuclear AT1 receptors sensitive to losartan (LOS) was 2-fold higher [67 ± 6% vs. 27 ± 9%, p < 0.01] in BMX compared to control. In contrast, the proportion of AT2 sites was only one-third that of controls (BMX: 25 ± 11% vs. CON: 78 ± 4%, p < 0.01) with a similar reduction in sites sensitive to the Ang-(1-7) antagonist D-Ala7-Ang-(1-7) with BMX exposure. Functional studies revealed that Ang II stimulated ROS to a greater extent in BMX than control sheep (16 ± 3% vs. 6 ± 4%; P<0.05); however NO production to Ang II was attenuated in BMX (26 ± 7% vs. 82 ± 14%; P<0.05). BMX-exposure was also associated with a reduction in the Ang-(1-7) NO response [75 ± 8% vs. 131 ± 26%; P<0.05]. We conclude that altered expression of angiotensin receptor subtypes may be one mechanism whereby functional changes in NO- and ROS-dependent signaling pathways may favor the sustained increase in blood pressure evident in fetal programming. PMID:21220702

  10. Psoriasis triggered by mefloquine.

    Science.gov (United States)

    Pace, Joseph L

    2010-01-01

    A 46-year-old Caucasian man living on the central Mediterranean island of Gozo (Malta) was started on mefloquine 250 mg once weekly before a trip to lower Egypt. He took his medication 1 week before starting his holiday and was advised to continue it for 4 weeks after returning. He did not take any other medication and enjoyed the holiday, which he initially intended to repeat in the near future. His medical history revealed a number of episodes of psoriasis for which he sought dermatologic advice. He had been given systemic therapy on at least one occasion, but the condition had been fairly quiescent for some time and he had not needed to consult a dermatologist for more than 4 years. Soon after the third tablet of mefloquine and effectively just after his return home to Gozo, the patient noticed that the psoriasis was "creeping back." He noted progressive deterioration in his skin problem but nevertheless finished the recommended course of therapy considering that "being sure about not developing malaria was far more important than a touch of psoriasis." The psoriasis worsened to the extent that he had taken off work for 2 weeks from his job as a self-employed carpenter at the time of referral. On examination, clearly there was a significant flare up of his psoriasis with severe involvement of the hands (Figure 1) and feet and less so over the rest of his body. He had been off work and matters were steadily getting worse in spite of topical treatment with a combination of calcipotriol-betamethasone ointment. Oral methotrexate 15 mg once weekly was commenced together with topical therapy with good results (Figure 2).

  11. Fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar axial or discogenic pain.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar; Benyamin, Ramsin

    2012-01-01

    Among the multiple causes of chronic low back pain, axial and discogenic pain are common. Various modalities of treatments are utilized in managing discogenic and axial low back pain including epidural injections. However, there is a paucity of evidence regarding the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. In an interventional pain management practice in the US, a randomized, double-blind, active control trial was conducted. The objective was to assess the effectiveness of lumbar interlaminar epidural injections of local anesthetic with or without steroids for managing chronic low back pain of discogenic origin. However, disc herniation, radiculitis, facet joint pain, or sacroiliac joint pain were excluded. Two groups of patients were studied, with 60 patients in each group receiving either local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Primary outcome measures included the pain relief-assessed by numeric rating scale of pain and functional status assessed by the, Oswestry Disability Index, Secondary outcome measurements included employment status, and opioid intake. Significant improvement or success was defined as at least a 50% decrease in pain and disability. Significant improvement was seen in 77% of the patients in Group I and 67% of the patients in Group II. In the successful groups (those with at least 3 weeks of relief with the first two procedures), the improvement was 84% in Group I and 71% in Group II. For those with chronic function-limiting low back pain refractory to conservative management, it is concluded that lumbar interlaminar epidural injections of local anesthetic with or without steroids may be an effective modality for managing chronic axial or discogenic pain. This treatment appears to be effective for those who have had facet joints as well as sacroiliac joints eliminated as the pain source.

  12. Fluoroscopic cervical epidural injections in chronic axial or disc-related neck pain without disc herniation, facet joint pain, or radiculitis

    Directory of Open Access Journals (Sweden)

    Manchikanti L

    2012-07-01

    Full Text Available Laxmaiah Manchikanti, Kimberly A Cash, Vidyasagar Pampati, Yogesh MallaPain Management Center of Paducah, Paducah, KY, USABackground: While chronic neck pain is a common problem in the adult population, with a typical 12-month prevalence of 30%–50%, there is a lack of consensus regarding its causes and treatment. Despite limited evidence, cervical epidural injections are one of the commonly performed nonsurgical interventions in the management of chronic neck pain.Methods: A randomized, double-blind, active, controlled trial was conducted to evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of chronic neck pain with or without upper extremity pain in patients without disc herniation, radiculitis, or facet joint pain.Results: One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of two treatment groups, ie, injection of local anesthetic only (group 1 or local anesthetic mixed with nonparticulate betamethasone (group 2. The primary outcome of significant pain relief and improvement in functional status (≥50% was demonstrated in 72% of group 1 and 68% of group 2. The overall average number of procedures per year was 3.6 in both groups with an average total relief per year of 37–39 weeks in the successful group over a period of 52 weeks.Conclusion: Cervical interlaminar epidural injections of local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic or axial pain.Keywords: chronic neck pain, cervical disc herniation, cervical discogenic pain, cervical epidural injections, epidural steroids, local anesthetics

  13. A case of follicular mucinosis in children%儿童毛囊黏蛋白病

    Institute of Scientific and Technical Information of China (English)

    王冲; 梁建华; 刘桂英; 许俊龙; 贾爱华

    2011-01-01

    报告1例儿童毛囊黏蛋白病.患儿男,14岁.因眉间皮肤起浸润性红斑伴眉毛部分脱落半年余就诊.皮肤科检查:眉间偏左侧一约2.5 cm × 3.0 cm浸润性红斑,其上覆少许片状鳞屑,皮损累及处眉毛缺失.皮损组织病理检查:表皮轻度角化不全,棘层增生,真皮毛囊上皮水肿、破坏,少许淋巴细胞移入,胶原间血管壁增厚,周围淋巴细胞及嗜酸性粒细胞浸润;阿新蓝染色示毛囊上皮内较多黏液样物质沉积.诊断:毛囊黏蛋白病.给予复方倍他米松注射液局部封闭治疗后,皮损消退.%A case of follicular mucinosis is reported.A 14-year-old boy presented with half a year history of facial pink infiltrated plaque associated with loss of hair.Histopathologic examination showed parakeratosis.acanthosis in the epidermis, there was a mild lymphocytic infiltration in the dermis around and within the affected follicles.Inflammatory lymphocytic infiltrate , admixed with several eosinophils, located around the vessels.Alcian blue stain was positive within the follicular structures.A diagnosis of follicular mucinosis was finally made.He was successfully treated with intralesional compound betamethasone injection.

  14. Ultrasound guided percutaneous treatment and follow-up of Baker's cyst in knee osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Koeroglu, Mert, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Call Latin-Small-Letter-Dotless-I oglu, Mehmet, E-mail: mehmetcallioglu@hotmail.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Eris, Hueseyin Naim, E-mail: drhneris@hotmail.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Kayan, Mustafa, E-mail: drkayan32@hotmail.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Cetin, Meltem, E-mail: meltemcetin2011@yahoo.com [Sueleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta (Turkey); Yener, Mahmut, E-mail: bahtiyaryener@yahoo.com [Sueleyman Demirel University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Isparta (Turkey); Guerses, Cemil, E-mail: cemilgurses@gmail.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Erol, Bekir, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Tuerkbey, Bar Latin-Small-Letter-Dotless-I s, E-mail: bturkbey@yahoo.com [Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara (Turkey); Parlak, Ayse Eda, E-mail: drteda@yahoo.com [Antalya Education and Research Hospital, Department of Radiology, Antalya (Turkey); Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara (Turkey)

    2012-11-15

    Objective: Purpose of this study is to assess sonographic changes and clinical response in different subgroups of Baker's cyst patients with knee osteoarthritis after a single session of ultrasound-guided percutaneous aspiration and corticosteroid injection. Materials and methods: Thirty-two knee osteoarthritis patients (46-85 years, mean 58.97 {+-} 9.88) with symptomatic Baker's cyst diagnosed at ultrasonography were included in the study. To determine the grade of the symptoms, Visual Analogue Scale was applied. The patients were grouped in two, as simple (n = 24) and complex (n = 8) Baker's cyst. Thirty-two ultrasound-guided cyst aspirations concomitant 1 ml betamethasone injection (24 simple, 8 complex subgroups) were performed. Patients were followed clinically as well as via ultrasonography for 6 months after procedures. Results: A significant decrease in volume of the Baker's cysts after percutaneous treatment was accompanied by a significant clinical improvement. Moreover, the volume reduction of Baker's cyst after the treatment was significantly correlated with the clinical improvement (Pearson correlation coefficient = 0.542, p = 0.001). All 6 Baker's cysts relapsed at ultrasonography were complex type. Furthermore, a comparison of patients with simple Baker's cysts and those with complex Baker's cysts demonstrated no significant change in Visual Analogue Scale scores between two groups (p = 0.061, Mann-Whitney U). No complications (minor or major) occurred secondary to percutaneous treatment. Conclusion: Baker's cysts can be grouped as simple and complex groups via ultrasonography prior to the treatment. Cyst aspiration with ultrasound-guided corticosteroid injection yields clinical improvement and cyst volume reduction in all subgroups of patients with Baker's cyst secondary to knee osteoarthritis.

