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Sample records for cbg corticosteroid binding

  1. Expression of corticosteroid binding globulin in the rat olfactory system.

    Science.gov (United States)

    Dölz, Wilfried; Eitner, Annett; Caldwell, Jack D; Jirikowski, Gustav F

    2013-05-01

    Glucocorticoids are known to act on the olfactory system although their mode of action is still unclear since nuclear glucocorticoid receptors are mostly absent in the olfactory mucosa. In this study we used immunocytochemistry, in situ hybridization, and RT-PCR to study the expression and distribution of corticosteroid binding globulin (CBG) in the rat olfactory system. Mucosal goblet cells could be immunostained for CBG. Nasal secretion contained measurable amounts of CBG suggesting that CBG is liberated. CBG immunoreactivity was localized in many of the basal cells of the olfactory mucosa, while mature sensory cells contained CBG only in processes as determined by double immunostaining with the olfactory marker protein OMP. This staining was most pronounced in the vomeronasal organ (VNO). The appearance of CBG in the non-sensory and sensory parts of the VNO and in nerve terminals in the accessory bulb indicated axonal transport. Portions of the periglomerular cells, the mitral cells and the tufted cells were also CBG positive. CBG encoding transcripts were confirmed by RT-PCR in homogenates of the olfactory mucosa and VNO. Olfactory CBG may be significant for uptake, accumulation and transport of glucocorticoids, including aerosolic cortisol. PMID:23141917

  2. Corticosteroid-binding globulin: modulating mechanisms of bioavailability of cortisol and its clinical implications.

    Science.gov (United States)

    Bae, Yoon Ju; Kratzsch, Juergen

    2015-10-01

    Corticosteroid-binding globulin (CBG) is the principal transport protein of glucocorticoids. Approximately 80-90% of serum cortisol binds to CBG with high affinity and only about 5% of cortisol remain unbound and is considered biologically active. CBG seems to modulate and influence the bioavailability of cortisol to local tissues. In this review, we will discuss physicochemical properties of CBG and structure of CBG in the mechanisms of binding and release of cortisol. This review describes several factors affecting CBG functions, such as genetic factors or temperature. Furthermore, clinical implications of CBG abnormalities and the measurement of CBG and its use for assessment of free cortisol levels are described in this review. PMID:26522460

  3. Homologous radioimmunoassay for guinea pig corticosteroid-binding globulin

    International Nuclear Information System (INIS)

    A rapid, specific, and sensitive (requiring only 20 fmole of antigen equivalent to 0.007) μl of serum) radioimmunoassay (RIA) was developed for the measurement of guinea pig corticosteroid-binding globulin (CBG). CBG was purified to homogeneity from guinea pig serum by affinity chromatography and used for immunization, as the standard and as the radiolabeled trace in the RIA. The antiserum to CBG was raised in rabbits. It was judged specific by immunoelectrophoresis and by comparison of RIA values with steroid-binding assay profiles obtained on serum separated on the basis of size and ion-exchange properties. The results of the radioimmunoassays agree with those of a steroid-binding assay run on identical samples. The sensitivity of the assay allows detection of CBG in serial serum samples, other biologic fluids such as milk, and cell culture supernatants

  4. Corticosteroid-Binding Globulin: A Review of Basic and Clinical Advances.

    Science.gov (United States)

    Meyer, E J; Nenke, M A; Rankin, W; Lewis, J G; Torpy, D J

    2016-06-01

    Corticosteroid-binding globulin (CBG, transcortin) is the primary cortisol binding protein. It is a non-inhibitory serine protease inhibitor, capable of conformational change from a high cortisol-binding affinity form to a low affinity form upon cleavage of its reactive centre loop by various proteases, such as neutrophil elastase. The burgeoning inflammatory role of CBG applies to acute, severe inflammation where depletion is associated with mortality, and to chronic inflammation where defects in cortisol delivery may perpetuate inflammation. Naturally occurring human mutations influence a wide range of CBG properties and point toward a role in hitherto unexplained chronic musculoskeletal pain and fatigue disorders as well as potentially affecting fertility outcomes including offspring gender. In vitro and knock-out animal models of CBG propose a role for CBG in cortisol transport to the brain, providing a foundation for understanding the human observations in those with CBG mutations and sex differences in stress-related mood and behaviour. Finally, CBG measurement has a practical role in the estimation of free cortisol, useful in clinical circumstances where CBG levels or cortisol binding affinity is reduced. Taken together, novel data suggest a role for cortisol in targeted cortisol delivery, with implications in acute and chronic inflammation, as well as roles in metabolism and neurocognitive function, implying that CBG is a multifaceted component in the mechanisms of hypothalamic-pituitary-adrenal axis related homeostasis. PMID:27214312

  5. New Roles for Corticosteroid Binding Globulin and Opposite Expression Profiles in Lung and Liver.

    Science.gov (United States)

    Gulfo, Jose; Ledda, Angelo; Gea-Sorlí, Sabrina; Bonjoch, Laia; Closa, Daniel; Grasa, Mar; Esteve, Montserrat

    2016-01-01

    Corticosteroid-binding globulin (CBG) is the specific plasma transport glycoprotein for glucocorticoids. Circulating CBG is mainly synthesized in liver but, its synthesis has been located also in other organs as placenta, kidney and adipose tissue with unknown role. Using an experimental model of acute pancreatitis in cbg-/- mice we investigated whether changes in CBG affect the progression of the disease as well as the metabolism of glucocorticoids in the lung. Lack of CBG does not modify the progression of inflammation associated to pancreatitis but resulted in the loss of gender differences in corticosterone serum levels. In the lung, CBG expression and protein level were detected, and it is noteworthy that these showed a sexual dimorphism opposite to the liver, i.e. with higher levels in males. Reduced expression of 11β-HSD2, the enzyme involved in the deactivation of corticosterone, was also observed. Our results indicate that, in addition to glucocorticoids transporter, CBG is involved in the gender differences observed in corticosteroids circulating levels and plays a role in the local regulation of corticosteroids availability in organs like lung. PMID:26741814

  6. Corticosteroid-binding globulin cleavage is paradoxically reduced in alpha-1 antitrypsin deficiency: Implications for cortisol homeostasis.

    Science.gov (United States)

    Nenke, Marni A; Holmes, Mark; Rankin, Wayne; Lewis, John G; Torpy, David J

    2016-01-15

    High-affinity corticosteroid-binding globulin (haCBG) is cleaved by neutrophil elastase (NE) resulting in permanent transition to the low cortisol-binding affinity form (laCBG), thereby increasing cortisol availability at inflammatory sites. Alpha-1 antitrypsin (AAT) is the major inhibitor of NE. AAT deficiency (AATD) predisposes patients to early-onset emphysema due to increased proteolytic destruction from the inherent proteinase-antiproteinase imbalance. We hypothesized that AATD may result in increased CBG cleavage in vivo. We collected demographic data and blood samples from 10 patients with AATD and 28 healthy controls measuring total CBG and haCBG levels by parallel in-house ELISAs, as well as AAT, total and free cortisol levels. haCBG was higher (median [range]); 329 [210-551] vs. 250 [175-365] nmol/L; PAAT levels (P<0.05, R=-0.64). Paradoxically, proteolytic cleavage of CBG was reduced in AATD, despite the recognized increase in NE activity. This implies that NE activity is not the mechanism for systemic CBG cleavage in basal, low inflammatory conditions. Relatively low levels of laCBG may have implications for cortisol action in AATD. PMID:26522656

  7. Biological half-life and transfer of maternal corticosteroid-binding globulin to amniotic fluid in the rabbit

    International Nuclear Information System (INIS)

    Rabbit corticosteroid-binding globulin (CBG) from the serum of pregnant and nonpregnant females differs in terms of charge microheterogeneity, and both forms were, therefore, radiolabeled and injected iv into 23- to 27-day pregnant rabbits (n = 6) to assess their biological half-lives and possible transfer to the fetal compartment. After an initially rapid distribution phase, the serum half-lives of both forms of [125I]CBG were essentially identical (approximately 13 h) and did not vary at different gestational ages. There was also no difference in the transfer of either form of [125I]CBG from maternal to fetal compartments in any of the animals studied. Moreover, [125I]CBG showed no sign of degradation and retained its steroid-binding activity in fetal urine and amniotic fluid. Twenty-two hours after administration of [125I]CBG to rabbits (n = 2) at 23 days gestation, its mean level in fetal urine (7 cpm/microliter) and amniotic fluid (2.5 cpm/microliter) was much higher than that in fetal blood (0.6 cpm/microliter). More importantly, the specific activities of [125I]CBG in fetal urine and amniotic fluid were comparable to that in maternal serum, and approximately 2 orders of magnitude higher than that in fetal serum. Taken together, these results suggest that CBG in fetal urine and amniotic fluid is largely of maternal origin, and that maternal CBG crosses the fetal kidney preferentially

  8. Corticosteroid-binding globulin contributes to the neuroendocrine phenotype of mice selected for extremes in stress reactivity.

    Science.gov (United States)

    Mattos, Gabriele E; Heinzmann, Jan-Michael; Norkowski, Stefanie; Helbling, Jean-Christophe; Minni, Amandine M; Moisan, Marie-Pierre; Touma, Chadi

    2013-12-01

    Increasing evidence indicates an important role of steroid-binding proteins in endocrine functions, including hypothalamic-pituitary-adrenal (HPA) axis activity and regulation, as they influence bioavailability, local delivery, and cellular signal transduction of steroid hormones. In the plasma, glucocorticoids (GCs) are mainly bound to the corticosteroid-binding globulin (CBG) and to a lesser extend to albumin. Plasma CBG levels are therefore involved in the adaptive stress response, as they determine the concentration of free, biologically active GCs. In this study, we investigated whether male mice with a genetic predisposition for high-reactivity (HR), intermediate-reactivity (IR), or low-reactivity (LR) stress-induced corticosterone (CORT) secretion present different levels of free CORT and CORT-binding proteins, basally and in response to stressors of different intensity. Our results suggest a fine control interaction between plasma CBG expression and stress-induced CORT release. Although plasma CBG levels, and therefore CBG binding capacity, were higher in HR animals, CORT secretion overloaded the CBG buffering function in response to stressors, resulting in clearly higher free CORT levels in HR compared with IR and LR mice (HR>IR>LR), resembling the pattern of total CORT increase in all three lines. Both stressors, restraint or forced swimming, did not evoke fast CBG release from the liver into the bloodstream and therefore CBG binding capacity was not altered in our three mouse lines. Thus, we confirm CBG functions in maintaining a dynamic equilibrium between CBG-bound and unbound CORT, but could not verify its role in delaying the rise of plasma free CORT immediately after stress exposure. PMID:24048966

  9. Primary structure of human corticosteroid binding globulin, deduced from hepatic and pulmonary cDNAs, exhibits homology with serine protease inhibitors

    International Nuclear Information System (INIS)

    The authors have isolated and sequenced cDNAs for corticosteroid binding globulin (CBG) prepared from human liver and lung mRNAs. The results indicate that CBG mRNA is relatively abundant in the liver but is also present in the lung, testis, and kidney. The liver CBG cDNA contains an open reading frame for a 405-amino acid (M/sub r/ 45,149) polypeptide. This includes a predominantly hydrophobic, leader sequence of 22 residues that precedes the known NH2-terminal sequence of human CBG. We, therefore, predict that the mature protein is composed of 383 amino acids and is a polypeptide of M/sub r/ 42,646. A second, in-frame, 72-base-pair cistron of unknown significance exists between the TAA termination codon for CBG and a possible polyadenylylation signal (AATAAA) located 16 nucleotides before the polyadenylylation site. The deduced amino acid sequence of mature CBG contains two cysteine residues and consensus sequences for the attachment of six possible N-linked oligosaccharide chains. The sequences of the human lung and liver CBG cDNAs differ by only one nucleotide within the proposed leader sequence,and they attribute this to a point mutation. No sequence homology was found between CBG and other steroid binding proteins, but there is a remarkable similarity between the amino acid sequences of CBG and of α1-antitrypsin, and this extends to other members of the serpin (serine protease inhibitor) superfamily

  10. Chronic stress does not further exacerbate the abnormal psychoneuroendocrine phenotype of Cbg-deficient male mice.

    Science.gov (United States)

    de Medeiros, Gabriela F; Minni, Amandine M; Helbling, Jean-Christophe; Moisan, Marie-Pierre

    2016-08-01

    Chronic stress leads to a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis which can constitute a base for pathophysiological consequences. Using mice totally deficient in Corticosteroid binding globulin (CBG), we have previously demonstrated the important role of CBG in eliciting an adequate response to an acute stressor. Here, we have studied its role in chronic stress situations. We have submitted Cbg ko and wild-type (WT) male mice to two different chronic stress paradigms - the unpredictable chronic mild stress and the social defeat. Then, their impact on neuroendocrine function - through corticosterone and CBG measurement - and behavioral responses - via anxiety and despair-like behavioral tests - was evaluated. Both chronic stress paradigms increased the display of despair-like behavior in WT mice, while that from Cbg ko mice - which was already high - was not aggravated. We have also found that control and defeated (stressed) Cbg ko mice show no difference in the social interaction test, while defeated WT mice reduce their interaction time when compared to unstressed WT mice. Interestingly, the same pattern was observed for corticosterone levels, where both chronic stress paradigms lowered the corticosterone levels of WT mice, while those from Cbg ko mice remained low and unaltered. Plasma CBG binding capacity remained unaltered in WT mice regardless of the stress paradigm. Through the use of the Cbg ko mice, which only differs genetically from WT mice by the absence of CBG, we demonstrated that CBG is crucial in modulating the effects of stress on plasma corticosterone levels and consequently on behavior. In conclusion, individuals with CBG deficiency, whether genetically or environmentally-induced, are vulnerable to acute stress but do not have their abnormal psychoneuroendocrine phenotype further affected by chronic stress. PMID:27153522

  11. Genome wide association identifies common variants at the SERPINA6/SERPINA1 locus influencing plasma cortisol and corticosteroid binding globulin.

    Directory of Open Access Journals (Sweden)

    Jennifer L Bolton

    2014-07-01

    Full Text Available Variation in plasma levels of cortisol, an essential hormone in the stress response, is associated in population-based studies with cardio-metabolic, inflammatory and neuro-cognitive traits and diseases. Heritability of plasma cortisol is estimated at 30-60% but no common genetic contribution has been identified. The CORtisol NETwork (CORNET consortium undertook genome wide association meta-analysis for plasma cortisol in 12,597 Caucasian participants, replicated in 2,795 participants. The results indicate that <1% of variance in plasma cortisol is accounted for by genetic variation in a single region of chromosome 14. This locus spans SERPINA6, encoding corticosteroid binding globulin (CBG, the major cortisol-binding protein in plasma, and SERPINA1, encoding α1-antitrypsin (which inhibits cleavage of the reactive centre loop that releases cortisol from CBG. Three partially independent signals were identified within the region, represented by common SNPs; detailed biochemical investigation in a nested sub-cohort showed all these SNPs were associated with variation in total cortisol binding activity in plasma, but some variants influenced total CBG concentrations while the top hit (rs12589136 influenced the immunoreactivity of the reactive centre loop of CBG. Exome chip and 1000 Genomes imputation analysis of this locus in the CROATIA-Korcula cohort identified missense mutations in SERPINA6 and SERPINA1 that did not account for the effects of common variants. These findings reveal a novel common genetic source of variation in binding of cortisol by CBG, and reinforce the key role of CBG in determining plasma cortisol levels. In turn this genetic variation may contribute to cortisol-associated degenerative diseases.