  15. Refractory ulcerative colitis accompanied with cytomegalovirus colitis and multiple liver abscesses:A case report

    Institute of Scientific and Technical Information of China (English)

    Takuya Inoue; Ken Toshina; Takashi Nishikawa; Norihiro Hamamoto; Ken Nakagawa; Ken-Ichi Katsu; Ichiro Hirata; Yutaro Egashira; Kumi Ishida; Ken Kawakami; Eijiro Morita; Naoko Murano; Shingo Yasumoto; Mitsuyuki Murano

    2005-01-01

    Various hepato-biliary complications are an increased incidence in patients with inflammatory bowel disease,and portal bacteremia is well documented in patients with ulcerative colitis (UC). However, few reports mention UC in association with liver abscesses. Recently, there are several reports describing cytomegalovirus (CMV) infection in association with disease exacerbation and steroid refractoriness in patients with UC. Here we present a case of refractory UC accompanied with multiple liver abscesses and CMV colitis. The patient, a 72-year-old male, with a five-year history of repeated admissions to our hospital for UC, presented with an exacerbation of his UC.Sigmoidoscopy performed on admission suggested that his UC was exacerbated, then he was given prednisolone and mesalazine orally, and betamethasone enemas.However, he had exacerbated symptoms. Repeat sigmoidoscopy revealed multiple longitudinal ulcers and pseudopolyps in the rectosigmoid colon. Although immunohistochemical staining of biopsy specimens and the serum testing for antigenemia were negative on admission and after the repeat sigmoidoscopy, they became histologically positive for CMV. Nonetheless, the patient developed spiking fevers, soon after ganciclovir was administered. Laboratory studies revealed an increased white cell count with left shift, and Enterococcus fecalis grew in blood cultures. An abdominal computed tomography (CT) scan was obtained and the diagnosis of liver abscesses associated with UC was made, based on CT results. The hepatic abscesses were successfully treated with intravenous meropenem for 6 wk, without further percutaneous drainage. To our knowledge, this is the first reported case of multiple liver abscesses that develop during UC exacerbation complicated by CMV colitis.

  16. Repetitive prenatal glucocorticoids increase lung endothelial nitric oxide synthase expression in ovine fetuses delivered at term.

    Science.gov (United States)

    Grover, T R; Ackerman, K G; Le Cras, T D; Jobe, A H; Abman, S H

    2000-07-01

    Antenatal administration of glucocorticoids has been shown to improve postnatal lung function after preterm birth in the ovine fetus. Mechanisms of steroid-induced lung maturation include increased surfactant production and altered parenchymal lung structure. Whether steroid treatment also affects lung vascular function is unclear. Because nitric oxide contributes to the fall in pulmonary vascular resistance at birth, we hypothesized that the improvement of postnatal lung function of preterm lambs after treatment with prenatal glucocorticoids may be in part caused by an increase in endothelial nitric oxide synthase (eNOS) activity. To determine whether glucocorticoid treatment increases lung eNOS expression, we measured eNOS protein content by Western blot analysis of distal lung homogenates and immunostaining of formalin-fixed lungs from ovine fetuses delivered at preterm and term gestation after prenatal administration of glucocorticoids. Treatment protocols were followed in which ewes were treated with intramuscular betamethasone (0.5 mg/kg) at single or multiple doses at weekly intervals, and fetuses were delivered at 125, 135, or 145 d gestation. All groups were compared with saline-treated controls. Western blot analysis of whole lung homogenates demonstrated a 4-fold increase in eNOS protein content in lambs treated with repetitive doses of glucocorticoids and delivery at term (145 d; p preterm ages (125 and 135 d). Immunostaining showed eNOS predominantly in the vascular endothelium in all vessel sizes. Pattern of staining was not altered by treatment with antenatal glucocorticoids. We conclude that maternal treatment with glucocorticoids increases lung eNOS content after multiple doses and delivery at term gestation. We speculate that antenatal glucocorticoids may up-regulate eNOS but that the timing and duration of steroid administration appears to be critical to this response.

  17. Biopartitioning micellar chromatography as a predictive tool for skin and corneal permeability of newly synthesized 17β-carboxamide steroids.

    Science.gov (United States)

    Dobričić, Vladimir; Nikolic, Katarina; Vladimirov, Sote; Čudina, Olivera

    2014-06-02

    In this paper, human skin and corneal permeability of twenty-two newly synthesized 17β-carboxamide steroids was predicted using biopartitioning micellar chromatography (BMC). These compounds are potential soft glucocorticoids with local anti-inflammatory activity when applied to the skin or eye. BMC systems are used to simulate physicochemical properties of human skin (BMC-skin) and cornea (BMC-cornea). Micellar mobile phase, consisted of 0.04 M solution of polyoxyethylene (23) lauryl ether (Brij 35), was prepared at different pH values - 5.50 (BMC-skin) and 7.50 (BMC-cornea). Retention factors (k), obtained by use of BMC, were calculated for all newly synthesized 17β-carboxamide steroids as well as for parent glucocorticoids (hydrocortisone, prednisolone, methylprednisolone, dexamethasone and betamethasone). Good correlation was obtained between BMC-skin retention factors and permeability coefficients calculated by use of the artificial membrane that simulates stratum corneum of the human skin. Quantitative structure-retention relationship (QSRR) study was performed in order to explain retention factors of these compounds in the tested BMC systems. ANN-QSRR(k), PLS-QSRR(k) and MLR-QSRR(k) models, created by use of BMC-skin retention data, were compared and optimal model (PLS-QSRR(k)) was selected. Molecular descriptors of the selected model indicate that lipophilicity and number of short C-C fragments of tested compounds have the strongest influence on the retention in the BMC-skin system and presumably on their in vivo permeability through human skin. The same model can be applied to the BMC-cornea system and the same conclusion can be drawn for corneal permeability. This model could be used as a predictive tool for the synthesis of novel 17β-carboxamide steroids with desirable permeability through human skin or cornea, depending on their potential pharmacological application.

  18. Effects of glucocorticoid treatment given in early or late gestation on growth and development in sheep.

    Science.gov (United States)

    Li, S; Sloboda, D M; Moss, T J M; Nitsos, I; Polglase, G R; Doherty, D A; Newnham, J P; Challis, J R G; Braun, T

    2013-04-01

    Antenatal corticosteroids are used to augment fetal lung maturity in human pregnancy. Dexamethasone (DEX) is also used to treat congenital adrenal hyperplasia of the fetus in early pregnancy. We previously reported effects of synthetic corticosteroids given to sheep in early or late gestation on pregnancy length and fetal cortisol levels and glucocorticoids alter plasma insulin-like growth factor (IGF) and insulin-like growth factor binding protein (IGFBP) concentrations in late pregnancy and reduce fetal weight. The effects of administering DEX in early pregnancy on fetal organ weights and betamethasone (BET) given in late gestation on weights of fetal brain regions or organ development have not been reported. We hypothesized that BET or DEX administration at either stage of pregnancy would have deleterious effects on fetal development and associated hormones. In early pregnancy, DEX was administered as four injections at 12-hourly intervals over 48 h commencing at 40-42 days of gestation (dG). There was no consistent effect on fetal weight, or individual fetal organ weights, except in females at 7 months postnatal age. When BET was administered at 104, 111 and 118 dG, the previously reported reduction in total fetal weight was associated with significant reductions in weights of fetal brain, cerebellum, heart, kidney and liver. Fetal plasma insulin, leptin and triiodothyronine were also reduced at different times in fetal and postnatal life. We conclude that at the amounts given, the sheep fetus is sensitive to maternal administration of synthetic glucocorticoid in late gestation, with effects on growth and metabolic hormones that may persist into postnatal life.

  19. Is the drug-induced hypersensitivity syndrome (DIHS due to human herpesvirus 6 infection or to allergy-mediated viral reactivation? Report of a case and literature review

    Directory of Open Access Journals (Sweden)

    Borgia Guglielmo

    2010-03-01

    Full Text Available Abstract Background Drug-Induced Hypersensitivity Syndrome (DIHS is a severe and rare systemic reaction triggered by a drug (usually an antiepileptic drug. We present a case of DISH and we review studies on the clinical features and treatment of DIHS, and on its pathogenesis in which two elements (Herpesvirus infection and the drug interact with the immune system to trigger such a syndrome that can lead to death in about 20% of cases. Case presentation We report the case of a 26-year old woman with fever, systemic maculopapular rash, lymphadenopathy, hepatitis and eosinophilic leukocytosis. She had been treated with antibiotics that gave no benefit. She was taking escitalopram and lamotrigine for a bipolar disease 30 days before fever onset. Because the patient's general condition deteriorated, betamethasone and acyclovir were started. This treatment resulted in a mild improvement of symptoms. Steroids were rapidly tapered and this was followed with a relapse of fever and a worsening of laboratory parameters. Human herpesvirus 6 (HHV-6 DNA was positive as shown by PCR. Drug-Induced Hypersensitivity Syndrome (DIHS was diagnosed. Symptoms regressed on prednisone (at a dose of 50 mg/die that was tapered very slowly. The patient recovered completely. Conclusions The search for rare causes of fever led to complete resolution of a very difficult case. As DIHS is a rare disease the most relevant issue is to suspect and include it in differential diagnosis of fevers of unknown origin. Once diagnosed, the therapy is easy (steroidal administration and often successful. However our case strongly confirms that attention should be paid on the steroidal tapering that should be very slow to avoid a relapse.

  20. Differential effect of exogenous interleukin-10 versus glucocorticoids on gene expression and pro-inflammatory cytokine release by polymorphonuclear leukocytes and monocytes of the newly born

    Science.gov (United States)

    Davidson, Dennis; Patel, Hardik; Degoy, Ana C; Gershkovich, Irina; Vancurova, Ivana; Miskolci, Veronika

    2013-01-01

    Bronchopulmonary dysplasia (BPD) is one of the most common causes of mortality and morbidity in neonatal intensive care units. Persistent inflammation, with an abnormal influx of polymorphonuclear leukocytes (PMNs) followed by monocytes (MONOs), occurs early in the pathogenesis of BPD. Anti-inflammatory therapy with better efficacy and safety than dexamethasone (DEX) is needed. In the present study we determined cell-specific gene expression and cytokine release in response to glucocorticoids versus interleukin-10 (IL-10). Subsequently, we hypothesized that the insensitivity of MONOs to DEX was associated with a failure of the glucocorticoid receptor to translocate to the nucleus. PMNs and MONOs were isolated from umbilical cord blood at birth, and pretreated with PBS vehicle, IL-10 or glucocorticoids prior to endotoxin (LPS)-stimulation for 4 and 18h. Genome-wide gene expressions were determined by microarray and validated by RT-qPCR. Interleukin 8 release in cell culture supernatant was measured by ELISA. To examine the mechanism of monocyte insensitivity to glucocorticoids, nuclear translocation of the glucocorticoid receptor was determined by Western blots. MONOs had 6 times the number of genes changing expression with IL-10 compared to PMNs at 4h. DEX at the therapeutic level for neonates with BPD had no effect on gene expression in MONOs. The order of potency for inhibition of interleukin-8 release from MONOs was IL-10 >betamethasone >dexamethasone and hydrocortisone. Glucocorticoid potency in MONOs was directly related to glucocorticoid receptor translocation to nucleus. Gene expression profiling for IL-10 versus glucocorticoids indicates there may be major differences in therapeutic efficacy for BPD. PMID:23390570

  1. Drug-induced acute myocardial infarction: identifying 'prime suspects' from electronic healthcare records-based surveillance system.

    Directory of Open Access Journals (Sweden)

    Preciosa M Coloma

    Full Text Available BACKGROUND: Drug-related adverse events remain an important cause of morbidity and mortality and impose huge burden on healthcare costs. Routinely collected electronic healthcare data give a good snapshot of how drugs are being used in 'real-world' settings. OBJECTIVE: To describe a strategy that identifies potentially drug-induced acute myocardial infarction (AMI from a large international healthcare data network. METHODS: Post-marketing safety surveillance was conducted in seven population-based healthcare databases in three countries (Denmark, Italy, and the Netherlands using anonymised demographic, clinical, and prescription/dispensing data representing 21,171,291 individuals with 154,474,063 person-years of follow-up in the period 1996-2010. Primary care physicians' medical records and administrative claims containing reimbursements for filled prescriptions, laboratory tests, and hospitalisations were evaluated using a three-tier triage system of detection, filtering, and substantiation that generated a list of drugs potentially associated with AMI. Outcome of interest was statistically significant increased risk of AMI during drug exposure that has not been previously described in current literature and is biologically plausible. RESULTS: Overall, 163 drugs were identified to be associated with increased risk of AMI during preliminary screening. Of these, 124 drugs were eliminated after adjustment for possible bias and confounding. With subsequent application of criteria for novelty and biological plausibility, association with AMI remained for nine drugs ('prime suspects': azithromycin; erythromycin; roxithromycin; metoclopramide; cisapride; domperidone; betamethasone; fluconazole; and megestrol acetate. LIMITATIONS: Although global health status, co-morbidities, and time-invariant factors were adjusted for, residual confounding cannot be ruled out. CONCLUSION: A strategy to identify potentially drug-induced AMI from electronic healthcare

  2. Short term administration of glucocorticoids in patients with protracted and chronic gout arthritis. Part III – frequency of adverse events

    Directory of Open Access Journals (Sweden)

    A A Fedorova

    2009-01-01

    Full Text Available Objective. To assess frequency of adverse events during short term administration of gluco- corticoid (GC in protracted and chronic gout arthritis. Material and methods. 59 pts with tophaceous gout (crystal-verified diagnosis and arthritis of three and more joints lasting more than a months in spite of treatment with sufficient doses of nonsteroidal anti-inflammatory drugs were included. Median age of pts was 56 [48;63], median disease duration – 15,2 years [7,4;20], median swollen joint count at the examination – 8 [5;11]. The patients were randomized into 2 groups. Methylprednisolone (MP 500 mg/day iv during 2 days and placebo im once was administered in one of them, betamethasone (BM 7 mg im once and placebo iv twice – in the other. Clinical evaluation of inflamed joints was performed every day. Standard laboratory examination and ECG were done before drug administration, at 3rd, 7th, and 14th day of follow up. Immunoreactive insulin level was evaluated before drug administration and at day 14. Blood pressure (BP was measured every day. Results. After first GC administration BP elevated in 28 (47% pts. In pts not having appropriate BP values BP elevated in 73% of cases. Pts with appropriate BP values showed less frequent BP elevation – 38% (p=0,02. In 8 (13% pts at day 3 after GC administration ECG signs of myocardial blood supply deterioration were revealed. Glucose level elevated in 10 (17% pts and after the second BM administration – in 5 (8% pts. Cholesterol level did not significantly change after 14 days of follow up but in 28 (47% pts it increased in comparison with baseline. Trigliceride level significantly decreased at day 14 from 149 [106; 187] to 108 [66,5; 172] mg/dl (p=0,02. 26 (44% pts had face hyperemia, 4 (7% –42 palpitation and 2 (3,4% – bitter taste. Conclusion. Administration of short course of GC in pts with gout requires monitoring of possible adverse events. Antihypertensive therapy providing appropriate BP

  3. 微量氟尿嘧啶皮损内注射治疗成人疥疮结节临床观察%Clinical Observation of Treating Scabies Nodules by Injecting Fluorouracil Topically with Low Dose

    Institute of Scientific and Technical Information of China (English)

    池丽俏; 钟文俊; 潘新锋; 王强; 李媛媛

    2012-01-01

    目的 探讨微量氟尿嘧啶皮损内注射治疗疥疮结节的临床疗效与安全性.方法 治疗组31例,用氟尿嘧啶利多卡因混合注射液,每个疥疮结节皮损内注射混合液0.1~0.2mL;对照组30例,应用复方倍他米松利多卡因混合注射液,每个疥疮结节皮损内注射混合液0.1~0.2mL.两组均给予单次治疗,于14d时评价其疗效与安全性.结果 治疗组痊愈率为90.32%,对照组为66.67%,两组的差异有统计学意义(P<0.05);治疗组血常规、肝功及肾功检验结果无异常.结论 微量氟尿嘧啶注射液单次皮损内注射是治疗成人疥疮结节的方法之一.%Objective To evaluate the clinical effect and safety of treat scabies nodules with low dose fluorouracil topically injecting. Methods Every nodule of the 31 cases in the treatment group was injected with 0. 1 -0. 2mL fluorouracil and lidocaine mixtured; every nodule of 30 cases in the control group was injected with 0. 1-0.2mL compound betamethasone and lidocaine mixtured; both group were the two treated only once. The clinical effects and safety of the two groups were evaluated after 14 days. Results The recovery rate of the treament group was 90.32% ; the recovery rate of the control group was 66.67%. Significant statistic value was demonstrated by comparing the two groups ( P < 0. 05 ) ; the results of blood routine examination, liver function and kidney function all turned out normal. Conclusion Injecting scabies nodules topically with low dose fluorouracil once can be considered as a method to treat adult patients.

  4. Analysis of an Adulterated Herbal Medicinal Product Using Ultra-Performance Liquid Chromatography Coupled with QTOF Mass Spectrometry

    Institute of Scientific and Technical Information of China (English)

    Kate Yu; Mark Powell; Margaret Maziarz; Dhavalkumar Narendrabhai Patel

    2016-01-01

    The reports of severe adverse effects and fatalities associated with herbal medicinal products adulterated with synthetic compounds have raised global concerns. The objective of this study is to analyze one commercial herbal medicinal product suspected to be adulterated with synthetic drugs in order to identify potential adulterants, to verify if the product contained the herbs listed as ingredients in label claim and to determine quality consistency among different batches of the product. Analyses of suspected product obtained from seven different batches were performed using ultra performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) with multiple data processing tools and multivariate analyses. In addition, 23 individual powdered herbs (12 as per label claim and 11 suspected herbs), 11 marker compounds of the labeled herbs and five suspected synthetic drugs as adulterants were also concurrently analyzed to have clear understanding of product composition. Based on our analysis, the major ingredients of studied product were found to be 5 synthetic compounds:caffeine, chlorphenamine, piroxicam, betamethasone and oxethazaine. Three of them have been found to exceed their recommended doses. From the herbal composition analysis, GanCao (Glycyrrhizae radix et rhizoma) was found to be the main ingredient, which is not among the claimed 12 herbs that were supposed to be in the product. Other herbs detected as minor ingredients were MuGua (Chaenomelis fructus), DangGui (Angelicae sinensis radix), and HuangQi (Astragali radix), which are among the 12 herbs that were supposed to be in the product. Based on our results we demonstrated that UPLC-QTOF MS is an effective and versatile tool for the analysis of herbal medicinal products. It is highly desirable to have a streamlined process with automatic workflow and fit-for-purpose database to increase efficiency and productivity of sample analysis. Results of this work also