  12. Elevation of corticosteroid-binding globulin in Obese strain (OS) chickens: possible implications for the disturbed immunoregulation and the development of spontaneous autoimmune thyroiditis

    International Nuclear Information System (INIS)

    Basal plasma levels of corticosterone and corticosteroid-binding globulin (CBG) have been investigated in Obese strain (OS) chickens afflicted with spontaneous autoimmune thyroiditis (SAT). Corticosterone was determined radioimmunologically, and CBG by using a highly sensitive radioligand saturation assay. OS chickens displayed total corticosterone levels not different from healthy normal White Leghorn (NWL) chickens. CBG, however, was found to be twice as high in OS chickens as compared with their healthy counterparts, irrespective of sex or age. This quantitative difference in the CBG level is not compensated for by either altered affinity or specificity of the molecule. Furthermore, no differences were found in the response of OS and NWL lymphocytes to the suppressive effect of glucocorticoids in vitro. It was therefore assumed that OS animals are deficient in free, hormonally active corticosterone. An additional indication for such a diminished glucocorticoid tonus was that in vivo treatment of OS chickens with glucocorticoid hormones, thus increasing the free and active hormone fraction, normalizes the T cell hyperreactivity and significantly reduces thyroid infiltration. Possible pathophysiological implications of a diminished glucocorticoid tonus for spontaneous autoimmunity, as well as possible explanations for the beneficial effects of glucocorticoid treatment on the development of SAT, are discussed

  13. Corticosteroids

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    ... corticosteroids? If your child has asthma or allergic rhinitis ( hay fever ), your pediatrician may prescribe a corticosteroid, ... Inhaled Corticosteroids May be given to prevent or control asthma symptoms. Inflammation inside the bronchial tubes of ...

  14. Investigation of genetic variants, birthweight and hypothalamic-pituitary-adrenal axis function suggests a genetic variant in the SERPINA6 gene is associated with corticosteroid binding globulin in the western Australia pregnancy cohort (Raine study.

    Directory of Open Access Journals (Sweden)

    Laura N Anderson

    Full Text Available The hypothalamic-pituitary-adrenal (HPA axis regulates stress responses and HPA dysfunction has been associated with several chronic diseases. Low birthweight may be associated with HPA dysfunction in later life, yet human studies are inconclusive. The primary study aim was to identify genetic variants associated with HPA axis function. A secondary aim was to evaluate if these variants modify the association between birthweight and HPA axis function in adolescents.Morning fasted blood samples were collected from children of the Western Australia Pregnancy Cohort (Raine at age 17 (n = 1077. Basal HPA axis function was assessed by total cortisol, corticosteroid binding globulin (CBG, and adrenocorticotropic hormone (ACTH. The associations between 124 tag single nucleotide polymorphisms (SNPs within 16 HPA pathway candidate genes and each hormone were evaluated using multivariate linear regression and penalized linear regression analysis using the HyperLasso method.The penalized regression analysis revealed one candidate gene SNP, rs11621961 in the CBG encoding gene (SERPINA6, significantly associated with total cortisol and CBG. No other candidate gene SNPs were significant after applying the penalty or adjusting for multiple comparisons; however, several SNPs approached significance. For example, rs907621 (p = 0.002 and rs3846326 (p = 0.003 in the mineralocorticoid receptor gene (NR3C2 were associated with ACTH and SERPINA6 SNPs rs941601 (p = 0.004 and rs11622665 (p = 0.008, were associated with CBG. To further investigate our findings for SERPINA6, rare and common SNPs in the gene were imputed from the 1,000 genomes data and 8 SNPs across the gene were significantly associated with CBG levels after adjustment for multiple comparisons. Birthweight was not associated with any HPA outcome, and none of the gene-birthweight interactions were significant after adjustment for multiple comparisons.Our study suggests that genetic variation in the SERPINA

  15. Effect of corticosteroid binding proteins on the steroidogenic activity of bovine adrenocortical cell suspensions.

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    Basset, M; Rostaing-Metz, B; Chambaz, E M

    1982-07-01

    The possible role of steroid binding proteins in the hormonal secretion process of a steroidogenic tissue was examined using bovine adrenocortical cell suspensions, either under basal conditions or in the presence of half-maximally active concentration (1 x 10(-9) M) of synthetic adrenocorticotropic hormone (ACTH). Three types of plasma cortisol binding proteins were used, namely bovine serum albumine (BSA), purified transcortin (CBG) and purified anticortisol immunoglobulins (IgG). When added to the incubation medium, CBG (at 1 x 10(-10) to 2 x 10(-9) M cortisol binding sites) and anticortisol IgG (at 4.8 x 10(-10) to 3 x 10(-9) M cortisol binding sites) did not influence either the basal nor the ACTH-stimulated net cortisol production of the cell preparations. Whereas crystallized and delipidated BSA showed also no effect, crude commercial BSA preparation (Cohn fraction V) exhibited an ACTH-like cofactor effect which resulted in a marked increase in the net cortisol production by stimulated cells. These observations might be explained by the presence in crude BSA of lipoprotein-cholesterol complexes, possibly acting as an extracellular source of cholesterol available for corticosteroidogenesis. It may be concluded that specific high affinity cortisol binding systems present outside adrenocortical steroidogenic cells do not influence their secretory activity under short term in vitro condition. In addition, it can be stressed that use of ill defined protein preparations (e.g. crude BSA) may lead to artifactual observations in the study of the differentiated functions of isolated steroidogenic cells. PMID:6287106

  16. Enhanced Activity of Topical Hydrocortisone by Competitive Binding of Corticosteroid-Binding Globulin.

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    Bodor, Erik T; Wu, Whei-Mei; Chandran, V Ravi; Bodor, Nicholas

    2016-09-01

    Atopic dermatitis of sensitive areas such as the face, particularly in children, is a difficult disease to treat as the standard therapeutic, topical steroids, is contraindicated for this application in children. Hydrocortisone (HC) can be used in these instances because it has been shown to be safe, but is often ineffective as it is a relatively weak steroid, especially at over-the-counter concentrations. To enhance the local topical activity of HC, the terminal inactive metabolite of prednisolone, Δ(1)-cortienic acid (Δ(1)-CA), is added to HC, as Δ(1)-CA preferentially binds transcortin, liberating more HC to elicit its therapeutic effect. Skin blanching studies, which are used to evaluate the potency of topical steroids, were employed to assess the ability of Δ(1)-CA to enhance the activity of HC. The results demonstrate that Δ(1)-CA, when applied in combination with HC, does indeed potentiate the vasoconstriction effect of topically applied HC, while having no effect alone. Thus, addition of the inert prednisolone metabolite Δ(1)-CA can increase the therapeutic effect of over-the-counter concentrations of HC when applied topically. PMID:27179671

  17. Comparison of β-adrenergic receptors between different strains of rat with different susceptibility to hypertension: a survey of binding characteristics, responsiveness and corticosteroid induced modulation

    International Nuclear Information System (INIS)

    The objective of this research was two fold: the first objective was to measure β-adrenergic receptor characteristics (Bmax and Kd) and responsiveness (isoproterenol induced c-AMP production) between different strains of rat with different susceptibility to hypertension. The second objective of this research was to determine if β-adrenergic receptors of arterial smooth muscle cells (ASMC) can be modulated by corticosteroids. These studies were done under controlled conditions using ASMC grown in culture from the rat aorta. [3H]-dihydroalprenolol (DHA) was used to measure β-adrenergic receptor binding characteristics (Kd and Bmax). Scatchard analysis of [3H]-DHA binding revealed one class of binding sites with affinity in the range of 100 pM. [3H]-DHA binding comparison between Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) revealed that the Bmax for SHR was significantly lower than WKY. However, isoproterenol stimulated c-AMP production by SHR, is significantly higher than WKY. Fischer 344 rats, showed similar Bmax, Kd, and responsiveness as WKY rats. Dahl-sensitive and Dahl-resistant rats had equal Bmax and Kd measured by [3H]-DHA binding

  18. MULTIDIMENSIONAL MODELING OF COMPRESSED BIO GAS (CBG) ENGINE FOR ULTRA LOW EMISSION

    OpenAIRE

    Koten, Hasan; Gul, Zafer

    2014-01-01

    The purpose of this study is to find out in-cylinder flow characteristics of a four-cylinder, 2,3 liter diesel engine before the fuel injection and also properly simulate the atomization process in order to improve the combustion efficiency and emission parameters. A complete intake stroke with Compressed Bio Gas (CBG) port injection, compression stroke, pilot fuel injection at the end of the compression and exhaust stroke simulated in 3D. Both naturally aspirated and turbo-charged modes of o...

  19. Serum pharmacodynamic biomarkers for chronic corticosteroid treatment of children.

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    Hathout, Yetrib; Conklin, Laurie S; Seol, Haeri; Gordish-Dressman, Heather; Brown, Kristy J; Morgenroth, Lauren P; Nagaraju, Kanneboyina; Heier, Christopher R; Damsker, Jesse M; van den Anker, John N; Henricson, Erik; Clemens, Paula R; Mah, Jean K; McDonald, Craig; Hoffman, Eric P

    2016-01-01

    Corticosteroids are extensively used in pediatrics, yet the burden of side effects is significant. Availability of a simple, fast, and reliable biochemical read out of steroidal drug pharmacodynamics could enable a rapid and objective assessment of safety and efficacy of corticosteroids and aid development of corticosteroid replacement drugs. To identify potential corticosteroid responsive biomarkers we performed proteome profiling of serum samples from DMD and IBD patients with and without corticosteroid treatment using SOMAscan aptamer panel testing 1,129 proteins in leptin, afamin), stunting of growth (growth hormone binding protein), and connective tissue remodeling (MMP3). Significant suppression of multiple adrenal steroid hormones was also seen in treated children (reductions of 17-hydroxyprogesterone, corticosterone, 11-deoxycortisol and testosterone). A panel of new pharmacodynamic biomarkers for corticosteroids in children was defined. Future studies will need to bridge specific biomarkers to mechanism of drug action, and specific clinical outcomes. PMID:27530235

  20. About Steroids (Inhaled and Oral Corticosteroids)

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    ... Medications > Long-Term Control Medications > About Steroids About Steroids (Inhaled and Oral Corticosteroids) What are corticosteroids (‘steroids’) ... considerations when your dosage changes? What are corticosteroids (‘steroids’)? Corticosteroids (steroids) are medicines that are used to ...

  1. Hypersensitivity reactions to corticosteroids.

    Science.gov (United States)

    Vatti, Rani R; Ali, Fatima; Teuber, Suzanne; Chang, Christopher; Gershwin, M Eric

    2014-08-01

    Hypersensitivity reactions to corticosteroids (CS) are rare in the general population, but they are not uncommon in high-risk groups such as patients who receive repeated doses of CS. Hypersensitivity reactions to steroids are broadly divided into two categories: immediate reactions, typically occurring within 1 h of drug administration, and non-immediate reactions, which manifest more than an hour after drug administration. The latter group is more common. We reviewed the literature using the search terms "hypersensitivity to steroids, adverse effects of steroids, steroid allergy, allergic contact dermatitis, corticosteroid side effects, and type I hypersensitivity" to identify studies or clinical reports of steroid hypersensitivity. We discuss the prevalence, mechanism, presentation, evaluation, and therapeutic options in corticosteroid hypersensitivity reactions. There is a paucity of literature on corticosteroid allergy, with most reports being case reports. Most reports involve non-systemic application of corticosteroids. Steroid hypersensitivity has been associated with type I IgE-mediated allergy including anaphylaxis. The overall prevalence of type I steroid hypersensitivity is estimated to be 0.3-0.5%. Allergic contact dermatitis (ACD) is the most commonly reported non-immediate hypersensitivity reaction and usually follows topical CS application. Atopic dermatitis and stasis dermatitis of the lower extremities are risk factors for the development of ACD from topical CS. Patients can also develop hypersensitivity reactions to nasal, inhaled, oral, and parenteral CS. A close and detailed evaluation is required for the clinician to confirm the presence of a true hypersensitivity reaction to the suspected drug and choose the safest alternative. Choosing an alternative CS is not only paramount to the patient's safety but also ameliorates the worry of developing an allergic, and potentially fatal, steroid hypersensitivity reaction. This evaluation becomes

  2. How corticosteroids control inflammation: Quintiles Prize Lecture 2005.

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    Barnes, Peter J

    2006-06-01

    Corticosteroids are the most effective anti-inflammatory therapy for many chronic inflammatory diseases, such as asthma but are relatively ineffective in other diseases such as chronic obstructive pulmonary disease (COPD). Chronic inflammation is characterised by the increased expression of multiple inflammatory genes that are regulated by proinflammatory transcription factors, such as nuclear factor-kappaB and activator protein-1, that bind to and activate coactivator molecules, which then acetylate core histones to switch on gene transcription. Corticosteroids suppress the multiple inflammatory genes that are activated in chronic inflammatory diseases, such as asthma, mainly by reversing histone acetylation of activated inflammatory genes through binding of liganded glucocorticoid receptors (GR) to coactivators and recruitment of histone deacetylase-2 (HDAC2) to the activated transcription complex. At higher concentrations of corticosteroids GR homodimers also interact with DNA recognition sites to active transcription of anti-inflammatory genes and to inhibit transcription of several genes linked to corticosteroid side effects. In patients with COPD and severe asthma and in asthmatic patients who smoke HDAC2 is markedly reduced in activity and expression as a result of oxidative/nitrative stress so that inflammation becomes resistant to the anti-inflammatory actions of corticosteroids. Theophylline, by activating HDAC, may reverse this corticosteroid resistance. This research may lead to the development of novel anti-inflammatory approaches to manage severe inflammatory diseases. PMID:16604091

  3. Genome Sequence of Azospirillum brasilense CBG497 and Comparative Analyses of Azospirillum Core and Accessory Genomes provide Insight into Niche Adaptation

    OpenAIRE

    Victor González; Alberto Mendoza Herrera; Valérie Barbe; Zoé Rouy; Claire Prigent-Combaret; Benoît Drogue; Stéphanie Borland; Erika Acosta-Cruz; Luis Lozano; Florence Wisniewski-Dyé; Patrick Mavingui

    2012-01-01

    Bacteria of the genus Azospirillum colonize roots of important cereals and grasses, and promote plant growth by several mechanisms, notably phytohormone synthesis. The genomes of several Azospirillum strains belonging to different species, isolated from various host plants and locations, were recently sequenced and published. In this study, an additional genome of an A. brasilense strain, isolated from maize grown on an alkaline soil in the northeast of Mexico, strain CBG497, was obtained. Co...

  4. Corticosteroids in Lumbar Disc Surgery

    OpenAIRE

    Lundin, Anders

    2005-01-01

    In a prospective randomised double-blind study eighty patients with MRI verified lumbar disc herniation and corresponding clinical findings underwent microscopic disc removal. The patients were peroperatively given systemic and local corticosteroids or placebo, and followed for 2 years. The hospital stay and time to return to full-time work was significantly shorter in the treatment group. Pain measured as worst pain during the last week was also lower in the corticosteroid group. The results...

  5. Corticosteroids for managing tuberculous meningitis

    OpenAIRE

    Prasad, Kameshwar; Singh, Mamta B.; Ryan, Hannah

    2016-01-01

    Background Tuberculous meningitis is a serious form of tuberculosis (TB) that affects the meninges that cover a person's brain and spinal cord. It is associated with high death rates and with disability in people who survive. Corticosteroids have been used as an adjunct to antituberculous drugs to treat people with tuberculous meningitis, but their role has been controversial. Objectives To evaluate the effects of corticosteroids as an adjunct to antituberculous treatment on death and severe ...

  6. Ethical use of topical corticosteroids

    Directory of Open Access Journals (Sweden)

    Abir Saraswat

    2014-01-01

    Full Text Available Dermatologists rely very heavily on corticosteroids for treating many common dermatoses. Concerns about their incorrect use are widely expressed both in lay public and specialist discourse. From the point of view of medical ethics, issues of autonomy, beneficence and non-maleficence are all raised frequently when we prescribe topical corticosteroids to our patients. We need to be aware of situations when conflicts between these issues arise and have a clear thought process about resolving them. This can only be achieved if we have a thorough understanding of the skin disease being treated coupled with expertise in the use of the varied potencies and available dosage forms of topical corticosteroids. A good understanding of human psychology and effective communication is also needed to use these agents optimally.

  7. Corticosteroid Injections for Common Musculoskeletal Conditions.

    Science.gov (United States)

    Foster, Zoë J; Voss, Tyler T; Hatch, Jacquelynn; Frimodig, Adam

    2015-10-15

    Family physicians considering corticosteroid injections as part of a comprehensive treatment plan for musculoskeletal diagnoses will find few high-quality studies to assist with evidence-based decision making. Most studies of corticosteroid injections for the treatment of osteoarthritis, tendinopathy, bursitis, or neuropathy include only small numbers of patients and have inconsistent long-term follow-up. Corticosteroid injections for the treatment of adhesive capsulitis result in short-term improvements in pain and range of motion. For subacromial impingement syndrome, corticosteroid injections provide short-term pain relief and improvement in function. In medial and lateral epicondylitis, corticosteroid injections offer only short-term improvement of symptoms and have a high rate of symptom recurrence. Corticosteroid injections for carpal tunnel syndrome may help patients avoid or delay surgery. Trigger finger and de Quervain tenosynovitis may be treated effectively with corticosteroid injections. Patients with hip or knee osteoarthritis may have short-term symptom relief with corticosteroid injections. PMID:26554409

  8. Corticosteroids compromise survival in glioblastoma.

    Science.gov (United States)

    Pitter, Kenneth L; Tamagno, Ilaria; Alikhanyan, Kristina; Hosni-Ahmed, Amira; Pattwell, Siobhan S; Donnola, Shannon; Dai, Charles; Ozawa, Tatsuya; Chang, Maria; Chan, Timothy A; Beal, Kathryn; Bishop, Andrew J; Barker, Christopher A; Jones, Terreia S; Hentschel, Bettina; Gorlia, Thierry; Schlegel, Uwe; Stupp, Roger; Weller, Michael; Holland, Eric C; Hambardzumyan, Dolores

    2016-05-01

    Glioblastoma is the most common and most aggressive primary brain tumour. Standard of care consists of surgical resection followed by radiotherapy and concomitant and maintenance temozolomide (temozolomide/radiotherapy→temozolomide). Corticosteroids are commonly used perioperatively to control cerebral oedema and are frequently continued throughout subsequent treatment, notably radiotherapy, for amelioration of side effects. The effects of corticosteroids such as dexamethasone on cell growth in glioma models and on patient survival have remained controversial. We performed a retrospective analysis of glioblastoma patient cohorts to determine the prognostic role of steroid administration. A disease-relevant mouse model of glioblastoma was used to characterize the effects of dexamethasone on tumour cell proliferation and death, and to identify gene signatures associated with these effects. A murine anti-VEGFA antibody was used in parallel as an alternative for oedema control. We applied the dexamethasone-induced gene signature to The Cancer Genome Atlas glioblastoma dataset to explore the association of dexamethasone exposure with outcome. Mouse experiments were used to validate the effects of dexamethasone on survival in vivo Retrospective clinical analyses identified corticosteroid use during radiotherapy as an independent indicator of shorter survival in three independent patient cohorts. A dexamethasone-associated gene expression signature correlated with shorter survival in The Cancer Genome Atlas patient dataset. In glioma-bearing mice, dexamethasone pretreatment decreased tumour cell proliferation without affecting tumour cell viability, but reduced survival when combined with radiotherapy. Conversely, anti-VEGFA antibody decreased proliferation and increased tumour cell death, but did not affect survival when combined with radiotherapy. Clinical and mouse experimental data suggest that corticosteroids may decrease the effectiveness of treatment and shorten

  9. How corticosteroids control inflammation: Quintiles Prize Lecture 2005

    OpenAIRE

    Peter J. Barnes

    2006-01-01

    Corticosteroids are the most effective anti-inflammatory therapy for many chronic inflammatory diseases, such as asthma but are relatively ineffective in other diseases such as chronic obstructive pulmonary disease (COPD). Chronic inflammation is characterised by the increased expression of multiple inflammatory genes that are regulated by proinflammatory transcription factors, such as nuclear factor-kappaB and activator protein-1, that bind to and activate coactivator molecules, which then a...

  10. Corticosteroids for managing tuberculous meningitis

    Science.gov (United States)

    Prasad, Kameshwar; Singh, Mamta B; Ryan, Hannah

    2016-01-01

    Background Tuberculous meningitis is a serious form of tuberculosis (TB) that affects the meninges that cover a person's brain and spinal cord. It is associated with high death rates and with disability in people who survive. Corticosteroids have been used as an adjunct to antituberculous drugs to treat people with tuberculous meningitis, but their role has been controversial. Objectives To evaluate the effects of corticosteroids as an adjunct to antituberculous treatment on death and severe disability in people with tuberculous meningitis. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register up to the 18 March 2016; CENTRAL; MEDLINE; EMBASE; LILACS; and Current Controlled Trials. We also contacted researchers and organizations working in the field, and checked reference lists. Selection criteria Randomized controlled trials that compared corticosteroid plus antituberculous treatment with antituberculous treatment alone in people with clinically diagnosed tuberculous meningitis and included death or disability as outcome measures. Data collection and analysis We independently assessed search results and methodological quality, and extracted data from the included trials. We analysed the data using risk ratios (RR) with 95% confidence intervals (CIs) and used a fixed-effect model. We performed an intention-to-treat analysis, where we included all participants randomized to treatment in the denominator. This analysis assumes that all participants who were lost to follow-up have good outcomes. We carried out a sensitivity analysis to explore the impact of the missing data. Main results Nine trials that included 1337 participants (with 469 deaths) met the inclusion criteria. At follow-up from three to 18 months, steroids reduce deaths by almost one quarter (RR 0.75, 95% CI 0.65 to 0.87; nine trials, 1337 participants, high quality evidence). Disabling neurological deficit is not common in survivors, and steroids may have little or no

  11. Topical corticosteroid addiction and phobia

    OpenAIRE

    Aparajita Ghosh; Sujata Sengupta; Arijit Coondoo; Amlan Kusum Jana

    2014-01-01

    Corticosteroids, one of the most widely prescribed topical drugs, have been used for about six decades till date. However, rampant misuse and abuse down the years has given the drug a bad name. Topical steroid abuse may lead to two major problems which lie at the opposing ends of the psychosomatic spectrum. Topical steroid addiction, a phenomenon that came to be recognized about a decade after the introduction of the molecule is manifested as psychological distress and rebound phenomenon on s...

  12. Modulation in Wistar Rats of Blood Corticosterone Compartmentation by Sex and a Cafeteria Diet

    Science.gov (United States)

    Romero, María del Mar; Holmgren-Holm, Fredrik; Grasa, Maria del Mar; Esteve, Montserrat; Remesar, Xavier; Fernández-López, José Antonio; Alemany, Marià

    2013-01-01

    In the metabolic syndrome, glucocorticoid activity is increased, but circulating levels show little change. Most of blood glucocorticoids are bound to corticosteroid-binding globulin (CBG), which liver expression and circulating levels are higher in females than in males. Since blood hormones are also bound to blood cells, and the size of this compartment is considerable for androgens and estrogens, we analyzed whether sex or eating a cafeteria diet altered the compartmentation of corticosterone in rat blood. The main corticosterone compartment in rat blood is that specifically bound to plasma proteins, with smaller compartments bound to blood cells or free. Cafeteria diet increased the expression of liver CBG gene, binding plasma capacity and the proportion of blood cell-bound corticosterone. There were marked sex differences in blood corticosterone compartmentation in rats, which were unrelated to testosterone. The use of a monoclonal antibody ELISA and a polyclonal Western blot for plasma CBG compared with both specific plasma binding of corticosterone and CBG gene expression suggested the existence of different forms of CBG, with varying affinities for corticosterone in males and females, since ELISA data showed higher plasma CBG for males, but binding and Western blot analyses (plus liver gene expression) and higher physiological effectiveness for females. Good cross- reactivity to the antigen for polyclonal CBG antibody suggests that in all cases we were measuring CBG.The different immunoreactivity and binding affinity may help explain the marked sex-related differences in plasma hormone binding as sex-linked different proportions of CBG forms. PMID:23451210

  13. Brachial neuritis following a corticosteroid injection

    OpenAIRE

    Robinson, Matthew; Fulcher, Mark

    2014-01-01

    This report presents a case of brachial neuritis following a subacromial corticosteroid injection. The patient developed an anterior interosseous neuropathy shortly after the injection, with no other trigger being identified. This neuropathy has unfortunately not shown any sign of recovery at 2 years. The authors propose that corticosteroid injection be added to the list of possible triggering events of brachial neuritis and highlight the frequent use of oral corticosteroids in its treatment....

  14. Corticosteroids

    Science.gov (United States)

    ... marks high blood sugar levels weakened bones (osteoporosis) insomnia (difficulty sleeping) Because of these side effects, doctors ... 2016 Crohn's & Colitis Foundation of America Sign Up Jobs at CCFA Privacy Policy Sitemap CONTACT + Visit our ...

  15. Genome Sequence of Azospirillum brasilense CBG497 and Comparative Analyses of Azospirillum Core and Accessory Genomes provide Insight into Niche Adaptation

    Directory of Open Access Journals (Sweden)

    Victor González

    2012-09-01

    Full Text Available Bacteria of the genus Azospirillum colonize roots of important cereals and grasses, and promote plant growth by several mechanisms, notably phytohormone synthesis. The genomes of several Azospirillum strains belonging to different species, isolated from various host plants and locations, were recently sequenced and published. In this study, an additional genome of an A. brasilense strain, isolated from maize grown on an alkaline soil in the northeast of Mexico, strain CBG497, was obtained. Comparative genomic analyses were performed on this new genome and three other genomes (A. brasilense Sp245, A. lipoferum 4B and Azospirillum sp. B510. The Azospirillum core genome was established and consists of 2,328 proteins, representing between 30% to 38% of the total encoded proteins within a genome. It is mainly chromosomally-encoded and contains 74% of genes of ancestral origin shared with some aquatic relatives. The non-ancestral part of the core genome is enriched in genes involved in signal transduction, in transport and in metabolism of carbohydrates and amino-acids, and in surface properties features linked to adaptation in fluctuating environments, such as soil and rhizosphere. Many genes involved in colonization of plant roots, plant-growth promotion (such as those involved in phytohormone biosynthesis, and properties involved in rhizosphere adaptation (such as catabolism of phenolic compounds, uptake of iron are restricted to a particular strain and/or species, strongly suggesting niche-specific adaptation.

  16. Corticosteroids for fat embolism after multiple fractures

    Institute of Scientific and Technical Information of China (English)

    CHEN Huai-sheng; ZHANG Qing-mei; WEN Jun-min; WEN Shun-kang; YI Jing; ZHOU Zhi-qiang; WU Sheng-nan

    2007-01-01

    @@ Fat embolism is a common complication of multiple fractures. Corticosteroids are usually prescribed in prophylactic and treatment of fat embolism. A case of fat embolism followed multiple fractures was hospitalized, and we searched best evidences about corticosteroids for fat embolism so as to provide best therapeutics for the patient.

  17. Corticosteroid contact allergy: an EECDRG multicentre study

    DEFF Research Database (Denmark)

    Dooms-Goossens, A; Andersen, Klaus Ejner; Brandäo, F M; Bruynzeel, D; Burrows, D; Camarasa, J; Ducombs, G; Frosch, P; Hannuksela, M; Lachapelle, J M; Lahti, A; Menné, T; Wahlberg, J E; Wilkinson, J D

    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., be...

  18. Degradation of corticosteroids during activated sludge processing.

    Science.gov (United States)

    Miyamoto, Aoi; Kitaichi, Yuko; Uchikura, Kazuo

    2014-01-01

    Laboratory tests of the decomposition of corticosteroids during activated sludge processing were investigated. Corticosteroid standards were added to activated sludge, and aliquots were regularly taken for analysis. The corticosteroids were extracted from the samples using a solid-phase extraction method and analyzed LC-MS. Ten types of corticosteroids were measured and roughly classified into three groups: 1) prednisolone, triamcinolone, betamethasone, prednisolone acetate, and hydrocortisone acetate, which decomposed within 4 h; 2) flunisolide, betamethasone valerate, and budesonide of which more than 50% remained after 4 h, but almost all of which decomposed within 24 h; and 3) triamcinolone acetonide, and fluocinolone acetonide of which more than 50% remained after 24 h. The decomposed ratio was correlated with each corticosteroid's Log P, especially groups 2) and 3). PMID:24390495

  19. Topical corticosteroid addiction and phobia

    Directory of Open Access Journals (Sweden)

    Aparajita Ghosh

    2014-01-01

    Full Text Available Corticosteroids, one of the most widely prescribed topical drugs, have been used for about six decades till date. However, rampant misuse and abuse down the years has given the drug a bad name. Topical steroid abuse may lead to two major problems which lie at the opposing ends of the psychosomatic spectrum. Topical steroid addiction, a phenomenon that came to be recognized about a decade after the introduction of the molecule is manifested as psychological distress and rebound phenomenon on stoppage of the drug. The rebound phenomenon, which can affect various parts of the body particularly the face and the genitalia has been reported by various names in the literature. TC phobia which lies at the opposite end of the psychiatric spectrum of steroid abuse has been reported particularly among parents of atopic children. Management of both conditions is difficult and frustrating. Psychological counseling and support can be of immense help in both the conditions.

  20. Topical corticosteroid addiction and phobia.

    Science.gov (United States)

    Ghosh, Aparajita; Sengupta, Sujata; Coondoo, Arijit; Jana, Amlan Kusum

    2014-09-01

    Corticosteroids, one of the most widely prescribed topical drugs, have been used for about six decades till date. However, rampant misuse and abuse down the years has given the drug a bad name. Topical steroid abuse may lead to two major problems which lie at the opposing ends of the psychosomatic spectrum. Topical steroid addiction, a phenomenon that came to be recognized about a decade after the introduction of the molecule is manifested as psychological distress and rebound phenomenon on stoppage of the drug. The rebound phenomenon, which can affect various parts of the body particularly the face and the genitalia has been reported by various names in the literature. TC phobia which lies at the opposite end of the psychiatric spectrum of steroid abuse has been reported particularly among parents of atopic children. Management of both conditions is difficult and frustrating. Psychological counseling and support can be of immense help in both the conditions. PMID:25284851

  1. Brachial neuritis following a corticosteroid injection.

    Science.gov (United States)

    Robinson, Matthew; Fulcher, Mark

    2014-01-01

    This report presents a case of brachial neuritis following a subacromial corticosteroid injection. The patient developed an anterior interosseous neuropathy shortly after the injection, with no other trigger being identified. This neuropathy has unfortunately not shown any sign of recovery at 2 years. The authors propose that corticosteroid injection be added to the list of possible triggering events of brachial neuritis and highlight the frequent use of oral corticosteroids in its treatment. (1) The injection of local anaesthetic and corticosteroid should be considered as a potential trigger for brachial neuritis. (2) Brachial neuritis should be considered in the differential diagnosis for patients presenting with severe arm pain and weakness. (3) The nerves originating from the upper trunk of the brachial plexus are most commonly affected. (4) The anterior interosseous nerve is involved in one-third of cases. PMID:24596414

  2. Immediate-Type Hypersensitivity to Succinylated Corticosteroids

    OpenAIRE

    Walker, Annett Isabel; Raewer, Helen-Caroline; Sieber, Wolfgang; Przybilla, Bernhard

    2011-01-01

    Background: Despite their frequent use, systemic corticosteroids have rarely elicited immediate-type reactions. Objective: We report two male patients, aged 26 and 70 years, respectively, with severe immediate-type hypersensitivity secondary to the administration of corticosteroids esterified with succinate. Methods: Skin tests, basophil activation tests and challenge tests were performed for diagnostic evaluation. Results: In both patients, immediate-type skin test reactions were found to me...