  5. Gateways to clinical trials.

    Science.gov (United States)

    Bayes, M; Rabasseda, X; Prous, J R

    2005-01-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data in the following tables have been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: (-)-Epigallocatechin gallate; ACP-103, Ad.Egr.TNF.11 D, adalimumab, AF-IL 12, AIDSVAX gp120 B/B, alefacept, alemtuzumab, a-Galactosylceramide, ALVAC vCP 1452, alvimopan hydrate, alvocidib hydrochloride, aminolevulinic acid hydrochloride, aminolevulinic acid methyl ester, anakinra, anidulafungin, antarelix, aprepitant, aripiprazole, arsenic sulfide, asoprisnil, atazanavir sulfate, atomoxetine hydrochloride; Bevacizumab, bimatoprost, BMS-184476, bortezomib, bosentan, botulinum toxin type B, BrachySil, brivudine; Caffeine, calcipotriol/betamethasone dipropionate, cannabidiol, capsaicin for injection, caspofungin acetate, CC-4047, cetuximab, CGP-36742, clofazimine, CpG-7909, Cypher; Darbepoetin alfa, dextromethorphan/quinidine sulfate, dimethylfumarate, dronabinol/cannabidiol, drotrecogin alfa (activated), duloxetine hydrochloride, dutasteride; Ecogramostim, efalizumab, eletriptan, emtricitabine, enfuvirtide, eplerenone, esomeprazole magnesium, estradiol acetate, eszopiclone, etoricoxib, exenatide, ezetimibe, ezetimibe/simvastatin; Fampridine, fondaparinux sodium, fosamprenavir calcium; Gefitinib, GPI-0100; hA 20, HTU-PA, human insulin, HuOKT 3 gamma 1(Ala 234-Ala 235), hyaluronic acid; Icatibant, imatinib mesylate, Indiplon, INKP-100, INKP-102, iodine (I131) tositumomab, istradefylline, IV gamma-globulin, ivabradine hydrochloride, ixabepilone; Lacosamide, landiolol, lanthanum carbonate, lasofoxifene tartrate, LB-80380, lenalidomide, lidocaine/tetracaine, linezolid, liposomal doxorubicin, liposomal vincristine sulfate, lopinavir, lopinavir/ritonavir, lumiracoxib, lurtotecan; Maribavir, morphine glucuronide, MVA-5 T

  6. Controlled release of cortisone drugs from block copolymers synthetized by ATRP

    Science.gov (United States)

    Valenti, G.; La Carta, S.; Mazzotti, G.; Rapisarda, M.; Perna, S.; Di Gesù, R.; Giorgini, L.; Carbone, D.; Recca, G.; Rizzarelli, P.

    2016-05-01

    Diseases affecting posterior eye segment, like macular edema, infection and neovascularization, may cause visual impairment. Traditional treatments, such as steroidal-drugs intravitreal injections, involve chronic course of therapy usually over a period of years. Moreover, they can require frequent administrations of drug in order to have an adequately disease control. This dramatically reduce patient's compliance. Efforts have been made to develop implantable devices that offer an alternative therapeutic approach to bypass many challenges of conventional type of therapy. Implantable drug delivery systems (DDS) have been developed to optimize therapeutic properties of drugs and ensure their slow release in the specific site. Polymeric materials can play an essential role in modulating drug delivery and their use in such field has become indispensable. During last decades, acrylic polymers have obtained growing interest. Biocompatibility and chemical properties make them extremely versatile, allowing their use in many field such as biomedical. In particular, block methacrylate copolymer with a balance of hydrophilic and hydrophobic properties can be suitable for prolonged DDS in biomedical devices. In this work, we focused on the realization of a system for controlled and long term release of betamethasone 17,21-dipropionate (BDP), a cortisone drug, from methacrylic block copolymers, to be tested in the treatment of the posterior eye's diseases. Different series of methyl methacrylate/hydroxyethyl methacrylate (MMA/HEMA) block and random copolymers, with different monomer compositions (10-60% HEMA), were synthetized by Atom Transfer Radical Polymerization (ATRP) to find the best hydrophilic/hydrophobic ratio, able to ensure optimal kinetic release. Copolymer samples were characterized by NMR spectroscopy (1H-NMR, 13C-NMR, CosY), SEC, TGA and DSC. Monitoring of drug release from films loaded with BDP was carried out by HPLC analysis. Evaluation of different kinetic

  7. Assessment of Effectiveness of Percutaneous Adhesiolysis in Managing Chronic Low Back Pain Secondary to Lumbar Central Spinal Canal Stenosis

    Directory of Open Access Journals (Sweden)

    Laxmaiah Manchikanti, Kimberly A. Cash, Carla D. McManus, Vidyasagar Pampati

    2013-01-01

    Full Text Available Background: Chronic persistent low back and lower extremity pain secondary to central spinal stenosis is common and disabling. Lumbar surgical interventions with decompression or fusion are most commonly performed to manage severe spinal stenosis. However, epidural injections are also frequently performed in managing central spinal stenosis. After failure of epidural steroid injections, the next sequential step is percutaneous adhesiolysis and hypertonic saline neurolysis with a targeted delivery. The literature on the effectiveness of percutaneous adhesiolysis in managing central spinal stenosis after failure of epidural injections has not been widely studied.Study Design: A prospective evaluation.Setting: An interventional pain management practice, a specialty referral center, a private practice setting in the United States.Objective: To evaluate the effectiveness of percutaneous epidural adhesiolysis in patients with chronic low back and lower extremity pain with lumbar central spinal stenosis.Methods: Seventy patients were recruited. The initial phase of the study was randomized, double-blind with a comparison of percutaneous adhesiolysis with caudal epidural injections. The 25 patients from the adhesiolysis group continued with follow-up, along with 45 additional patients, leading to a total of 70 patients. All patients received percutaneous adhesiolysis and appropriate placement of the Racz catheter, followed by an injection of 5 mL of 2% preservative-free lidocaine with subsequent monitoring in the recovery room. In the recovery room, each patient also received 6 mL of 10% hypertonic sodium chloride solution, and 6 mg of non-particulate betamethasone, followed by an injection of 1 mL of sodium chloride solution and removal of the catheter.Outcomes Assessment: Multiple outcome measures were utilized including the Numeric Rating Scale (NRS, the Oswestry Disability Index 2.0 (ODI, employment status, and opioid intake with assessment at 3, 6

  8. 腰2神经节阻滞治疗慢性腰痛的疗效观察%EFFICACY OF LUMBAR 2 DRGs BLOCK ON TREATMENT OF CHRONIC LOW BACK PAIN

    Institute of Scientific and Technical Information of China (English)

    卜国云; 商卫林; 黄伟; 任东风; 吴叶; 侯树勋

    2011-01-01

    Objective: To evaluate the effect of L2 dorsal root ganglion(DRG) blockage on chronic low back pain(LBP). Methods: 155 consecutive cases suffering from chronic low back pain accompanying with leg pain or not had received L2 DRG blockage using ropivacaine and compound betamethasone ( Diprospan, Schering-Plough Labo N. V. ) from June 2009 to June 2010. Comparing the patients' VAS scores at 0h, 1 d, 7d, 1 m, 3m, 6m with that of pre-block. Pain relief is considered positive if there was a decrease at 50% in VAS scores, otherwise negative. Result: There were 155, 150, 102, 78, 40, 27 patients reaching a pain relief at least 50% in VAS at corresponding point listed above. None of patients developed complications associated with blockage. Conclusion: L2 DRG blockage is effective for chronic low back pain in short term, and it would make surgery on them be postponed or avoided for a small number of patients.%目的:观察腰2(L2)神经节阻滞治疗慢性腰痛的疗效.方法2009年6月至2010年6月,我们对155例慢性腰痛或伴腿痛的患者用罗哌卡因+得宝松进行L2神经节阻滞,比较术后0h、1d、7d、1m、3m、6m视觉模拟评分量表(VAS)得分与术前VAS评分变化,以VAS评分减少50%或以上判定为治疗有效.结果术后0h、1d、7d、1m、3m、6m各有155例、150例、102例、78例、40例、27例患者VAS评分减少50%或以上.患者无阻滞相关的并发症.结论:L2神经节阻滞治治疗慢性腰痛在短期内有效,对于部分患者,可能推迟或避免手术治疗.

  9. Enhanced activity of an angiotensin-(1-7) neuropeptidase in glucocorticoid-induced fetal programming.

    Science.gov (United States)

    Marshall, Allyson C; Shaltout, Hossam A; Pirro, Nancy T; Rose, James C; Diz, Debra I; Chappell, Mark C

    2014-02-01

    We previously identified angiotensin converting enzyme (ACE) and an endopeptidase activity that degraded angiotensin-(1-7) [Ang-(1-7)] to Ang-(1-5) and Ang-(1-4), respectively, in the cerebrospinal fluid (CSF) of 6-month old male sheep. The present study undertook a more comprehensive analysis of the CSF peptidase that converts Ang-(1-7) to Ang-(1-4) in control and in utero betamethasone-exposed sheep (BMX). Characterization of the Ang-(1-7) peptidase revealed that the thiol agents 4-aminophenylmercuric acetate (APMA) and p-chloromercuribenzoic acid (PCMB), as well as the metallo-chelators o-phenanthroline and EDTA essentially abolished the enzyme activity. Additional inhibitors for serine, aspartyl, and cysteine proteases, as well as selective inhibitors against the endopeptidases neprilysin, neurolysin, prolyl and thimet oligopeptidases did not attenuate enzymatic activity. Competition studies against the peptidase revealed similar IC50s for Ang-(1-7) (5μM) and Ang II (3μM), but lower values for Ala(1)-Ang-(1-7) and Ang-(2-7) of 1.8 and 2.0μM, respectively. In contrast, bradykinin exhibited a 6-fold higher IC50 (32μM) than Ang-(1-7) while neurotensin was a poor competitor. Mean arterial pressure (78±1 vs. 94±2mmHg, N=4-5, P<0.01) and Ang-(1-7) peptidase activity (14.2±1 vs 32±1.5fmol/min/ml CSF, N=5, P<0.01) were higher in the BMX group, and enzyme activity inversely correlated with Ang-(1-7) content in CSF. Lower Ang-(1-7) expression in brain is linked to baroreflex impairment in hypertension and aging, thus, increased activity of an Ang-(1-7) peptidase may contribute to lower CSF Ang-(1-7) levels, elevated blood pressure and impaired reflex function in this model of fetal programming.

  10. Sintesis y caracterizacion de portadores magneticos coloidales. Aplicaciones al diseno de sistemas de liberacion de farmacos

    Science.gov (United States)

    Gomez Lopera, Salvador Angel

    2003-10-01

    The present work is mainly dedicated to the synthesis and characterization of composite colloidal particles with a magnetic core (magnetite) and a polymeric biodegradable material shell (poly(DL-lactide), PLA). The aim is to use them as drug carrier systems in the field of controlled (or modified) release. The appropriate synthesis conditions are analyzed for such purpose, starting with the synthesis of the magnetic nuclei, and continuing with that of microspheres of the polymer used later as shell material. The final step is the manufacture of the composite colloids. In order to have a good comparison, all the experiments of the work have been run in triplicate, that is, for the three individual materials (magnetic nuclei, PLA and composite particles magnetite/PLA) and all the discussions are presented by way of parallel study of the three colloidal systems. The following surface and bulk properties have been studied: shape and size of the particles, specific surface area, chemical composition. The magnetic behavior of the nuclei is characterized, as well as that of the composite particles, through measurement of the magnetic susceptibility and the hysteresis cycles. In addition, a study of the electrokinetic behavior of the systems as a function of pH---at constant ionic strength---has been complemented by an investigation of their surface thermodynamics to check the extent of coverage achieved. Very significant results were also obtained in the analysis of the stability of the suspensions. Since our final aim was the design of a drug carrier and controlled release system, we also present a series of preliminary results concerning the effect of the glucocorticoid betamethasone 21-phosphate sodium salt on the surface electrical properties of the three kinds of particles, observing clear differences between the behavior of magnetite particles and of composite or pure polymeric colloids. It is demonstrated that the polymer layer affects considerably the capacity of

  11. Oral Administration of Xiaojin Pills Combined with Drug Injection for Treating Penile Induration in 28 Cases%小金丸口服配合药物注射治疗阴茎硬结症28例

    Institute of Scientific and Technical Information of China (English)

    杨顺利; 杨立杰

    2016-01-01

    Objective To observe the clinical efficacy of Xiaojin Pills oral administration combined with drug injection in the treatment of penile induration. Methods 56 cases were selected and randomly divided into the observation group and the control group,28 cases in each group. The control group was treated by nodal injections of Compound Betamethasone Injection;based on the above treatment, the observation group was added with oral administration of Xiaojin Pills. After 4 weeks of treatment,the clinical efficacy and treat-ment-related adverse reactions were evaluated;3 months and 12 months after the end of treatment,the pain to the penis,penis bend-ing,penile erectile dysfunction and sexual ability improvement were self-evaluated by the patients. Results The total effective rate of the observation group was 85. 71%,which was higher than 64. 29% of the control group( P 0. 05). Partial bleeder and hematoma in the patients were all mild,can be self-healed and did not need special treatment;swelling and itching were relieved after stopping taking medication. 3 months after the end of treatment,the pain in the penis,penis bending,self-evaluation of penile erectile dysfunction,sexual ability in the observation group were superior to the control group( P 0.05);局部出血点及血肿患者轻微,不需特殊治疗均可自愈,红肿瘙痒情况在服药停止后缓解。治疗结束后3个月,观察组患者阴茎疼痛、阴茎弯曲、阴茎勃起障碍、性生活能力自评情况均优于对照组( P<0.05);治疗结束后12个月,患者阴茎勃起障碍、性生活能力自评情况好于对照组( P<0.05)。结论口服小金丸配合局部复方倍他米松注射疗法治疗阴茎硬结症,简单、安全,疗效肯定,能缓解患者的临床症状,减轻患者的痛苦,值得临床推广。

  12. Hyperthyroid-associated EMA syndrome:four cases report and review of literature%甲状腺功能亢进症相关性EMA综合征四例报道并文献复习

    Institute of Scientific and Technical Information of China (English)

    鹿斌; 刘红; 叶红英; 张朝云; 杨叶虹; 闻杰; 赵晓龙; 吴晞; 李益明; 胡仁明

    2015-01-01

    4例甲状腺功能亢进症相关性EMA 综合征患者男性3例,女性1例,均为Graves 病且131 I 治疗后。起病时均有甲状腺毒血症,经过抗甲状腺药物治疗和131 I 治疗后出现胫前黏液水肿和杵状指等表现,2例眼征加重,另外2例眼征变化不明显;4例胫前黏液性水肿予外用索咪新尿素乳膏或联合胫前局部注射复方倍他米松注射液,3例联合小剂量口服强的松治疗,治疗后胫前黏液性水肿表现及眼征均明显好转。因此,131 I 治疗后应警惕可能出现甲状腺功能亢进症相关性EMA 综合征,其采用激素治疗效果较好。%[Summary] Four patients with hyperthyroid-associated exophthalmos, myxedema, acropachy ( EMA ) syndrome, including three male patients and one female patient were diagnosed with Graves′diseases and treated by 131 I therapy. Complaints of thyrotoxicosis were presented at the onset. Tibia myxedema and acropathy appeared, and eye symptoms aggravated in two patients after anti-thyroid drug therapy and 131 I therapy. Four cases were all given clobetasol propionate, miconazole nitrate, neomycin sulfate and urea cream alone or in combination with compound betamethasone local injection treatment, and three cases were given low-dose oral prednisone treatment. Complaints of tibia myxedema and eye symptoms were significantly improved after the treatment. Therefore, we should be wary of the occurrence of hyperthyroid-associated EMA syndrome after 131 I therapy. Corticosteroid might be the effective therapy for myxedema and eye symptoms of EMA syndrome.

  13. 液质联用法检测中成药和保健食品中的6种肾上腺皮质激素%Determination of 6 adrenal corticosteroids in Chinese patent drugs or functional foods by HPLC-MS

    Institute of Scientific and Technical Information of China (English)

    关日晴; 刘敏敏; 李晨辉

    2011-01-01

    Objective To establish a method for determining 6 adrenal corticosteroids which may be added illegally to Chinese patent drugs or functional foods. Methods HPLC-MS was used after a serial extraction and separation procedure. HPLC conditions:C18-column at 30 ℃, eluting with acetonitrile-water(40: 60)at a flow rate of 1.0 mL/min,detecting at 240 nm wavelength, 10 μL injection volume;ESI-MS data was obtained in positive ion mode. Results 6 adrenal corticosteroids (dexamethasone acetate, prednisolone acetate, hydrocortisone acetate, prednisone acetate, cortisone acetate, betamethasone ) were accurately identified simultaneously. Conclusion The method was accurate and suitable for determining 6 adrenal corticosteroids which may be added illegally to Chinese patent drugs or functional foods.%目的 建立中成药或保健食品中非法添加的6种肾上腺皮质激素的检验方法.方法 样品经溶剂提取分离后,采用高效液相色谱-串联质谱法测定.色谱条件:色谱柱为C18柱,流动相为乙腈-水(体积比40∶60),检测波长240 nm,柱温30℃,流速1.0 mL/min,进样量10μL;质谱条件:以ESI电喷雾电离源正离子模式进行质谱数据采集.结果 可同时对中国药典收载的醋酸地塞米松、醋酸可的松、醋酸氢化可的松、醋酸泼尼松、醋酸泼尼松龙和倍他米松6种常用口服肾上腺皮质激素进行检查,准确率达到100%.结论 该方法准确性、专属性强,可作为中成药或保健食品中非法添加的6种肾上腺皮质激素的检验方法.

  14. Fístula arteriovenosa del labio inferior: Presentación de un caso Arteriovenous fistula of the lower lip: Case report

    Directory of Open Access Journals (Sweden)

    M. Estrada Sarmiento

    2007-10-01

    Full Text Available El objetivo del trabajo es exponer nuestra experiencia en el tratamiento quirúrgico de una fístula arteriovenosa del labio inferior de una paciente de 15 años de edad, producida por un mordisco. La paciente fue diagnosticada en su inicio como un hemangioma traumático, el cual fue tratado con esteroides y exéresis quirúrgica. A los 4 años apareció con una tumoración más voluminosa, se realizó disección de la carótida externa y arteriografía carotídea la cual diagnóstico fístula arteriovenosa, se realizó ligadura de la facial y de los vasos venosos, para aislarla de la circulación. Se inyectaron 4 cc de betametazona en la tumoración, posteriormente se inyectaron 4 inyecciones adicionales con intervalos e 3 semanas, a los tres meses de la ligadura de los vasos sé realizo la exéresis de la fibrosis de la tumoración. En estos momentos la paciente tiene 5 años desde la última intervención, no presentando recidiva. Se destaca la importancia del estudio angiográfico para el diagnóstico y tratamiento de esta entidad patológica, que es poco frecuente.The object of this work is to present our experience in the surgical management of an arteriovenous fistula in the lower lip of a fifteen year-old patient as a result of a bite. The patient was diagnosed initially as having a trauma-induced hemangioma, which was treated with steroid and surgical exeresis. Four years later, a larger tumor appeared. The external carotid artery was dissected and an arteriography of the carotid was carried out that gave the diagnosis of arteriovenous fistula. Ligation was carried out of the facial artery and of the venous vessels for isolation from the circulation. Four injections were given with 4cc of betamethasone into the mass. Later 4 additional injections were given with intervals of 3 weeks. Four months after the ligation of the vessels, the fibrous mass was excised. Five years have now passed since the last intervention and there has been no

  15. LC-MS method for the simultaneous determination of six glucocorticoids in pharmaceutical formulations and counterfeit cosmetic products.