  3. Patent perspectives for corticosteroids based ophthalmic therapeutics.

    Science.gov (United States)

    Suresh, Preeti K; Sah, Abhishek K

    2014-01-01

    Eye inflammation, if untreated at right time poses the risk of vision loss. Several categories of drugs are available in the global market, but corticosteroids are still used for the treatment of ocular inflammation including anterior/ posterior uveitis, age related macular degeneration (AMD) and post cataract surgery inflammation. Although corticosteroids have well-documented side effects as compared to non steroidal anti-inflammatory drugs (NSAIDs), but they are still regarded as better anti-inflammatory agents for treating ocular inflammations. The prime concern with conventional formulations such as (ophthalmic solutions, suspensions, ointments) is low drug bioavailability due to precorneal barrier of the eye, tear turnover and rapid drainage of drug via nasolacrimal drainage and drug induced systemic toxicity. To overcome these limitations, various novel formulations of corticosteroids have been explored. These include nanoparticles, solid lipid nanoparticles (SLN), nanostructured lipid carriers (NLC), nanomicelles, in-situ gels, iontophoresis, liposomes, nanoemulsions, microemulsions and ocular implants for the effective ophthalmic delivery of the corticosteroids. Topical nanocarriers have also been demonstrated to be promising vectors with potential application in the ophthalmic therapeutics. This review summarizes the clinical findings and patents on various corticosteroids as ocular pharmacotherapeutics. PMID:25020063

  4. [Inhaled corticosteroids: Which regimens are appropriate?].

    Science.gov (United States)

    Giovannini-Chami, L; Piccini-Bailly, C; Albertini, M

    2016-06-01

    Inhaled corticosteroids are the cornerstone of asthma management. Inhaled corticosteroid regimens differ slightly in various international guidelines on asthma management but are based on the principles of continuous treatment and titration to the lowest effective dose. Several recent studies, nevertheless, appear to demonstrate the potential value of preemptive or "pro re nata" regimens in infants and children. These studies were included in GINA 2015 for children 5 years of age and younger in whom discontinuous treatment is proposed as a second-line option. Should we change our practices after a critical reading of these studies? PMID:27133372

  5. Evolution of ligand specificity in vertebrate corticosteroid receptors

    Directory of Open Access Journals (Sweden)

    Deitcher David L

    2011-01-01

    Full Text Available Abstract Background Corticosteroid receptors include mineralocorticoid (MR and glucocorticoid (GR receptors. Teleost fishes have a single MR and duplicate GRs that show variable sensitivities to mineralocorticoids and glucocorticoids. How these receptors compare functionally to tetrapod MR and GR, and the evolutionary significance of maintaining two GRs, remains unclear. Results We used up to seven steroids (including aldosterone, cortisol and 11-deoxycorticosterone [DOC] to compare the ligand specificity of the ligand binding domains of corticosteroid receptors between a mammal (Mus musculus and the midshipman fish (Porichthys notatus, a teleost model for steroid regulation of neural and behavioral plasticity. Variation in mineralocorticoid sensitivity was considered in a broader phylogenetic context by examining the aldosterone sensitivity of MR and GRs from the distantly related daffodil cichlid (Neolamprologus pulcher, another teleost model for neurobehavioral plasticity. Both teleost species had a single MR and duplicate GRs. All MRs were sensitive to DOC, consistent with the hypothesis that DOC was the initial ligand of the ancestral MR. Variation in GR steroid-specificity corresponds to nine identified amino acid residue substitutions rather than phylogenetic relationships based on receptor sequences. Conclusion The mineralocorticoid sensitivity of duplicate GRs in teleosts is highly labile in the context of their evolutionary phylogeny, a property that likely led to neo-functionalization and maintenance of two GRs.

  6. Help Desk Answers: Do corticosteroids relieve Bell's palsy?

    Science.gov (United States)

    Soch, Kathy; Purtle, David; Ara, Mary; Dabbs, Kimberly

    2016-03-01

    Yes, but not severe disease. Corticosteroids likely improve facial motor function in adults with mild to moderate Bell's palsy. Corticosteroids are probably ineffective in treating cosmetically disabling or severe disease. PMID:27158696

  7. Corticosteroid responsiveness and clinical characteristics in childhood difficult asthma

    OpenAIRE

    Bossley, C.J.; Saglani, S; Kavanagh, C.; Payne, D.N.R.; Wilson, N; Tsartsali, L.; Rosenthal, M; Balfour-Lynn, I M; Nicholson, A.G.; Bush, A

    2009-01-01

    This study describes the clinical characteristics and corticosteroid responsiveness of children with difficult asthma (DA). We hypothesised that complete corticosteroid responsiveness (defined as improved symptoms, normal spirometry, normal exhaled nitric oxide fraction (FeNO) and no bronchodilator responsiveness (BDR

  8. Increasing awareness of corticosteroid hypersensitivity reactions is important

    DEFF Research Database (Denmark)

    Knarborg, Malene; Bendstrup, Elisabeth; Hilberg, Ole

    2013-01-01

    Corticosteroid hypersensitivity is a rare, but troublesome condition often mimicking the symptoms of the underlying disease and therefore probably underdiagnosed. Our objective is to underline the importance of increased awareness of corticosteroid hypersensitivity and of determining the tolerabi...

  9. Corticosteroids for acute adult bacterial meningitis

    NARCIS (Netherlands)

    D. van de Beek

    2009-01-01

    Bacterial meningitis in adults is a severe disease, with high fatality and morbidity rates. Experimental studies showed that the inflammatory response in the subarachnoid space is associated with unfavorable outcome. In these experiments, corticosteroids, and in particular dexamethasone, were able t

  10. Anaphylactic shock after intradermal injection of corticosteroid

    DEFF Research Database (Denmark)

    Meyer, Martin Willy; Zachariae, Claus; Garvey, Lene Heise

    2015-01-01

    Carboxymethylcellulose (CMC) is a derivative of cellulose found in many food products, pharmaceuticals and cosmetics. Allergy to CMC in parenteral corticosteroid preparations leading to anaphylaxis is rare, but has previously been reported. We report a case of a 52-year-old woman with prurigo...

  11. Medical adherence to topical corticosteroid preparations prescribed for psoriasis

    DEFF Research Database (Denmark)

    Svendsen, Mathias Tiedemann; Andersen, Flemming; Hansen, Jakob;

    2016-01-01

    OBJECTIVE: Topical corticosteroids and corticosteroid combinations are the principal treatments in psoriasis. The aim of this study was to investigate published literature dealing with medical adherence to topical corticosteroid or corticosteroid combinations in patients with psoriasis. MATERIALS...... improve health outcome in topical treatment of psoriasis, further studies should be conducted addressing determinants of nonadherence and test interventions to improve adherence. Validated measurements of medical nonadherence, prescription registers, or medication-weight are needed....

  12. Prenatal corticosteroid impact on hippocampus: Implications for postnatal outcomes

    OpenAIRE

    Velíšek, Libor

    2005-01-01

    Prenatal administration of corticosteroids is common in obstetrics to improve the outcome of premature deliveries. Many pregnant women receive multiple corticosteroid courses. Long-term follow-up studies in humans are limited, but those available suggest detrimental effects on the behavior of those children. Animal data also show adverse effects of prenatal corticosteroids mainly in the hippocampus, a structure sensitive to corticosteroid action. Several molecules involved in neuronal surviva...

  13. Stability of corticosteroids under anaerobic conditions. C6 and C9 fluorine-containing corticosteroids

    NARCIS (Netherlands)

    Dekker, D.; Buijs, D.J.

    1980-01-01

    The decomposition of corticosteroids due to a fluorine atom at C6 and/or C9 is investigated. Chromatographic properties, the isolation and the structure elucidation of decomposition products are given.

  14. Rapid nontranscriptional activation of endothelial nitric oxide synthase mediates increased cerebral blood flow and stroke protection by corticosteroids

    Science.gov (United States)

    Limbourg, Florian P.; Huang, Zhihong; Plumier, Jean-Christophe; Simoncini, Tommaso; Fujioka, Masayuki; Tuckermann, Jan; Schütz, Günther; Moskowitz, Michael A.; Liao, James K.

    2002-01-01

    Many cellular responses to corticosteroids involve the transcriptional modulation of target genes by the glucocorticoid receptor (GR). A rapid, non-nuclear effect of GR was found to mediate neuroprotection. High-dose corticosteroids (20 mg/kg intraperitoneally), given within 2 hours of transient cerebral ischemia, acutely increased endothelial nitric oxide synthase (eNOS) activity, augmented regional cerebral blood flow (CBF) by 40% to 50%, and reduced cerebral infarct size by 32%. These neuroprotective effects of corticosteroids were abolished by the GR antagonist RU486 and by inhibition of phosphatidylinositol 3-kinase (PI3K), and were absent in eNOS–/– mice. To determine the mechanism by which GR activated eNOS, we measured the effect of corticosteroids on PI3K and the protein kinase Akt. In a ligand-dependent manner, GR activated PI3K and Akt in vitro and in vivo caused NO-dependent vasodilation, which was blocked by cotreatment with RU486 or the PI3K inhibitor LY294002 but not by transcriptional inhibitors. Indeed, a mutant GR, which cannot dimerize and bind to DNA, still activated PI3K and Akt in response to corticosteroids. These findings indicate that non-nuclear GR rapidly activates eNOS through the PI3K/Akt pathway and suggest that this mechanism mediates the acute neuroprotective effects of corticosteroids through augmentation of CBF. PMID:12464678

  15. Use of inhaled corticosteroids in pediatric asthma

    DEFF Research Database (Denmark)

    Bisgaard, H

    1997-01-01

    Inhaled corticosteroids reduce asthma symptoms and exacerbations, improve lung function, and reduce airway inflammation and bronchial hyperreactivity more effectively than other treatments. However, inhaled corticosteroids may be unable to return lung function and bronchial hyperreactivity to...... normal when introduced for moderately severe asthma. This finding highlights the need to improve treatment strategy in pediatric asthma. The natural progression of persistent asthma may lead to loss of lung function and chronic bronchial hyperreactivity for children and adults. There is evidence to...... suggest that asthma acts via a chronic inflammatory process that causes remodeling of the airways with mucosal thickening and smooth muscle hypertrophy. An optimal treatment strategy would be one aimed at reducing the ongoing airway inflammation. Inhaled steroids ameliorate the inflammation, whereas this...

  16. Asthma and Adherence to Inhaled Corticosteroids

    DEFF Research Database (Denmark)

    Bårnes, Camilla Boslev; Ulrik, Charlotte Suppli

    2015-01-01

    Inhaled corticosteroids (ICS) are the cornerstone of maintenance asthma therapy. However, in spite of this, adherence to ICS remains low. The aim of this systematic literature review was to provide an overview of the current knowledge of adherence to ICS, effects of poor adherence, and means to...... was found to be between 22 and 63%, with improvement up to and after an exacerbation. Poor adherence was associated with youth, being African-American, having mild asthma, < 12 y of formal education, and poor communication with the health-care provider, whereas improved adherence was associated with...... asthma-related hospitalizations could be attributed to poor adherence. Most studies have reported an increase in adherence following focused interventions, followed by an improvement in quality of life, symptoms, FEV1, and oral corticosteroid use. However, 2 studies found no difference in health...

  17. Primary Treatment of Kawasaki Disease with Corticosteroids

    OpenAIRE

    Singhal, Swati; Mishra, Devendra; Kurien, Sumod; Juneja, Monica

    2014-01-01

    Kawasaki disease (KD), is the leading cause of acquired heart disease in children in the developed world. The use of aspirin and intravenous immunoglobulin as the initial therapy in KD is the standard of care, as they reduce the incidence of coronary artery aneurysms, the major cardiac morbidity from this disease. The place of corticosteroids in the initial therapy is; however, controversial. We describe the course of a one-year-old child with Kawasaki disease who was treated with aspirin and...

  18. [Anaphylactic shock after intradermal injection of corticosteroid].

    Science.gov (United States)

    Meyer, Martin Willy; Zachariae, Claus; Garvey, Lene Heise

    2015-01-19

    Carboxymethylcellulose (CMC) is a derivative of cellulose found in many food products, pharmaceuticals and cosmetics. Allergy to CMC in parenteral corticosteroid preparations leading to anaphylaxis is rare, but has previously been reported. We report a case of a 52-year-old woman with prurigo nodularis of Hyde, who reacted with anaphylaxis after intradermal injection of Kenalog 40 mg/ml. Allergy testing showed a positive skin prick test for CMC and the patient was advised to avoid future parenteral exposure to CMC. This case highlights the need to examine excipients in severe cases of drug allergy. PMID:25613209

  19. [Perinatal corticosteroid therapy: modalities, efficacy, consequences].

    Science.gov (United States)

    Magny, J F; Rigourd, V; Kieffer, F; Voyer, M

    2001-02-01

    During perinatal period, corticosteroid treatment has two major indications: first antenatally to improve fetal maturity and then to treat postnatal bronchopulmonary dysplasia. Antenatal corticosteroid treatment is widely proved to be efficient in reducing hyaline membrane disease and perinatal mortality incidence. Moreover, it has positive effects on intraventricular hemorrhage incidence, on hemodynamic failure, on persistent patent ductus arteriosus and on necrotizing enterocolitis. Side-effects are few and mild considering expected benefits and they usually occurs after multiple courses. Contra-indications are rare. Bronchopulmonary dysplasia comes with early, important and prolonged inflammatory processes. Corticotherapy allows decreasing significantly length of mechanical ventilation and oxygenotherapy among ventilated premature infants diagnosed with bronchopulmonary dysplasia. In the meantime, acute side-effects are frequent and benefits on mortality rate and long term outcome are not obvious. Main concern remains on possible long-term deleterious consequences on growth, lung and central nervous system development. In this field, clinical data are still insufficient as animal experimentation data promote caution and search for a minimal efficient therapeutic pathway. PMID:11240516

  20. Plantar fasciitis: corticosteroid injection versus chiropractic therapy

    Directory of Open Access Journals (Sweden)

    Siddharth Raveendran

    2014-04-01

    Full Text Available The diagnosis of plantar fasciitis is usually clinical and rarely needs to be investigated further. The patient complains of pain in the medial side of the heel, most noticeable with initial steps after a period of inactivity and usually lessens with increasing level of activity during the day, but will tend to worsen toward the end of the day. Symptoms may become worse following prolonged weight bearing, and often precipitated by increase in weight bearing activities. Paresthesia is uncommon. It is usually unilateral, but up to 30% of cases have a bilateral presentation. In our study patients who received chiropractic therapy were treated by rest, heat, ice pack, non-steroidal anti-inflammatory drugs (NSAIDS, heel pads, magnetic insole, night splints, walking cast, taping, ultrasound, plantar and Achilles stretching for a period of 6 weeks scheduled accordingly. Patients receiving corticosteroid injection were administered 80mg methyl prednisolone locally at the heel. Each patient received 3 doses of methyl prednisolone injections on 1st day, 2nd week, and 4th week. The results with corticosteroid injection were better when analyzed with numeric rating scale over a period of 6 weeks. [Int J Res Med Sci 2014; 2(2.000: 639-642

  1. Corticosteroid Therapy for Liver Abscess in Chronic Granulomatous Disease

    OpenAIRE

    Leiding, Jennifer W; FREEMAN, ALEXANDRA F.; Marciano, Beatriz E.; Anderson, Victoria L.; Uzel, Gulbu; Malech, Harry L.; DeRavin, SukSee; Wilks, David; Venkatesan, Aradhana M.; Zerbe, Christa S.; Heller, Theo; Holland, Steven M.