    Science.gov (United States)

    Fiori, Jessica; Andrisano, Vincenza

    2014-03-01

    A screening method based on liquid chromatography-electrospray mass spectrometry for the simultaneous determination of six corticosteroids (betamethasone 17-valerate BM 17-V, beclomethasone BC, beclomethasone dipropionate BCDP, methylprednisolone MP, budesonide BD, flunisolide FN) was developed in order to control their illegal use in cosmetic and natural products. Indeed, despite corticosteroids are banned in cosmetics, counterfeit products might be present on the market, representing a health hazard. Therefore, effective analytical methods are required to rapidly screen over the counter products in health care shops for counterfeit corticosteroids. The analytical method involves the employment of a Waters Synergy C18 column (150mm×2.0mm I.D.) by using the following mobile phase: A (0.1% formic acid in acetonitrile), B (0.1% formic acid in water) in a linear gradient (from A-B 25:75, v/v to A-B 95:5, v/v in 30min) at the flow rate of 0.3mL/min. The detection was performed with an ion trap (IT) mass spectrometer in positive polarity, total ion current (TIC) and tandem mass modalities for qualitative purpose; single ion monitoring (SIM) mode was used for quantitative analysis on the ESI generated most abundant ion for each steroid. The method was fully validated in terms of precision, detection and quantification limits, linearity, recovery, and it was applied to the identification and quantification of corticosteroids in pharmaceutical formulations and cosmetic products. The mean recovery of BM 17-V, BC, BCDP, MP, BD and FN were found to be 101.3, 101.5, 98.8, 98.9, 98.1, 99.0%, respectively. Limits of quantitation (LOQ) were comprised in the range 29-95ng/mL. To the best of our knowledge, for the first time this mix of glucocorticoids were simultaneously determined in cosmetic products by using a fully validated method. BMV, in its two isomeric forms BM 17-V and BM 21-V, was found to be illegally present in one cream sample (A) with the total concentration level

  16. Fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar axial or discogenic pain

    Directory of Open Access Journals (Sweden)

    Manchikanti L

    2012-08-01

    Full Text Available Laxmaiah Manchikanti,1,2 Kimberly A Cash,1 Carla D McManus,1 Vidyasagar Pampati,1 Ramsin Benyamin3,41Pain Management Center of Paducah, Paducah, KY; 2University of Louisville, Louisville, KY; 3Millennium Pain Center, Bloomington, IL; 4University of Illinois, Urbana-Champaign, IL, USAAbstract: Among the multiple causes of chronic low back pain, axial and discogenic pain are common. Various modalities of treatments are utilized in managing discogenic and axial low back pain including epidural injections. However, there is a paucity of evidence regarding the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. In an interventional pain management practice in the US, a randomized, double-blind, active control trial was conducted. The objective was to assess the effectiveness of lumbar interlaminar epidural injections of local anesthetic with or without steroids for managing chronic low back pain of discogenic origin. However, disc herniation, radiculitis, facet joint pain, or sacroiliac joint pain were excluded. Two groups of patients were studied, with 60 patients in each group receiving either local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Primary outcome measures included the pain relief-assessed by numeric rating scale of pain and functional status assessed by the, Oswestry Disability Index, Secondary outcome measurements included employment status, and opioid intake. Significant improvement or success was defined as at least a 50% decrease in pain and disability. Significant improvement was seen in 77% of the patients in Group I and 67% of the patients in Group II. In the successful groups (those with at least 3 weeks of relief with the first two procedures, the improvement was 84% in Group I and 71% in Group II. For those with chronic function-limiting low back pain refractory to conservative management

  17. Análise macroscópica dos efeitos dos hialuronatos e do corticosteroide no tratamento da osteoartrose induzida em joelhos de coelho Mcroscopic analyses of the effects of hyaluronates and corticosteroids on induced osteoarthritis in rabbits' knees

    Directory of Open Access Journals (Sweden)

    Mauro Batista Albano

    2010-06-01

    underwent anterior cruciate ligament resection and were subsequently divided into four groups, composed of eleven subjects each. Group 1: rabbits received weekly intraarticular injections of saline over a period of four weeks; Group 2: the animals received three weekly intraarticular injections of native hyaluronic acid; Group 3: rabbits in this group received three weekly intraarticular injections of branched-chain hyaluronic acid; Group 4: two injections of betamethasone over a period of three weeks. A macroscopic study of the cartilage of the tibial plateaus was performed twelve weeks after surgery and changes in the joint surface were graded accordingly: Grade 0: smooth joint surface without relief changes; Grade 1: rough surface without any depression; Grade 2: similar to grade 1, but with depressions on the joint surface and Grade 3: subchondral bone exposure. Statistical analysis was performed with the use of Student's T test, chi-square test and analysis of variance (ANOVA, with a significance level of 5%. RESULTS: A statistical difference was found between the control group and the three study groups (2, 3 and 4 in both the development and severity of arthrosis. However, there was no difference in outcome among the three different drugs. CONCLUSION: A similar degree of attenuation of the osteoarthrosis process in rabbits' knees was found in all three study groups (low-molecular-weight glycosaminoglycans, high-molecular-weight glycosaminoglycans and betamethasone when compared to placebo.

  18. A simple and specific high performance liquid chromatography method for the assay of a series of novel dermal penetration enhancers.

    Science.gov (United States)

    Michniak, B B; Seyda, K L

    1993-02-01

    Synopsis A series of clofibric acid amides has been synthesized and previously reported by the authors as possessing enhancer activity in vitro in athymic nude mouse skin against model drugs, hydrocortisone-21-acetate and beta-methasone-17-valerate. An assay was required for each of these enhancers however, which would be specific for each compound and would also separate model drugs and their metabolite peaks. This study reports reverse phase high performance liquid chromatography assays for clofibric acid amide and seven derivatives (Ia-Ig). All enhancers showed maximum absorption at 232 nm, betamethasone (BM) and its valerate (BMV) at 238 nm, and hydrocortisone (HC) and its acetate (HCA) at 242 nm. Practical units of detection for the amides were 0.46-2.8 mug ml(-1) and peaks were sharp and well-separated from steroid peaks in three vehicles - methanol alone. Franz diffusion cell receptor phase samples (isotonic phosphate buffer), and full-thickness athymic nude mouse skin extracts in methanol. Mobile phases consisted of various proportions of acetonitrile and water, some with 2-propanol. The octyl amide for example, with mobile phase CH(3)CN: H(2)O (85:15) at 1 ml min(-1) had a retention time (t(R)) of 7.9 mins. Under the same conditions, retention times for the steroids were HC, t(R)= 3.3 mins; HCA, t(R)= 4.3 mins; BM, t(R)= 3.4 mins; BMV, t(R)= 4.6 mins. Résumé Les auteurs avaient démontré dans un article précédent le pouvoir accélérateur de pénétration dermique in vitro d'une gamme d'amides d'acide clofibrique sur la peau de souris sans poils, et sans thymus avec des médicaments types tels que l'acetate 21 d'hydrocortisone et le valerate 17 de beta-metasone. Il a cependant été requis, pour chacun de ces accélérateurs, un test spécifique pour chaque composition, permettant de séparer chaque médicament et les pics des métabolites. Cette étude décrit des tests par chromatographie liquide à haute performance en phase inverse pour l

  19. 污水中18种类固醇激素化合物的痕量分析%Analysis of 18 Trace Steroid Hormone Compounds in Wastewater

    Institute of Scientific and Technical Information of China (English)

    葛峰; 谭丽超; 单正军; 王懿

    2011-01-01

    A sensitive ultra-performance liquid chromatography - electrospray tandem mass spectro-metric method(UPLC -MS/MS) combined with solid-phase extraction(SPE) was established for the determination of eighteen steroid hormones, including prednisolone, prednisone, methylprednisolo-ne, betamethasone, dexamethasone, trenbolone, prednisolone acetate, hydrocortisone acetate, nortestosterone, testosterone, stanozolol, norethindrone, hydroxyprogesterone, methyltestosterone, androstenedione, megestrol acetate, progesterone and medroxyprogesterone acetate in the influent and final effluent from wastewater treatment plant ( WWTP). The operation conditions influencing the SPE performance were optimized by single factor experiments and orthogonal test, and UPLC - MS/ MS experimental parameters were also studied in detail. The results indicated that, under the optimal conditions, the calibration curves of eighteen steroid hormones were linear in the range of 1. 0 -200 μg ? L-1 with their correlation coefficients ( r2 ) not less than 0.997 6. The detection limits for the method ranged from 1.49 ng ? L-1 to 10. 59 ng ? L-1. The recoveries of WWTP water samples at spiked levels of 20 -100 ng ? L-1 were between 67% and 109% with RSDs not more than 13. 9% . The method was applied in the determination of steroid hormones in wastewater from four sewage treatment plants in Nanjing. Nortestosterone, androstenedione, testosterone, hydroxyprogesterone, prednisone and prednisolone were found in the influent of the four sewage treatment plants, in which the concentration of prednisone was the highest. A certain amount of steroid hormones were also found in the final effluent.%采用HLB固相萃取柱和超高效液相色谱-串联质谱法(UPLC - MS/MS),在多反应监测(MRM)模式下建立了污水处理厂进出水样中18种类固醇激素(群勃龙、诺龙、雄烯二酮、睾酮、炔诺酮、甲基睾酮、孕酮、康力龙、羟孕酮、泼尼松、氢化泼