    2011-01-01

    Liver abscesses in chronic granulomatous disease (CGD) are typically difficult to treat and often require surgery. We describe 9 X-linked CGD patients with staphylococcal liver abscesses refractory to conventional therapy successfully treated with corticosteroids and antibiotics. Corticosteroids may have a role in treatment of Staphylococcus aureus liver abscesses in CGD.

  2. Corticosteroids reduce the tensile strength of isolated collagen fascicles

    DEFF Research Database (Denmark)

    Haraldsson, Bjarki Thor; Langberg, Henning; Aagaard, Per; Zuurmond, Anne-Marie; van El, Benno; Degroot, Jeroen; Kjaer, Michael; Magnusson, S Peter

    2006-01-01

    Overuse tendon injuries are frequent. Corticosteroid injections are commonly used as treatment, although their direct effects on the material properties of the tendon are poorly understood.......Overuse tendon injuries are frequent. Corticosteroid injections are commonly used as treatment, although their direct effects on the material properties of the tendon are poorly understood....

  3. Risk of miscarriage among users of corticosteroid hormones

    DEFF Research Database (Denmark)

    Bjørn, Anne-Mette B; Nielsen, Rikke B; Nørgaard, Mette;

    2013-01-01

    The purpose of this nested case-control study in Denmark was to study the association between use of corticosteroids and risk of miscarriage.......The purpose of this nested case-control study in Denmark was to study the association between use of corticosteroids and risk of miscarriage....

  4. Safety of bronchodilators and corticosteroids for asthma during pregnancy

    DEFF Research Database (Denmark)

    Gregersen, Thorbjørn Lomholt; Ulrik, Charlotte Suppli

    2013-01-01

    Asthma is a common medical condition complicating pregnancy with potentially serious effects on pregnancy outcome. The aim of this review is to provide an update on efficacy and safety of asthma medications, primarily bronchodilators and corticosteroids, used during pregnancy with focus on...... safety of add-on long-acting β2-agonists to inhaled corticosteroids. Inhaled corticosteroids are generally found to be safe, although further research is needed to investigate both the efficacy and safety of high dose therapy with inhaled corticosteroids. Studies have reported associations between the...... use of systemic corticosteroids and adverse perinatal outcomes, such as preterm birth, low birth weight, and pre-eclampsia. This must, however, be weighed against the potential serious impact of severe, uncontrolled asthma itself on pregnancy outcome. The main obstacle to a valid interpretation of...

  5. Corticosteroids and ARDS: A review of treatment and prevention evidence

    Directory of Open Access Journals (Sweden)

    G C Khilnani

    2011-01-01

    Full Text Available To systematically review the role of corticosteroids in prevention of acute respiratory distress syndrome (ARDS in high-risk patients, and in treatment of established ARDS. Primary articles were identified by English-language Pubmed/MEDLINE, Cochrane central register of controlled trials, and Cochrane systemic review database search (1960-June 2009 using the MeSH headings: ARDS, adult respiratory distress syndrome, ARDS, corticosteroids, and methylprednisolone (MP. The identified studies were reviewed and information regarding role of corticosteroids in prevention and treatment of ARDS was evaluated. Nine trials have evaluated the role of corticosteroid drugs in management of ARDS at various stages. Of the 9, 4 trials evaluated role of corticosteroids in prevention of ARDS, while other 5 trials were focused on treatment after variable periods of onset of ARDS. Trials with preventive corticosteroids, mostly using high doses of MP, showed negative results with patients in treatment arm, showing higher mortality and rate of ARDS development. While trials of corticosteroids in early ARDS showed variable results, somewhat, favoring use of these agents to reduce associated morbidities. In late stage of ARDS, these drugs have no benefits and are associated with adverse outcome. Use of corticosteroids in patients with early ARDS showed equivocal results in decreasing mortality; however, there is evidence that these drugs reduce organ dysfunction score, lung injury score, ventilator requirement, and intensive care unit stay. However, most of these trials are small, having a significant heterogeneity regarding study design, etiology of ARDS, and dosage of corticosteroids. Further research involving large-scale trials on relatively homogeneous cohort is necessary to establish the role of corticosteroids for this condition.

  6. Corticosteroids In Infections Of Central Nervous System

    Directory of Open Access Journals (Sweden)

    Meena AK

    2003-01-01

    Full Text Available Infections of central nervous system are still a major problem. Despite the introduction of newer antimicrobial agents, mortality and long-term sequelace associated with these infections is unacceptably high. Based on the evidence that proinflammtory cytokines have a role in pathophysiology of bacterial and tuberculous meningitis, corticosteroids with a potent anti-inflammatory and immunomodulating effect have been tested and found to be of use in experimental and clinical studies, Review of the available literature suggests steroid administration just prior to antimicrobial therapy is effective in decreasing audiologic and neurologic sequelae in childern with H. influenzae nenigitis. Steroid use for bacterial meningitis in adults is found to be beneficial in case of S. pneumoniae. The value of adjunctive steroid therapy for other bacterial causes of meningitis remains unproven. Corticocorticoids are found to be of no benefit in viral meningitis, Role of steroids in HIV positive patients needs to be studied.

  7. Gender differences in the associations between cortisol and insulin in healthy subjects

    NARCIS (Netherlands)

    Stolk, RP; Lamberts, SWJ; deJong, FH; Pols, HAP; Grobbee, DE

    1996-01-01

    To investigate the role of cortisol in the etiology of insulin resistance in men and women, we examined 218 healthy non-hospitalized elderly, selected from the Rotterdam Study. Free cortisol was assessed by the ratio of fasting serum cortisol over corticosteroid-binding globulin (CBG), and insulin r

  8. Uso antenatal do corticosteroide e hemorragia peri-intraventricular Antenatal corticosteroids and intraventricular hemorrhage

    Directory of Open Access Journals (Sweden)

    Luis Eduardo de F. Vinagre

    2010-09-01

    Full Text Available OBJETIVO: Realizar uma revisão bibliográfica sobre o uso antenatal do corticosteroide na prevenção da hemorragia peri-intraventricular. FONTES DE DADOS: Levantamento bibliográfico por meio do Pubmed e SciELO abrangendo os últimos 20 anos. Foram utilizadas as palavras chaves no idioma inglês: "cerebral hemorrhage", "steroids" e "newborn, infant". SÍNTESES DE DADOS: A hemorragia peri-intraventricular é uma importante patologia nos prematuros, sobretudo nos menores de 34 semanas, devido a suas graves sequelas neurológicas. Uma vez ocorrido o sangramento, não há tratamento específico. Desta forma, a prevenção torna-se o maior objetivo das pesquisas. O resultado da meta-análise de estudos randomizados demonstrou que o corticosteroide antenatal reduz a mortalidade e a incidência da doença de membrana hialina e da hemorragia peri-intraventricular. O efeito protetor na redução do risco da hemorragia peri-intraventricular não está completamente esclarecido. Além de acelerar a maturidade pulmonar, o corticosteroide antenatal estimula a maturação da microvasculatura da matriz germinativa, promove o espessamento da membrana basal, acelera a formação proteica nas junções firmes e estabiliza o fluxo sanguíneo cerebral. Também melhora as condições de nascimento dos fetos pré-termo. CONCLUSÕES: O uso antenatal do corticosteroide associado à implementação de melhores práticas de atendimento ao prematuro tem sido responsável pela evidente redução dos índices dessa doença. Apesar de comprovada eficácia e segurança, não é amplamente utilizado. Medidas devem ser tomadas para estimular seu uso como prática rotineira no atendimento de gestantes com risco de parto prematuro.OBJECTIVE: To conduct a literature review on the use of antenatal corticosteroids for the prevention of peri-intraventricular hemorrhage. DATA SOURCE: Bibliography search in Pubmed and SciELO databases covering the past 20 years using the following

  9. On the determination of reducing corticosteroids

    Directory of Open Access Journals (Sweden)

    Luiz Augusto de Abreu

    1955-12-01

    Full Text Available 1. The authors preconize the use of Folin-Ciocalteu's reagent in the colorimetric determination of reducing cortcosteroids. 2. The reaction follows Beer's law in the range 0-50 μg of 11-desoxycorticosterone. 3. Determinations made in human urine and adrenal glands of rats and guinea pigs are comparable with results obtained by other methods.Os autores preconizam o reagente de Folin-Ciocalteu na determinação colorimétrica dos corticosteroides redutores. A reação segue a lei de Beer na faixa de 0 a 50 μg de 11-desoxycorticosterona. A excreção urinária de corticosteroides redutores, em 24 horas, de indivíduos normais variou de 0.83 mg a 2.72 mg com a média de 1.69 mg, sem hidrólise prévia pela β glicuronidase. A intensidade da reação permite efetuar a dosagem em quantidades de urina sensìvelmente menores às usadas por outros métodos baseados nas propriedades redutoras dos corticosteróides. Os resultados, obtidos com suprarrenais de ratos, variaram de 16.3 mg a 50.8 mg de corticosteróides redutores por 100 g de glândula, com uma média de 32.5 mg, fazendo-se as determinações com as duas glândulas em cada animal. A taxa média observada nas suprarrenais de cobaias foi 22.9 mg de corticosteróides redutores por 100 g de glândula, com uma variação individual de 12.6 a 33.2 mg, fazendo-se as determinações sòmente com uma glândula. Os resultados obtidos são comparáveis aos descritos na literatura.

  10. Inhaled corticosteroids in COPD: the clinical evidence.

    Science.gov (United States)

    Ernst, Pierre; Saad, Nathalie; Suissa, Samy

    2015-02-01

    In this article, we focus on the scientific evidence from randomised trials supporting treatment with inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD), including treatment with combinations of long-acting β-agonist (LABA) bronchodilators and ICS. Our emphasis is on the methodological strengths and limitations that guide the conclusions that may be drawn. The evidence of benefit of ICS and, therefore, of the LABA/ICS combinations in COPD is limited by major methodological problems. From the data reviewed herein, we conclude that there is no survival benefit independent of the effect of long-acting bronchodilation and no effect on FEV1 decline, and that the possible benefit on reducing severe exacerbations is unclear. Our interpretation of the data is that there are substantial adverse effects from the use of ICS in patients with COPD, most notably severe pneumonia resulting in excess deaths. Currently, the most reliable predictor of response to ICS in COPD is the presence of eosinophilic inflammation in the sputum. There is an urgent need for better markers of benefit and risk that can be tested in randomised trials for use in routine specialist practice. Given the overall safety and effectiveness of long-acting bronchodilators in subjects without an asthma component to their COPD, we believe use of such agents without an associated ICS should be favoured. PMID:25537556

  11. Help Desk Answers: Do corticosteroids reduce bronchiolitis hospitalizations?

    Science.gov (United States)

    Jendi, Mohammed R; Scott, Quincy O; Smaga, Sharon A

    2016-05-01

    Corticosteroids alone don't decrease hospital admissions or length of stay among children with bronchiolitis. Combining oral dexamethasone and inhaled epinephrine appears to prevent one hospital admission for every 11 patients treated. PMID:27275940

  12. Radiolytic degradation scheme for 60Co-irradiated corticosteroids

    Energy Technology Data Exchange (ETDEWEB)

    Kane, M.P.; Tsuji, K.

    1983-01-01

    The cobalt 60 radiolytic degradation products have been identified in the following corticosteroids: cortisone, cortisone acetate, hydrocortisone, hydrocortisone acetate, hydrocortisone sodium succinate, isoflupredone acetate, methylprednisolone, methylprednisolone acetate, prednisolone, prednisolone acetate, and prednisone. Two major types of degradation processes have been identified: loss of the corticoid side chain on the D-ring to produce the C-17 ketone and conversion of the C-11 alcohol, if present, to the C-11 ketone. Minor degradation products derived from other changes affecting the side chain are also identified in several corticosteroids. These compounds are frequently associated in corticosteroids as process impurities or degradation compounds. No new radiolytic compounds unique to 60Co-irradiation have been found. The majority of corticosteroids have been shown to be stable to 60Co-irradiation. The rates of radiolytic degradation ranged from 0.2 to 1.4%/Mrad.

  13. Emerging corticosteroid agonists for the treatment of asthma

    DEFF Research Database (Denmark)

    Westergaard, Christian G; Porsbjerg, Celeste; Backer, Vibeke

    INTRODUCTION: Asthma is one of the most frequent chronic diseases worldwide. For decades, asthma has been treated with bronchodilators and inhaled corticosteroids (ICS). However, adverse effects of ICS and disease heterogeneity necessitate improvements in the existing treatment regimes. Recently...

  14. Patch testing with corticosteroid mixes in Europe. A multicentre study of the EECDRG

    DEFF Research Database (Denmark)

    Isaksson, M; Andersen, Klaus Ejner; Brandão, F M; Bruynzeel, D P; Bruze, M; Camarasa, J G; Diepgen, T; Ducombs, G; Frosch, P J; Goossens, A; Lahti, A; Menné, T; Rycroft, R J; Seidenari, S; Shaw, S; Tosti, A; Wahlberg, J E; White, I R; Wilkinson, J D

    2000-01-01

    This study investigated whether a corticosteroid mix containing tixocortol pivalate, budesonide, and hydrocortisone-17-butyrate could detect contact allergy to corticosteroids. 2 corticosteroid mixes, 1 with a high (mix I) and 1 with a low (mix II) concentration and the 3 individual constituents...... allergy to corticosteroid markers was missed....

  15. Ultrasound-Guided Injection of a Corticosteroid and Hyaluronic Acid

    OpenAIRE

    Callegari, Leonardo; Spanò, Emanuela; Bini, Amedeo; Valli, Federico; GENOVESE, EUGENIO; Fugazzola, Carlo

    2012-01-01

    Background and Objectives: Stenosing tenosynovitis (trigger finger) is one of the most common causes of pain and disability in the hand, which may often require treatment with anti-inflammatory drugs, corticosteroid injection, or open surgery. However, there is still large room for improvement in the treatment of this condition by corticosteroid injection. The mechanical, viscoelastic, and antinociceptive properties of hyaluronic acid may potentially support the use of this molecule in associ...

  16. Corticosteroid treatment increases parasite numbers in murine giardiasis.

    OpenAIRE

    Nair, K V; Gillon, J; Ferguson, A.

    1981-01-01

    Corticosteroid therapy is known to be hazardous in patients with occult infection but the mechanism by which the host parasite relationship is altered by steroids is not known.We have used an intestinal protozoal parasite, Giardia muris, to examine the effects of corticosteroids on the number of parasites in the intestine in the course of a primary infection. A single injection of cortisone acetate, subcutaneously, one day before oral inoculation of CBA mice with 1000 cysts of Giardia muris, ...

  17. Prevention and Treatment of Corticosteroid-Induced Osteoporosis

    OpenAIRE

    Iwamoto, Jun; Takeda, Tsuyoshi; Sato, Yoshihiro

    2005-01-01

    Osteoporosis is one of the most serious complications of corticosteroid treatment. Loss of bone mineral density (BMD) and fractures occur early in the course of corticosteroid treatment, and thus early recognition of fracture risk and effective intervention based on evidence-based-medicine (EBM) are needed. A study of meta-analysis representing the highest level in a hierarchy of evidence showed that when the outcome measure of interest was limited to changes in lumbar spine BMD, bisphosphona...

  18. Prenatal corticosteroid exposure alters early developmental seizures and behavior

    OpenAIRE

    Velíšek, Libor

    2011-01-01

    In humans, corticosteroids are often administered prenatally to improve lung development in preterm neonates. Studies in exposed children as well as in children, whose mothers experienced significant stress during pregnancy indicate behavioral problems and possible increased occurrence of epileptic spasms. This study investigated whether prenatal corticosteroid exposure alters early postnatal seizure susceptibility and behaviors. On gestational day 15, pregnant rats were injected i.p. with hy...

  19. Reviewing the use of corticosteroids in bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Fernanda Aparecida de Oliveira Peixoto

    2016-04-01

    Full Text Available Abstract Objective: Review the risks and benefits of postnatal corticosteroid use for the treatment of bronchopulmonary dysplasia, considering that there is not a more effective therapy. Data sources: The literature review was carried out in the BIREME database, using the terms "bronchopulmonary dysplasia and corticosteroid" in the LILACS, IBECS, MEDLINE, Cochrane Library, and SciELO databases, selecting the most relevant articles on the subject, with emphasis on recent literature published in the last five years. Summary of the data: In preterm infants, bronchopulmonary dysplasia is still a common problem and remains without a specific therapy, despite knowledge of the several risk factors. The treatment essentially consists of supportive measures, but in the past, corticosteroids were widely used, as they are the only medications that have an impact on disease progression. However, the emergence of cerebral palsy associated with the indiscriminate use of corticosteroids has prevented the prescription of this drug in the last 15 years. Since then, no new measures have been taken, and the incidence of the disease tended to increase during this period, creating the need for a review of corticosteroid use and, possibly, more restricted indications. Conclusions: The association between risks and benefits of corticosteroid use in preterm infants needs to be considered due to the fact that some infant subpopulations may show more benefits than risks, such as those using mechanical ventilation with difficult weaning.

  20. Misuse of topical corticosteroids: A clinical study of adverse effects

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    Vivek Kumar Dey

    2014-01-01

    Full Text Available Background: Misuse of topical corticosteroids is a widespread phenomenon among young people in India, especially women. The practice is associated with significant adverse effects and poor awareness of these effects among the general public. Aim: This study was conducted to examine the misuse and adverse effects of topical corticosteroids among the people in Bastar region in Chhattisgarh state of India. Materials and Methods: Data collected from patients presenting with at least one of the adverse effects of topical corticosteroids as the chief complaint, from November 2010 to October 2011. Results: Out of the 6723 new patients, 379 (5.63% had presented with misuse and adverse effects of topical corticosteroids, of whom 78.89% were females. More than 65% of the patients were in the age group 10-29 years. The main reason for using the topical corticosteroids was to lighten skin colour and treat melasma and suntan. Acne (37.99% and telangiectasia (18.99% were the most common adverse effects noted. Conclusions: Misuse of topical corticosteroids has a huge impact on dermatological practice, leading to a significant proportion of visits to the dermatologist. This hydra-headed problem needs multi-dimensional interventions, involving educational, legal and managerial approaches with cooperation from different sectors of society.

  1. Corticosteroid therapy in IgA nephropathy.

    Science.gov (United States)

    Lv, Jicheng; Xu, Damin; Perkovic, Vlado; Ma, Xinxin; Johnson, David W; Woodward, Mark; Levin, Adeera; Zhang, Hong; Wang, Haiyan

    2012-06-01

    The benefits and risks of steroids for the treatment of IgA nephropathy remain uncertain. We systematically searched MEDLINE, EMBASE, and the Cochrane Library for randomized, controlled trials of corticosteroid therapy for IgA nephropathy published between 1966 and March 2011. We identified nine relevant trials that included 536 patients who had urinary protein excretion >1 g/d and normal renal function. Forty-six (8.6%) of these patients developed a kidney failure event, defined as doubling of the serum creatinine/halving of the GFR or ESRD. Overall, steroid therapy was associated with a lower risk for kidney failure (relative risk, 0.32 [95% confidence interval [CI], 0.15-0.67]; P=0.002) and a reduction in proteinuria (weighted mean difference, -0.46 g/d [95% CI, -0.63 to -0.29 g/d]), with no evidence of heterogeneity in these outcomes. Subgroup analysis suggested that the dose modifies the effect of steroids for renal protection (P for heterogeneity=0.030): Relatively high-dose and short-term therapy (prednisone >30 mg/d or high-dose pulse intravenous methylprednisolone with duration ≤1 year) produced significant renal protection, whereas low-dose, long-term steroid use did not. Steroid therapy was associated with a 55% higher risk for adverse events. The quality of included studies was low, however, limiting the generalizability of the results. In conclusion, steroids appear to provide renal protection in patients with IgA nephropathy but increase the risk for adverse events. Reliably defining the efficacy and safety of steroids in IgA nephropathy requires a high-quality trial with a large sample size. PMID:22539830

  2. Comparative analysis of acute and chronic corticosteroid pharmacogenomic effects in rat liver: Transcriptional dynamics and regulatory structures

    Directory of Open Access Journals (Sweden)

    DuBois Debra C

    2010-10-01

    framework to identify significant coexpressed clusters of genes across multiple conditions experimented from different microarray platforms, time-grids, and also tissues if applicable. Analysis on rich in vivo datasets of corticosteroid time-series yielded significant insights into the pharmacogenomic effects of corticosteroids, especially the relevance to metabolic side-effects. This has been illustrated through enriched metabolic functions in those transcriptional modules and the presence of GRE binding motifs in those enriched pathways, providing significant modules for further analysis on pharmacogenomic corticosteroid effects.

  3. Corticosteroids, but not NSAIDs, are associated with less Alzheimer neuropathology

    Science.gov (United States)

    Beeri, Michal Schnaider; Schmeidler, James; Lesser, Gerson T; Maroukian, Maria; West, Rebecca; Leung, Stephanie; Wysocki, Michael; Perl, Daniel P.; Purohit, Dushyant P.; Haroutunian, Vahram

    2011-01-01

    Objective To test the hypothesis that corticosteroid and non-steroidal anti-inflammatory (NSAIDs) medications are associated with less global and regional Alzheimer’s disease (AD) neuropathology. Methods This postmortem study was based on 694 brains of subjects from the Mount Sinai School of Medicine Brain Bank who did not have neuropathologies other than neuritic plaques (NPs), neurofibrillary tangles (NFTs), or cerebrovascular disease. Densities of NPs and of NFTs were assessed in several neocortical regions and in the hippocampus, entorhinal cortex, and amygdala. Counts of NPs in several neocortical regions were also assessed. For each neuropathology measure, analyses of covariance controlling for age at death and sex compared subjects who received only corticosteroids (n=54) or those who received only NSAIDs (n=56) to the same comparison group, subjects who received neither (n=576). Results Subjects receiving corticosteroids had significantly lower ratings and counts of NPs for all neuropathological measures, and NFTs overall and in the cerebral cortex and amygdala. In contrast, no measures were significant for subjects who received NSAIDs. Conclusions Use of corticosteroids was associated with approximately 50% less NPs and NFTs in most brain regions examined, compared to non-medicated subjects. In contrast, use of NSAIDs was not substantially associated with the reductions in hallmark lesions of AD. Since corticosteroids have anti-inflammatory as well as a myriad of other neurobiological effects, more direct studies in model systems could reveal novel therapeutic targets and mechanisms for AD lesion reduction. PMID:21458888

  4. Can intramuscular corticosteroid injection cause nonarteritic anterior ischemic optic neuropathy?

    Directory of Open Access Journals (Sweden)

    Bakbak B

    2013-03-01

    Full Text Available Berker Bakbak, Banu Turgut Ozturk, Sansal Gedik, Bengu Ekinci Koktekir, Saban Gonul Selcuk University Medical Faculty, Department of Ophthalmology, Konya, Turkey Abstract: A 56-year-old man noted a sudden decrease of vision in his right eye 4 hours after intramuscular triamcinolone acetonide (TA injection. A diagnosis of unilateral nonarteritic anterior ischemic optic neuropathy (NAION was made, and the patient was counseled to discontinue using TA. Examination for possible risk factors revealed controlled hypertension. Final visual acuity was finger counting at 1 m, and the optic disc was pale in his right eye. This is the first reported case of unilateral NAION that has occurred in a patient after intramuscular corticosteroid injection. Although a cause-and-effect relationship is difficult to prove, the short duration between the TA injection and the NAION is noteworthy. The history of corticosteroid injection should be questioned in cases with predisposing conditions such as hypertension. Keywords: ischemic optic neuropathy, corticosteroids, optic disc edema

  5. A rapid screen for four corticosteroids in equine synovial fluid.

    Science.gov (United States)

    Agrawal, Karan; Ebel, Joseph G; Bischoff, Karyn

    2014-06-01

    Most antidoping method development in the equine industry has been for plasma and urine, though there has been recent interest in the analysis of synovial fluid for evidence of doping by intra-articular corticosteroid injection. Published methods for corticosteroid analysis in synovial fluid are primarily singleplex methods, do not screen for all corticosteroids of interest and are not adequately sensitive. The purpose of this study is to develop a rapid and sensitive liquid chromatography-tandem mass spectrometry (LC-MS-MS) screening method for the detection of four of the most common intra-articularly administered corticosteroids--betamethasone, methylprednisolone, methylprednisolone acetate and triamcinolone acetonide. Sample preparation consisted of protein precipitation followed by a basified liquid-liquid extraction. LC-MS-MS experiments consisted of a six-min isocratic separation using a Phenomenex Polar-RP stationary phase and a mobile phase consisting of 35% acetonitrile, 5 mM ammonium acetate and 0.1% formic acid in nanopure water. The detection system used was a triple quadrupole mass analyzer with thermospray ionization, and compounds were identified using selective reaction monitoring. The method was validated to the ISO/IEC 17025 standard, and real synovial fluid samples were analyzed to demonstrate the application of the method in an antidoping context. The method was highly selective for the four corticosteroids with limits of detection of 1-3 ng/mL. The extraction efficiency was 50-101%, and the matrix effects were 14-31%. These results indicate that the method is a rapid and sensitive screen for the four corticosteroids in equine synovial fluid, fit for purpose for equine antidoping assays. PMID:24713534

  6. Lower corticosteroid skin blanching response is associated with severe COPD.

    Directory of Open Access Journals (Sweden)

    Susan J M Hoonhorst

    Full Text Available BACKGROUND: Chronic obstructive pulmonary disease (COPD is characterized by chronic airflow limitation caused by ongoing inflammatory and remodeling processes of the airways and lung tissue. Inflammation can be targeted by corticosteroids. However, airway inflammation is generally less responsive to steroids in COPD than in asthma. The underlying mechanisms are yet unclear. This study aimed to assess whether skin corticosteroid insensitivity is associated with COPD and COPD severity using the corticosteroid skin blanching test. METHODS: COPD patients GOLD stage I-IV (n = 27, 24, 22, and 16 respectively and healthy never-smokers and smokers (n = 28 and 56 respectively were included. Corticosteroid sensitivity was assessed by the corticosteroid skin blanching test. Budesonide was applied in 8 logarithmically increasing concentrations (0-100 μg/ml on subject's forearm. Assessment of blanching was performed after 7 hours using a 7-point scale (normal skin to intense blanching. All subjects performed spirometry and body plethysmography. RESULTS: Both GOLD III and GOLD IV COPD patients showed significantly lower skin blanching responses than healthy never-smokers and smokers, GOLD I, and GOLD II patients. Their area under the dose-response curve values of the skin blanching response were 586 and 243 vs. 1560, 1154, 1380, and 1309 respectively, p<0.05. Lower FEV1 levels and higher RV/TLC ratios were significantly associated with lower skin blanching responses (p = 0.001 and p = 0.004 respectively. GOLD stage I, II, III and IV patients had similar age and packyears. CONCLUSIONS: In this study, severe and very severe COPD patients had lower skin corticosteroid sensitivity than mild and moderate COPD patients and non-COPD controls with comparable age and packyears. Our findings together suggest that the reduced skin blanching response fits with a subgroup of COPD patients that has an early-onset COPD phenotype.

  7. Corticosteroid Injections Versus Manual Physical Therapy for Treatment of the Shoulder Impingement Syndrome

    Science.gov (United States)

    ... Medicine Summaries for Patients Corticosteroid Injections Versus Manual Physical Therapy for Treatment of the Shoulder Impingement Syndrome The ... Outcome of Subacromial Corticosteroid Injection Compared With Manual Physical Therapy for the Management of the Unilateral Shoulder Impingement ...

  8. Corticosteroids to prevent postextubation upper airway obstruction: the evidence mounts

    OpenAIRE

    Epstein, Scott K

    2007-01-01

    Intubation of the airway can lead to laryngotracheal injury, resulting in extubation failure from upper airway obstruction (UAO). A number of factors can help to identify patients who are at greatest risk for postextubation UAO. Three randomized controlled trials demonstrate that prophylactic corticosteroids decrease the risk for postextubation UAO and probably the need for re-intubation.

  9. Drug interactions between inhaled corticosteroids and enzymatic inhibitors

    OpenAIRE

    Daveluy, Amélie; Raignoux, Cécile; Miremont-Salamé, Ghada; Girodet, Pierre-Olivier; Moore, Nicholas; Haramburu, Françoise; Molimard, Mathieu

    2009-01-01

    Drug interactions between inhaled corticosteroids and enzymatic inhibitors phone: +33-557-571561 (Daveluy, Amelie) (Daveluy, Amelie) Centre Regional de Pharmacovigilance, Hopital Pellegrin - 33076 - Bordeaux Cedex - FRANCE (Daveluy, Amelie) Unite 657, INSERM - Bordeaux - FRANCE (Daveluy, Amelie) Departement de Pharmacologie, CHU de Bordeaux - Bordeaux - FRANCE (Daveluy, Amelie) Centre Regional de Pharmacovigilance, Hopital Pellegrin - 33076...

  10. Corticosteroid effects in the brain: U-shape it.

    NARCIS (Netherlands)

    M. Joëls

    2006-01-01

    The existence of U-shaped dose dependencies has been known for a long time. With regard to corticosteroid action in brain cells, a dual receptor system that works in opposing directions can explain the occurrence of a U-shaped dose dependency. However, recent evidence indicates that many cell- and t

  11. Corticosteroid therapy in Henoch-Schönlein gastritis

    Directory of Open Access Journals (Sweden)

    Pavlović Momčilo

    2007-01-01

    Full Text Available Introduction. Henoch-Schönlein purpura (HSP is the most common vascular disease of childhood. It is a multisystem disease most commonly affecting the skin, joints, gastrointestinal tract, and kidneys, but other organs may be affected, too. Gastrointestinal involvement occurs in approximately 65-90% of patients, ranging from mild symptoms such as abdominal pain, nausea, and vomiting, to more severe manifestations such as gastrointestinal bleeding and intussusception. In most cases, HSP spontaneously resolves without treatment. The use of corticosteroids is controversial and usually reserved for severe systemic manifestations. Some authors suggest that the abdominal pain and gastrointestinal hemorrhage of HSP may respond to steroids, with some suggesting that there is a benefit in their use and describing a regimen. Case outline. This is a case report of HSP in a fourteen year-old boy with abdominal pain and hematemesis. Upper endoscopy showed an edematous and erythematous change in the body of the stomach and purpuric lesions in the duodenum, while multiple erosions were found in the antral area. Parenteral corticosteroid therapy with gastric acid secretion inhibitor administration led to regression of gastrointestinal symptoms on the seventh day, with relapses on the fourth and sixth day. Peroral administration of corticosteroids and gradual decrease of daily doses started on the eighth day of abdominal symptoms. New purpuric skin rashes appeared during six weeks. Conclusion. Corticosteroid therapy with gastric acid secretion inhibitors showed a positive effect in our patient with a severe form of HSP accompanied by abdominal pain and gastrointestinal hemorrhage. .