  20. Chondroprotectant therapy in rats with degenerative joint disease experimentally transected cranial cruciateReprodução experimental da doença articular degenerativa, pelo método cirúrgico associado à terapia condroprotetora, em ratos

    Directory of Open Access Journals (Sweden)

    Marcos Marini Melo

    2013-06-01

    Full Text Available Osteoarthritis (OA is the most common joint disease in both humans and animals, and it results in movement restriction and pain at the affected area. This disorder affects more than 25% of people over 60 years of age, and it is considered universal for 70-year-old people. OA is estimated to affect over 20% of the canine population from the United States of America. The present study aimed to evaluate the treatment of rats that were surgically induced to OA using two different drug therapies, one with pentosan polysulfate, one with betamethasone, and one with chondroitin sulfate/ glucosamine. In order to produce joint disease, the cranial cruciate ligament was surgically transected. Animals were kept and treated for eight days after surgery and were assessed via both radiographies and tomographies taken before surgery and eight weeks later. All animals were euthanized having both macroscopic and microscopic analysis performed to evaluate the disorder progression and therapeutic action. Macroscopic analysis showed lesion in the knees subjected to OA induction. The untreated animals presented major lesions whereas the treated ones presented mild to moderate lesions. In conclusion, pentosan polysulfate is recommendable for the treatment of iatrogenic joint lesions in rats since the other treatments showed no significant difference. A osteoartrite (OA é a doença articular mais comum em humanos e animais, o que ocasiona restrição de movimentos e dor, na região acometida. Tal enfermidade afeta mais de 25% dos humanos acima de 60 anos e, aos 70 anos, ela é considerada universal. Estima-se que nos Estados Unidos da América, 20% ou mais da população canina é acometida pela OA. O presente estudo tem como finalidade avaliar a terapia medicamentosa (polisulfato de pentosano, betametasona e sulfato de condroitina/glucosamina, em um modelo experimental de OA cirurgicamente induzido, em ratos. A doença articular foi promovida pela transecção cir

  1. Determination of Four Prohibited Substances in Whitening or Acne Cosmetics by Ultra-performance Liquid Chromatography%超高效液相色谱法测定美白、祛痘化妆品中4种禁用激素

    Institute of Scientific and Technical Information of China (English)

    周江; 黄艳美; 龚越飞; 季倩祎

    2016-01-01

    建立了超高效液相色谱同时测定美白、祛痘化妆品中4种糖皮质激素氢化可的松、曲安奈德醋酸酯、氯倍他索丙酸酯、倍他米松双丙酸酯的方法。样品采用甲醇涡旋超声提取,色谱柱采用Waters ACQUITY UPLC BEH C18柱(100 mm×2.1 mm,1.7μm),流动相为乙腈–水溶液,梯度洗脱,流量为0.5 mL/min,用PDA检测器检测,检测波长为240 nm。方法检出限以3倍空白噪音计,氢化可的松、曲安奈德醋酸酯、氯倍他索丙酸酯、倍他米松双丙酸酯的检出浓度分别为0.12,0.18,0.30,0.30 mg/kg。在质量浓度为1.0~40.0 mg/L时,标准工作曲线相关系数r>0.9998,4种激素的回收率为85.3%~102.8%,测定结果的相对标准偏差为2.1%~5.0%(n=6)。该方法前处理简单,分离效果好,且灵敏度高,速度快,能满足美白、祛痘化妆品中4中糖皮质激素的检测需要。%An ultra-performance liquid chromatography method was established for simultaneously determination of four glucocorticoids: hydrocortisone, triamcinolone acetonide acetate, clobetasol 17-propionate and betamethasone dipropionate in whitening or acne cosmetics. After methanol extraction, glucocorticoids were separated on Waters ACQUITY UPLC BEH C18 Column (100 mm×2.1 mm, 1.7μm) by gradient elution using acetonitrile–water as the mobile phase at a flow rate of 0.5 mL/min, and detected by PDA detector at detecting wavelength of 240 nm. The detection limits asS/N=3 were 0.12, 0.18, 0.30, 0.30 mg/kg for hydrocortisone, triamcinolone acetonide acetate, clobetasol 17-propionate andbetamethasone dipropionate, respectively. Within a glucocorticoid concentration range of 1.0–40.0 mg/L, the average recoveries for glucocorticoids were 85.3%–102.8%, the correlation coefficients of linear calibration curve were all more than 0.999 8, the relative standard deviations were 2.1%–5.0%(n=6). The pretreatment is simple and the separation is

  2. Protocolo de tratamiento de cicatrices queloides en el pabellón auricular del Hospital General Dr. Manuel Gea González Treatment protocol of auricular keloid scars in the General Hospital Dr. Manuel Gea González

    Directory of Open Access Journals (Sweden)

    C. Gutiérrez Gómez

    2012-03-01

    scars.: All scars were injected with triamcinolone or betamethasone 3 times with 4-6 weeks between each injection. Four weeks after the last injection, the keloids were excised and skin closure was done without tension. In those patients with history of surgical excision, we added to the treatment colchicine, 1 mg daily, for 8 weeks with hepatic function test before and after the administration of colchicine. The keloid was unilateral in 74.5 % of the cases; 56.8 % females; the age of presentation was between 8 and 61 years old, with a media of 24 years old.The right auricle was affected in 65 % and the most frequently affected area was the lobule in 42 %.The etiology in 56 % of the cases were secondary to piercing. In 18.6 % of the cases the scar was resolved with the intralesional injection of triamcinolone or betametasone. From the 48 excisions performed, 12.5 % (6 keloid scars presented recurrence, with a follow up of 8 months to 6 years.

  3. Antisense CTGF inhibits the expression of CTGF in hypertrophic scar of rabbit ears%药物抑制兔耳病理性瘢痕中结缔组织生长因子的实验

    Institute of Scientific and Technical Information of China (English)

    王少华; 李健; 王燕华; 吕建平; 李记森; 王勇

    2011-01-01

    Objective To investigate a medicine which can inhibit the expression of connective tissue growth factor (CTGF) in hypertrophic scar of rabbit ears. Methods 24 bigears white rabbits were used to establish a model of hypertrophic scar of rabbit ears, which was randomly divided into four groups. The hypertrophic scar was injected intralesionally with antisense CTGF (group A), betamethason (group B), triamcinolone acetonide (group C) and physiological saline (group D). Some scar tissue samples were sectioned in every group when the scar was treated after 7, 14, 30, and 60 days, respectively. The expression of CTGF mRNA in the scar was assessed by in situ hybridization and hematoxylin and eosin stain (HE stain) in every samples. Results The expression of CTGF mRNA and the counting of fibroblasts decreased in group A, which showed statistical difference as compared with groups B, C and D. Conclusions The results suggesz that antisense CTGF is able to inhibit the proliferation process of hypertrophic scar in rabbit ears and to remarkably decrease the degree of fiborsis in the scar.%目的 探讨能有效抑制结缔组织生长因子(CTGF)的药物,以便为治疗病理性瘢痕提供依据.方法 选择24只大耳白兔建立兔耳病理性瘢痕模型,随机分为4组:A组注射CTGF反义寡核苷酸,B组注射复方倍他米松,C组注射醋酸曲安奈得,D组为对照组,仅注射生理盐水.通过原位杂交法分别检测瘢痕组织中不同治疗组不同时段的CTGF表达,并通过苏木精-伊红(HE)染色法检测瘢痕组织中不同治疗组不同时段的成纤维细胞数.结果 A、B、C 3组在同一时段其CTGF表达均比D组低,差异有统计学意义(P<0.05),A组较B、C两组CTGF表达低,差异也具有统计学意义(P<0.05).B、C两组之间CTGF表达差异无统计学意义(P>0.05).成纤维细胞计数结果与以上结果基本一致.结论 CTGF反义寡核苷酸、复方倍他米松、醋酸曲安奈得均可抑制病理性瘢痕

  4. Antenatal corticosteroids for maturity of term or near term fetuses: systematic review and meta-analysis of randomized controlled trials

    Science.gov (United States)

    Saccone, Gabriele

    2016-01-01

    Objective To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks’ gestation. Design Systematic review with meta-analysis. Data sources Electronic databases were searched from their inception to February 2016. Eligibility criteria for study selection Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks’ gestation. Trials on antenatal steroids in women expected to deliver late preterm (340-366 weeks) and trials given before planned cesarean delivery at term (≥37 weeks) were included. Data synthesis The primary outcome was the incidence of severe respiratory distress syndrome (RDS). The summary measures were reported as relative risks or mean differences with 95% confidence intervals. Results Six trials, including 5698 singleton pregnancies, were analyzed. Three included 3200 women at 340-366 weeks’ gestation and at risk of imminent premature delivery at the time of hospital admission. The three other trials included 2498 women undergoing planned cesarean delivery at ≥37 weeks. Overall, infants of mothers who received antenatal corticosteroids at ≥34 weeks had a significantly lower risk of RDS (relative risk 0.74, 95% confidence interval 0.61 to 0.91), mild RDS (0.67, 0.46 to 0.96), moderate RDS (0.39, 0.18 to 0.89), transient tachypnea of the newborn (0.56, 0.37 to 0.86), severe RDS (0.55, 0.33 to 0.91), use of surfactant, and mechanical ventilation, and a significantly lower time receiving oxygen (mean difference −2.06 hours, 95% confidence interval −2.17 to −1.95), lower maximum inspired oxygen concentration (−0.66%, −0.69% to −0.63%), shorter stay on a neonatal intensive care unit (−7.64 days, −7.65 to −7.64), and higher APGAR scores compared with controls. Infants of mothers who received antenatal betamethasone at 340-366 weeks’ gestation had a significantly lower incidence of transient tachypnea of the newborn

  5. Tratamiento del Síndrome de Dolor Miofascial con Toxina Botulínica tipo A Botulinum toxin type A in the management of Myofascial pain syndrome

    Directory of Open Access Journals (Sweden)

    M. Castro

    2006-03-01

    study. The aim of the study was to evaluate the clinical efficacy and safety of the muscular injection of the botulinum toxin in reducing pain in the MPS in 20 patients. All patients had a diagnostic injection of the lumbar musculature or the piriformis muscle of 8 ml of 0.2% ropi-vacaine and 6 mg of sodium betamethasone phosphate and 6 mg of acetate betamethasone in each muscle. We used anatomical references to localise each muscle and we injected 1 ml of hydrosoluble contrast to confirm by radioscopy guidance the correct localization of the needle in the muscle to treat. The administration of the botulinum toxin was carried out using the same method used for the diagnostic infiltrations. We decided to use one dose of 250 U of Dysport® in each muscle and we exceeded 1000 U in none patient. The assessment of the treatment efficacy was based on the pain reduction according to the visual analog scale (VAS on the first day of the injection (VAS 1, at day 15 (VAS 15, day 30 (VAS 30 and day 90 (VAS 90 after insertion of the botulinum toxin and the test of Lattinen was evaluated before the treatment (TLT 1 and at the completion of the study (TLT 2. All patients were asked regarding side effects and the grade of satisfaction at the end of the study was defined as excellent, good, regular or bad. Results: In all patients, the diagnostic injection was considerate positive with the posterior administration of the botulinum toxin. There was at least a reduction of 50% of the pain in the EVA in the 20 cases at day 15 and 30. At day 90, the reduction of the pain at 50% was maintained in 13 patients and less than 50% in the rest of the patients. The initial median EVA was 7.7 ± 1.2 standard desvia-tion and the TLT median initial of 12± 2.3. The evolution of the EVA median in the following controls was EVA 15 = 3,34 ± 2,5; EVA 30 = 3,54 ± 2,37 y EVA 90 = 4,94 ± 2,83. The median TLT at day 90 was de 7,43 ± 3,49. Only one patient referred mild muscle weakness of the lower limbs

  6. 瘢痕旁和瘢痕下扩张器埋植治疗17例胸部瘢痕疙瘩%Treatment of keloids on anterior chest by implantation of tissue expanders adjacent to or beneath keloid tissues: 17 case report

    Institute of Scientific and Technical Information of China (English)

    陈晓栋; 顾黎雄; 吴晓琰; 沈聪聪; 赵洪瑜

    2011-01-01

    Objective To observe and compare the efficacy and safety of implantation of tissue expanders adjacent to or under keloid tissues for large keloids on anterior chest. Methods Between Mar 2006 and June 2009, a total of 17 patients with large keloid lesions on anterior chest received treatment with 21 tissue expanders,among which 12 were placed under the normal skin adjacent to keloids, and 9 were inserted under the keloid lesions. The scar size varied from 4.5 cm × 3.0 cm to 15.7 cm × 5.5 cm. The capacity was 70 to 400 ml for expanders adjacent to the keloid tissue, 80 to 500 mi for those beneath the keloid tissues. After tissue expansion for 6 to 8 weeks, the expander was removed and keloid lesions were resected followed by the repair of defect with expanded flaps. Further more, the patients received intraoperative local intradermal injection of betamethasone and postoperative superficial electron beam irradiation with divided doses of 7 Gy in 3 consecutive days within 1 week after the surgery. Follow-up varied from 12 to 50 months. Results Twenty expanders, except 1expander pocket which was removed ahead of time due to infection, were implanted successfully during the whole course of treatment. The main complication was expander exposure in 4 patients, including 1 expander adjacent to the keloids and 3 under keloid lesions, which showed no significant influence on secondary operation. Fifteen patients reported relief of symptoms and achieved satisfactory outcomes, while 2 patients, including 1 treated with expanders adjacent to the keloids and 1 with expanders under the keloid tissue, showed great suture tension and experienced delayed stitch removal followed by the recurrence of keloids after the operation.Conclusions The implantation of tissue expanders under the adjacent normal skin or keloid lesions is an ideal treatment option for large keloids on anterior chest. Regional suture tension is a direct contributor to the recurrence of keloid formation after

  7. 侧隐窝注射臭氧治疗腰椎间盘突出症致神经根炎对糖尿病患者血糖的影响%Effect of injection of ozone through lateral recess for treatment of radiculitis caused by lumbar disc herniation on blood glucose in patients with diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    李慧; 傅志俭; 谢珺田; 魏广福; 贾明睿; 王珺楠; 陈颖

    2012-01-01

    ):non-diabetic patients-O3 group (group N-O3 ),non-diabetic patients-ghcocorticoid group (group N-GC),diabetic patients-O3 group (group D-O3 ),and diabetic patients-glucocorticoid group (group D-GC).In N-O3 and D-O3 groups,30 mg/L O3 10 ml was injected via the lateral recess.In N-GC and D-GC groups,compound betamethasone injection 3.5 mg was injected via the lateral recess.The blood glucose level was measured before treatment (T1),1 and 4 h after treatment (T3,4),and 1,3 and 7 days after treatment (T5-7).VAS score was recorded at T1,immediately after treatment (T2),and at T5-7.The patients' quality of life was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36 Health Survey) questionnaire at T1,7.The therapeutic effect was evaluated at T7.The side effects were recorded.Results Compared with the baseline value at T1,VAS scores were significantly decreased after treatment,while the MOS SF-36 Health Survey questionnaire scores for physical functioning,bodily pain,role emotional,and mental health in all groups,for general health in group N-GC,and for vitality in groups D-O3 and N-O3 were significantly increased at T7,and the blood glucose level was significantly increased at T4 in groups N-GC and D-O3,and at T3-7 in group D-GC ( P < 0.05).There was no significant change in the blood glucose level before and after treatment in group N-O3.The blood glucose level was significantly higher in group N-GC than in group N-O3,and in group D-GC than in group D-O3 ( P < 0.05).There were no significant differences in the excellent and good rates and all the MOS SF-36 Health Survey questionnaire scores among all groups.No side effects were found in the study.Conclusion Injection of ozone through lateral recess for treatment of radiculitis caused by lumbar disc herniation exerts no influence on the blood glucose level in patients with diabetes mellitus.

  8. Comprehensive therapy for infant vascular tumor associated with Kasabach-Merritt phenomenon%激素联合长春新碱和栓塞硬化剂治疗婴幼儿脉管肿瘤伴Kasabach-Merritt现象

    Institute of Scientific and Technical Information of China (English)

    徐苗; 欧阳天祥; 肖燕; 黄莹滢; 陈惠平; 虞杰; 马晓荣; 赵婷慧; 常梦玲

    2015-01-01

    sclerotherapy,were retrospectively studied.Oral corticosteroids (2 mg/kg per day) was used as the firstline therapy on all of the patients and intravenous vincristine (1.5 mg/m2 every week) was added when the platelet counts didn't recover obviously after 2-3 weeks.After the recovery of the platelet counts,the patients were admitted for sclerotherapy (average,4.56 sessions per case)with 100% alcohol (1-3 ml per session),Lauromacrogol (1.25-5 ml per session) and betamethasone (0.25-1 ml per session).All the patients were followed up for 42 months (range,9 months to 6.5 years).Therapeutic outcomes were assessed by evaluating platelet counts,size of lesion,function of trunk and limb.Results All the 25 cases got obvious recovery in the platelet counts [average,(94.3 ± 18.5) × 109/L] after drug therapy,of which 16 were treated by single oral corticosteroids for 4-7 weeks and 9 were treated by corticosteroids plus intravenous vincristine for 2-5 weeks.Meantime,11 cases received platelet transfusions,of which 3 were coupled with gamma globulin intramuscularly.During the first admission,each of the 25 cases received 1-4 sessions of sclerotherapy (average,2.6 sessions each case).One week after the sclerotherapy,the platelet counts returned to (167-312) × 10 9/L(average,(258.5 ± 34.4) × 109/L).The hemoglobin and blood coagulation function returned to normal within 1-5 weeks.Meanwhile the mental condition,appetite,body weight,sleeping were greatly improved.The size of the lesions decreased gradually after the combined therapy including 13 cases within 3-12 months and 13 cases within 13-36 months.Long term follow-up indicated that only 1 case need treatment for recurrent decrease of platelet counts,and all of the 25 cases kept the normal weight,height,immunity as well as the growing development.Conclusions Oral corticosteroids plus intravenous vincristine combined with sclerotherapy is a reliable management with high cure rate,short course and minor side-effect.