  12. Inhaled corticosteroids and Aspergillus fumigatus isolation in cystic fibrosis.

    Science.gov (United States)

    Noni, Maria; Katelari, Anna; Dimopoulos, George; Kourlaba, Georgia; Spoulou, Vana; Alexandrou-Athanassoulis, Helen; Doudounakis, Stavros-Eleftherios; Tzoumaka-Bakoula, Chryssa

    2014-10-01

    Aspergillus fumigatus isolation in cultures from respiratory specimens of patients with cystic fibrosis (CF) is quite common; however, the role of A. fumigatus as a pathogen and whether its presence is associated with progression of pulmonary disease remain unclear. We investigated the association between inhaled corticosteroids and the recovery of A. fumigatus by performing a retrospective cohort study of CF patients born between 1988 and 1996. The patients' medical records from their first visit to the CF Center until December 2010 were reviewed. Outcomes were the occurrence of A. fumigatus first isolation, chronic colonization, or the last visit at the CF Center. A number of possible confounders were included in the multivariate logistic regression analysis in order to identify an independent association between inhaled corticosteroids and colonization status. A total of 121 patients were included in the study. Thirty-nine patients (32.2%) had at least one positive culture and 14 (11.6%) developed chronic colonization. Multivariate logistic regression analysis was used to determine the independent effect of inhaled corticosteroids on the odds of first isolation (odds ratio [OR], 1.165; 95% confidence interval [CI], 1.015-1.337; P = 0.029) and chronic colonization (OR, 1.180; 95% CI, 1.029-1.353; P = 0.018). In conclusion, A. fumigatus first isolation and chronic colonization are associated with the duration of inhaled corticosteroid treatment. PMID:25056962

  13. Prevalence of and factors influencing sensitization to corticosteroids in a Danish patch test population

    DEFF Research Database (Denmark)

    Vind-Kezunovic, Dina; Johansen, Jeanne Duus; Carlsen, Berit Christina

    2011-01-01

    Corticosteroids are used to treat dermatoses, including allergic contact dermatitis, but can also cause contact allergy. The frequency of corticosteroid allergy varies between studies and is influenced by treatment traditions and availability.......Corticosteroids are used to treat dermatoses, including allergic contact dermatitis, but can also cause contact allergy. The frequency of corticosteroid allergy varies between studies and is influenced by treatment traditions and availability....

  14. Use of Inhaled and Oral Corticosteroids in Pregnancy and the Risk of Malformations or Miscarriage

    DEFF Research Database (Denmark)

    Bjørn, Anne-Mette Bay; Ehrenstein, Vera; Nohr, Ellen Aagaard;

    2014-01-01

    databases, this MiniReview provides an overview of inhaled and oral corticosteroid use in pregnancy with specific emphasis on the association between use of corticosteroids during pregnancy and risk of miscarriage and congenital malformations in offspring. Use of corticosteroids among pregnant women ranged...... inconsistent. Use of inhaled corticosteroids was associated with a slightly increased the risk of miscarriage, whereas use of oral corticosteroids was not; however, confounding by indication could not be ruled out. This article is protected by copyright. All rights reserved....

  15. Antibody induction versus corticosteroid induction for liver transplant recipients

    DEFF Research Database (Denmark)

    Penninga, Luit; Wettergren, André; Wilson, Colin H;

    2014-01-01

    . OBJECTIVES: To assess the benefits and harms of T-cell specific antibody induction versus corticosteroid induction for prevention of acute rejection in liver transplant recipients. SEARCH METHODS: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of...... Controlled Trials (CENTRAL), MEDLINE, EMBASE, Science Citation Index Expanded, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) on 30 September 2013 together with reference checking, citation searching, contact with trial authors and pharmaceutical companies to...... identify additional trials. SELECTION CRITERIA: We included all randomised clinical trials assessing immunosuppression with T-cell specific antibody induction versus corticosteroid induction in liver transplant recipients. Our inclusion criteria stated that participants within each included trial should...

  16. The use of inhaled corticosteroids in pediatric asthma: update.

    Science.gov (United States)

    Hossny, Elham; Rosario, Nelson; Lee, Bee Wah; Singh, Meenu; El-Ghoneimy, Dalia; Soh, Jian Yi; Le Souef, Peter

    2016-01-01

    Despite the availability of several formulations of inhaled corticosteroids (ICS) and delivery devices for treatment of childhood asthma and despite the development of evidence-based guidelines, childhood asthma control remains suboptimal. Improving uptake of asthma management plans, both by families and practitioners, is needed. Adherence to daily ICS therapy is a key determinant of asthma control and this mandates that asthma education follow a repetitive pattern and involve literal explanation and physical demonstration of the optimal use of inhaler devices. The potential adverse effects of ICS need to be weighed against the benefit of these drugs to control persistent asthma especially that its safety profile is markedly better than oral glucocorticoids. This article reviews the key mechanisms of inhaled corticosteroid action; recommendations on dosage and therapeutic regimens; potential optimization of effectiveness by addressing inhaler technique and adherence to therapy; and updated knowledge on the real magnitude of adverse events. PMID:27551328

  17. Laryngeal leishmaniasis in a patient taking inhaled corticosteroids.

    Science.gov (United States)

    Roberts, Rachel Margaret; Mukherjee, Jayanta; Phillips, David

    2016-01-01

    We present a case of a man in his late 60s, who had spent 3-4 months of the year in rural Spain, presenting with intermittent hoarseness of voice. He had a background of asthma and bronchiectasis, and was taking inhaled corticosteroids. His dysphonia was initially managed as bronchiectasis with little improvement. Bronchoscopy revealed a cystic lesion on his left vocal fold, and tissue biopsy revealed Leishmania amastigotes. This confirmed a diagnosis of laryngeal leishmaniasis. We propose that this is likely secondary to his inhaled corticosteroid therapy. The infection was treated with a 30-day course of miltefosine, and at most recent follow-up the patient was deemed free from leishmanial infection. PMID:27329097

  18. Corticosteroid Regulation of Synaptic Plasticity in the Hippocampus

    OpenAIRE

    Nicola Maggio; Menahem Segal

    2010-01-01

    Stress, via release of steroid hormones, has been shown to affect several cellular functions in the brain, including synaptic receptors and ion channels. As such, corticosteroids were reported to modulate plasticity, expressed as long-term changes in reactivity to afferent stimulation. The classical view of the effects of stress on synaptic plasticity and cognitive functions assumes an inverted U-shape curve, such that a low stress level facilitates and a high stress level (i.e., corticostero...

  19. Chronic rhinitis: Effects of local corticosteroids on eosinophils

    OpenAIRE

    Ursulović Dejan D.; Janošević Ljiljana B.; Janošević Slobodanka B.

    2002-01-01

    Clinical manifestation of chronic rhinitis is due to local release of mediators from inflammatory cells. Eosinophil leukocytes are important in pathogenesis of nasal hypersensitivity as well as nasal hyperreactivity [1,2]. The aim of the study was to follow-up the effect of local corticosteroid treatment on a number of eosinophils in nasal secretion of patients with chronic rhinitis. The study was prospective and controlled. A total number of 88 subjects was included in the study. Patients wi...

  20. Corticosteroid Treatment Impact on Spinal Deformity in Duchenne Muscular Dystrophy

    OpenAIRE

    Sanzarello, Ilaria; Merlini, Luciano; Traina, Francesco; Rosa, Michele Attilio; Faldini, Cesare

    2014-01-01

    Duchenne muscular dystrophy is a progressive disease with loss of ambulation at around 9-10 years of age, followed, if untreated, by development of scoliosis, respiratory insufficiency, and death in the second decade of life. This review highlights the natural history of the disease, in particular, with regard to the development of the spinal deformity and how this complication has been modified by surgical interventions and overall by corticosteroid treatment. The beneficial effect of cortic...

  1. Corticosteroids for severe influenza pneumonia: A critical appraisal

    OpenAIRE

    Nedel, Wagner Luis; Nora, David Garcia; Salluh, Jorge Ibrain Figueira; Lisboa, Thiago; Póvoa, Pedro

    2016-01-01

    Influenza pneumonia is associated with high number of severe cases requiring hospital and intensive care unit (ICU) admissions with high mortality. Systemic steroids are proposed as a valid therapeutic option even though its effects are still controversial. Heterogeneity of published data regarding study design, population demographics, severity of illness, dosing, type and timing of corticosteroids administered constitute an important limitation for drawing robust conclusions. However, it is...

  2. Corticosteroid Withdrawal Precipitates Perilesional Edema around Calcified Taenia solium Cysts

    OpenAIRE

    Mejia, Rojelio; Nash, Theodore E.

    2013-01-01

    Calcified Taenia solium granulomas are the focus of repeated episodes of perilesional edema and seizures in 50% of persons with calcifications, history of seizures, and a positive serology for cysticercosis. The pathophysiology is unclear but recent studies suggest the edema is caused by inflammation. We report two new cases and four other published cases where cessation of corticosteroids appeared to result in recurrence or new appearance of perilesional edema around calcifications. This sug...

  3. Neurosarcoidosis associated with hypersomnolence treated with corticosteroids and brain irradiation

    International Nuclear Information System (INIS)

    Narcoleptic features developed in a young man with CNS sarcoidosis. This was associated with a structural lesion in the hypothalamus as demonstrated on CT scans of the head. The diagnosis of narcolepsy was established by compatible clinical history and the Multiple Sleep Latency Test. Treatment with high-dose corticosteroids was ineffective, but when the low-dose, whole-brain irradiation was added, complete resolution of the narcoleptic features ensued

  4. Neurosarcoidosis associated with hypersomnolence treated with corticosteroids and brain irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Rubinstein, I.; Gray, T.A.; Moldofsky, H.; Hoffstein, V.

    1988-07-01

    Narcoleptic features developed in a young man with CNS sarcoidosis. This was associated with a structural lesion in the hypothalamus as demonstrated on CT scans of the head. The diagnosis of narcolepsy was established by compatible clinical history and the Multiple Sleep Latency Test. Treatment with high-dose corticosteroids was ineffective, but when the low-dose, whole-brain irradiation was added, complete resolution of the narcoleptic features ensued.

  5. Perioperative corticosteroid reduces hospital stay after fronto-orbital advancement.

    Science.gov (United States)

    Clune, James E; Greene, Arin K; Guo, Chao-Yu; Gao, Lin Lin; Kim, Sendia; Meara, John G; Proctor, Mark R; Mulliken, John B; Rogers, Gary F

    2010-03-01

    Facial swelling is common after fronto-orbital advancement. Edema and closure of the palpebral fissures can lead to prolonged hospitalization. The purpose of this study was to determine if perioperative corticosteroid shortens hospital stay after this procedure.We retrospectively studied consecutive children younger than 2 years who underwent primary fronto-orbital advancement between 1990 and 2008. Patients were categorized into 2 groups: group 1 patients were not given corticosteroid; group 2 patients received tapered perioperative dexamethasone. Primary outcome variables included length of hospital stay and infection rate.A total of 161 patients were included in the study. Hospitalization was significantly shorter (P = 0.008) for group 2 (n = 65; median duration, 3.0 d) than group 1 (n = 96; median duration, 5.0 d). Infection rates did not differ between groups (group 1, 2.1%; group 2, 1.5%; P = 0.8).Perioperative corticosteroid shortens hospitalization after fronto-orbital advancement without increasing the incidence of postoperative infection. The cost of postoperative hospital care was reduced by 27.2%. PMID:20186083

  6. Effectiveness of Blind & Ultrasound Guided Corticosteroid Injection in Impingement Syndrome

    Science.gov (United States)

    Haghighat, Shila; Taheri, Parisa; Banimehdi, Mohsen; Taghavi, Arash

    2016-01-01

    Local steroid injections are common for treatment of impingement syndrome. Corticosteroid injections methods are basically in two formats, blind or with image guidance. The aim of this study is to compare the effect of ultrasound-guided in comparison with blind corticosteroid injections in patients with impingement syndrome. This study is a randomized clinical trial study undertaken in patients with diagnosis of impingement syndrome done in Isfahan University of Medical Science clinics from February 2014 to February 2015. The number of all patients registered in the study is 48; and then 40 patients were allocated to either control group randomly which received blind steroid injection or case group that underwent ultrasound-guided steroid injection. The clinical symptoms were assessed using Shoulder Pain and Disability Index (SPADI) questionnaire, Visual Analogue Scale (VAS) and shoulder range of motion (ROM) using goniometer at baseline and six weeks after the injection. Data analysis revealed a significant difference in the mean of the VAS, SPADI and shoulder ROM in both groups 6 weeks after intervention (P guided corticosteroid injection had statistically significant improvements in function and shoulder ROM (abduction, flexion) compared to blind injection group after 6 weeks (P0.05). Our findings suggest that US image guided can improve the shoulder function of patients with impingement syndrome, and thus can be considered in comprehensive care programs of these patients for fast speed of rehabilitation.

  7. A severe case of acute exogenous lipoid pneumonia treated with systemic corticosteroid

    OpenAIRE

    Yasui, Hideki; Yokomura, Koshi; Suda, Takafumi

    2016-01-01

    Acute exogenous lipoid pneumonia is a rare disorder in adults. A treatment of choice for lipoid pneumonia has not been established, and systemic corticosteroid use remains controversial. We report the case of a 32-year-old man with schizophrenia who presented with kerosene-induced acute exogenous lipoid pneumonia that was treated with a systemic corticosteroid. In this case, supportive therapy did not improve the patient's condition, so systemic corticosteroid therapy was commenced four days ...

  8. Impact of the Topical Ophthalmic Corticosteroid Loteprednol Etabonate on Intraocular Pressure

    OpenAIRE

    Sheppard, John D.; Timothy L Comstock; Cavet, Megan E.

    2016-01-01

    Corticosteroids are a mainstay therapeutic option for the treatment of ocular inflammation. However, safety remains a concern for clinicians, particularly with long-term use. Though highly effective at suppressing inflammatory and allergic responses, topical ophthalmic corticosteroids carry an inherent risk of side effects, including elevated intraocular pressure (IOP), a risk factor for the development of glaucoma. The corticosteroid loteprednol etabonate (LE) contains an ester rather than a...

  9. Crystallization of Local Anesthetics When Mixed With Corticosteroid Solutions

    Science.gov (United States)

    Hwang, Hyeoncheol; Park, Jihong; Lee, Won Kyung; Lee, Woo Hyung; Leigh, Ja-Ho; Lee, Jin Joo; Chung, Sun G.; Lim, Chaiyoung; Park, Sang Jun

    2016-01-01

    Objective To evaluate at which pH level various local anesthetics precipitate, and to confirm which combination of corticosteroid and local anesthetic crystallizes. Methods Each of ropivacaine-HCl, bupivacaine-HCl, and lidocaine-HCl was mixed with 4 different concentrations of NaOH solutions. Also, each of the three local anesthetics was mixed with the same volume of 3 corticosteroid solutions (triamcinolone acetonide, dexamethasone sodium phosphate, and betamethasone sodium phosphate). Precipitation of the local anesthetics (or not) was observed, by the naked eye and by microscope. The pH of each solution and the size of the precipitated crystal were measured. Results Alkalinized with NaOH to a certain value of pH, local anesthetics precipitated (ropivacaine pH 6.9, bupivacaine pH 7.7, and lidocaine pH 12.9). Precipitation was observed as a cloudy appearance by the naked eye and as the aggregation of small particles (300 µm, pH 7.5). Ropivacaine with dexamethasone sodium phosphate also precipitated, but it was only observable by microscope (a few crystals of 10–100 µm, pH 7.0). Bupivacaine with betamethasone sodium phosphate formed precipitates of non-aggregated smaller particles (<10 µm, pH 7.7). Lidocaine mixed with corticosteroids did not precipitate. Conclusion Ropivacaine and bupivacaine can precipitate by alkalinization at a physiological pH, and therefore also produce crystals at a physiological pH when they are mixed with betamethasone sodium phosphate. Thus, the potential risk should be noted for their use in interventions, such as epidural steroid injections. PMID:26949665

  10. Benign fasciculations and Corticosteroid use: possible association? An update

    Directory of Open Access Journals (Sweden)

    Marco Orsini

    2011-09-01

    Full Text Available Fasciculations are characterized by visible subtle and fast contractions of muscle, even wormlike in movement, by the contraction of a fascicle of muscle fibers. The authors present the case study of a 28-year-old patient with the appearance of migratory and diffuse fasciculations with an onset after partial tapering off of oral corticosteroides (60 mg total dose indicated for treatment of Minimal change Glomerulopathy. Clinical Neurological physical exam allied with an ENMG, besides other complementary laboratory exams were used for screening the above-mentioned patient. Afterwards, current research relating to the topic at hand was made in order to update the data available in the Bireme, Scielo and PubMed Data Banks using the following key words: Fasciculation’s, motor neuron disease, and benign fasciculations in the Portuguese, English as well as Spanish language. Although fasciculation’s are most commonly associated with Motor neuron disease as well as with certain metabolic disorders, they may also be present in individuals with absolutely no underlying pathological disorders. In our case, fasciculation potentials that have been present for six months, with no other signs of a neurogenic disorder as well as absence of laboratory findings, the patient received a diagnosis of Benign Fasciculation Syndrome (BFS.We believe that the use of corticosteroides in high doses with subsequent tapering contributed to the fasciculation’s, especially due to the changes that this causes on the ionic channels. Fasciculation’s are symptoms seen in a large range of conditions, and also being the main symptom of the so-called Benign Fasciculation Syndrome. We have presented an example of this clinical syndrome in a patient whose complaint was fasciculation’s, with complete clinical remission of symptoms following complete tapering off of corticosteroid six months previously.

  11. Adjuvant corticosteroid therapy in hepatosplenic candidiasis-related IRIS

    Directory of Open Access Journals (Sweden)

    Cengiz Bayram

    2012-01-01

    Full Text Available

    Hepatosplenic candidiasis (HSC is a form of invasive fungal infection that occurs most commonly in patients with acute leukemia treated with chemotherapy and requires protracted antifungal therapy. Immune reconstitution inflammatory syndrome (IRIS is best characterized as a dysregulated inflammatory responses triggered by rapid resolution of immunosuppression.

    We present a child diagnosed with standard-risk precursor B cell-acute lymphoblastic leukemia who developed HSC and Candida-related IRIS during recovery of neutropenia associated with induction chemotherapy. Addition of corticosteroid therapy to antifungal treatment is associated with the resolution of the clinical symptoms and laboratory findings

  12. Experimental corticosteroid induction of Pneumocystis carinii pneumonia in piglets

    DEFF Research Database (Denmark)

    Nielsen, Jens; Bille-Hansen, Vivi; Settnes, O.P.

    1999-01-01

    Animal models of Pneumocystis carinii (Pc) pneumonia (PCP) play a central role in research on the Pc microorganism itself and the disease, especially the pathogenesis and the host defence. The classic rat model with corticosteroid-induced reactivation of a latent infection has been most widely used...... the frontal lung lobes and/or atelectatic looking diaphragmatic lobes. Histopathologically, there was a focal interstitial pneumonia. Alveolar walls and interstitia had mononuclear cell infiltrations and the alveolar lumina were occluded by foamy acidophilic honeycomb material with a varying number of...

  13. A Case of Recurrent Acute Pancreatitis Due to Intra-Articular Corticosteroid Injection

    Directory of Open Access Journals (Sweden)

    Patompong Ungprasert

    2014-03-01

    Full Text Available Context Corticosteroid is a well-established cause of drug-induced pancreatitis. However, acute pancreatitis from intraarticularinjection of corticosteroid has never been described. Case report A 69-year-old male presented with acuteabdominal pain and was diagnosed with acute pancreatitis. The patient had one episode of acute pancreatitis two yearearlier. Both episodes occurred after intra-articular cortisone injection. Investigations for other causes of pancreatitis werenegative. Conclusion We report the first case of acute pancreatitis from intra-articular corticosteroid injection. Physiciansshould be aware of this adverse reaction of corticosteroid that can even occur with local administration.

  14. Plasma transcortin influences endocrine and behavioral stress responses in mice

    OpenAIRE

    Richard, Elodie M.; Helbling, Jean-Christophe; Tridon, Claudine; Desmedt, Aline; Minni, Amandine; Cador, Martine; Pourtau, Line; Konsman, Jan Peter; Mormède, Pierre; Moisan, Marie-Pierre

    2010-01-01

    Glucocorticoids are released after hypothalamus-pituitary-adrenal axis stimulation by stress and act both in the periphery and in the brain to bring about adaptive responses that are essential for life. Dysregulation of the stress response can precipitate psychiatric diseases, in particular depression. Recent genetic studies have suggested that the glucocorticoid carrier transcortin, also called corticosteroid-binding globulin (CBG), may have an important role in stress response. We have inve...

  15. Purification and characterization of corticosteroid side chain isomerase

    International Nuclear Information System (INIS)

    Corticosteroid side chain isomerase of rat liver catalyzes the interconversion of the ketol (20-oxo-21-ol) and (20-hydroxy-21-al) forms of the corticosteroid side chain. The enzyme has now been purified to apparent homogeneity from rat liver cytosol by sequential chromatography on anionic, hydroxylapatite, and gel filtration columns. Ketol-aldol isomerization is followed by measuring the exchange of tritium from 21-tritiated steroids with water. The native enzyme is a dimer of MW 44,000. The isoelectric point is 4.8 ± 0.1 pH units. The purified enzyme is stimulated by Co3+ or Ni2+. The enzyme utilizes 11-deoxycorticosterone, corticosterone, and 17-deoxycortisol as substrate but not cortisol, tetrahydrocortisol, and prednisolone. Tritium-water exchange of (21S)-[21-3H]DOC is a pseudo-first-order reaction; 21-3H exchange from the 21R isomer proceeds with first-order kinetics only after a lag associated with its epimerization to the 21S form

  16. Effective topical delivery systems for corticosteroids: dermatological and histological evaluations.

    Science.gov (United States)

    Eroğlu, İpek; Azizoğlu, Erkan; Özyazıcı, Mine; Nenni, Merve; Gürer Orhan, Hande; Özbal, Seda; Tekmen, Işıl; Ertam, İlgen; Ünal, İdil; Özer, Özgen

    2016-06-01

    Atopic dermatitis (AD) is a chronic and relapsing skin disease with severe eczematous lesions. Long-term topical corticosteroid treatment can induce skin atrophy, hypopigmentation and transepidermal water loss (TEWL) increase. A new treatment approach was needed to reduce the risk by dermal targeting. For this purpose, Betamethasone valerate (BMV)/Diflucortolone valerate (DFV)-loaded liposomes (220-350 nm) were prepared and incorporated into chitosan gel to obtain adequate viscosity (∼13 000 cps). Drugs were localized in stratum corneum + epidermis of rat skin in ex-vivo permeation studies. The toxicity was assessed on human fibroblast cells. In point of in-vivo studies, pharmacodynamic responses, treatment efficacy and skin irritation were evaluated and compared with previously prepared nanoparticles. Liposome/nanoparticle in gel formulations produced higher paw edema inhibition in rats with respect to the commercial cream. Similar skin blanching effect with commercial creams was obtained via liposome in gels although they contain 10 times less drug. Dermatological scoring results, prognostic histological parameters and suppression of mast cell numbers showed higher treatment efficiency of liposome/nanoparticle in gel formulations in AD-induced rats. TEWL and erythema measurements confirmed these results. Overview of obtained results showed that liposomes might be an effective and safe carrier for corticosteroids in skin disease treatment. PMID:25259424

  17. Rate of improvement of pulmonary function in sarcoidosis during treatment with corticosteroids.

    OpenAIRE

    Goldstein, D. S.; Williams, M. H.

    1986-01-01

    Serial measurements of vital capacity were obtained in 11 patients with impaired pulmonary function due to sarcoidosis during 12 courses of corticosteroid treatment. Vital capacity improved promptly and approached a maximum value in about three weeks. A three week trial is probably sufficient to show whether or not corticosteroids are effective in a patient with sarcoidosis.

  18. Prescription audit of corticosteroid usage in the department of dermatology at a tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Mirshad PV

    2013-08-01

    Full Text Available Background: Corticosteroids are a group of commonly used drugs in dermatology practice whose non judicious use frequently results in undesirable and unwanted effects. Prescribing them rationally with care allows us to derive the maximum benefit out of them with minimal side effects. Methods: Retrospective analysis of 112 case files belonging to patients admitted in the department of dermatology over a period of one year was undertaken to ascertain the usage pattern of corticosteroids in relation to their potency, strength, frequency, duration, route, quantity to be applied. The data thus collected was expressed in terms of averages, ratios and proportions. Results: The total number of formulations prescribed were 929 out of which 10.8% were corticosteroids. The average number of formulations prescribed per patient was 8.29. About 78(70% patients admitted in dermatology received corticosteroids. Topical steroids were prescribed in 50 patients (44.7 % out of whom 36 (72% received only topical, the remaining 14(28% were prescribed both systemic and topical corticosteroids. Brand names were used in all cases. Highly potent corticosteroids like clobetasol, halobetasol and mometasone were prescribed to 39(50% of all cases who received topical corticosteroids. Conclusion: The study reveals the deficiencies which exist in the present prescribing pattern of corticosteroids. Educational interventions among the doctors as well as students should be carried out to in order to promote rational drug use. [Int J Basic Clin Pharmacol 2013; 2(4.000: 411-413

  19. An interesting uncommon side effect of topical corticosteroids-hidradenitis suppurativa

    Directory of Open Access Journals (Sweden)

    Yugandar Inakanti

    2015-07-01

    Full Text Available There are many local and systemic side-effects of topical corticosteroids. To the best of our Knowledge, Hidradenitis Supportive (HS due to topical corticosteroids has not been reported previously. We report a 39-year old, male patient who started himself a topical corticosteroid Pander Plus cream because of itching, scaly lesions over groins and buttocks since 6 months. After 4 months of topical treatment, he developed pus discharging sinuses over both groins and buttocks. Based on patient history, clinical and laboratory findings and the exclusion of other diagnoses, HS points out the use of topical corticosteroids. The case well highlights this unusual condition and represents the first case reported in India to our best of the knowledge. Having performed thorough literature search I would like to discuss in this report the evidence for this relation and stress the importance of appropriate usage of topical corticosteroids.

  20. The effect in premature infants of prenatal corticosteroids on endogenous surfactant synthesis as measured with stable isotopes

    NARCIS (Netherlands)

    J.E.H. Bunt (Jan Erik); V.P. Carnielli (Virgilio); J.L.D. Wattimena (Josias); W.C.J. Hop (Wim); P.J.J. Sauer (Pieter); L.J.I. Zimmermann (Luc)

    2000-01-01

    textabstractMost in vitro studies show that prenatal administration of corticosteroids stimulates the synthesis of surfactant phosphatidylcholine (PC), but studies in animals are controversial. Whether prenatal corticosteroids stimulate surfactant PC synthesis in humans

  1. The effect in premature infants of prenatal corticosteroids on endogenous surfactant synthesis as measured with stable isotopes

    NARCIS (Netherlands)

    Bunt, JEH; Carnielli, VP; Wattimena, JLD; Hop, WC; Sauer, PJJ; Zimmermann, LJI

    2000-01-01

    Most in vitro studies show that prenatal administration of corticosteroids stimulates the synthesis of surfactant phosphatidylcholine (PC), but studies in animals are controversial. Whether prenatal corticosteroids stimulate surfactant PC synthesis in humans has not been studied. We studied endogeno

  2. short history of anti-rheumatic therapy. IV. Corticosteroids

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available In 1948 a corticosteroid compound was administered for the first time to a patient affected by rheumatoid arthritis by Philip Showalter Hench, a rheumatologist at the Mayo Clinic in Rochester, Minnesota (USA. He was investigating since 1929 the role of adrenal gland-derived substances in rheumatoid arthritis. For the discovery of cortisone and its applications in anti-rheumatic therapy, Hench, along with Edward Calvin Kendall and Tadeusz Reichstein, won the 1950 Nobel Prize for Medicine. In this review we summarize the main stages that led to the identification of the so-called compound E, which was used by Hench. We also consider the subsequent development of steroid therapy in rheumatic diseases, through the introduction of new molecules with less mineralocorticoid effects, such as prednisone, and more recently, deflazacort.

  3. Risks of pneumonia in patients with asthma taking inhaled corticosteroids

    DEFF Research Database (Denmark)

    O'Byrne, Paul M; Pedersen, Soren; Carlsson, Lars-Göran;

    2011-01-01

    Rationale: Inhaled corticosteroids (ICS) are the mainstay of asthma treatment. Studies in chronic obstructive pulmonary disease reported increased rates of pneumonia with ICS. Concerns exist about an increased pneumonia risk in patients with asthma taking ICS. Objectives: To evaluate the risks...... of pneumonia in patients with asthma taking ICS. Methods: A retrospective analysis evaluated studies of the ICS budesonide in asthma. The primary data set were all double-blind, placebo-controlled trials lasting at least 3 months, involving budesonide (26 trials, n = 9,067 for budesonide; n = 5.......70% (12.7 per TPY), whereas the percentage of patients reporting pneumonia SAEs was 0.17% (3.1 per TPY). There was no increased risk with higher budesonide doses or any difference between budesonide and fluticasone. Conclusions: There is no increased risk of pneumonia in patients with asthma, identified...

  4. Intermittent inhaled corticosteroids in infants with episodic wheezing

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Hermansen, Mette Northman; Loland, Lotte; Halkjaer, Liselotte Brydensholt; Buchvald, Frederik

    2006-01-01

    BACKGROUND: We hypothesized that asthma is preceded by a stage of recurrent episodes of wheezing during the first years of life and that inhaled corticosteroid therapy during symptomatic episodes in this early phase may delay progression to persistent wheezing. METHODS: We assigned one-month-old...... infants to treatment with two-week courses of inhaled budesonide (400 mug per day) or placebo, initiated after a three-day episode of wheezing, in this single-center, randomized, double-blind, prospective study of three years' duration. The primary outcome was the number of symptom-free days; key...... (hazard ratio, 1.22; 95 percent confidence interval, 0.71 to 2.13)--a finding that was unaffected by the presence or absence of atopic dermatitis. The mean duration of the acute episodes was 10 days in both groups and was independent of respiratory viral status. Height and bone mineral density were not...

  5. [Treatment with topical corticosteroids in severe or resistant dermatoses].

    Science.gov (United States)

    Nolting, S

    1985-01-01

    The efficacy and safety of betamethasone dipropionate glycol cream 0.05% and desoximetasone ointment 0.25% were compared in a randomized, double-blind study of 80 patients with resistant or severe corticosteroid-responsive dermatoses. Medication was applied to affected areas at a dosage of 3.5 grams twice daily for 14 days. In each treatment group, evaluation of efficacy was based on results in 35 patients and that of safety in 40 patients. Among betamethasone dipropionate glycol cream 0.05%-treated patients, signs and symptoms of dermatologic disease either cleared completely or markedly improved in 34/35 (97%). Comparable responses were observed in 31/35 (89%) patients treated with desoximetasone ointment 0.25%. Local tolerance to both study medications was excellent; no adverse reactions occurred. Plasma cortisol reduction occurred in few patients (4 resp. 3 patients each group), however this effect was only transient and reversible. PMID:2931266

  6. Oral Corticosteroids in Asthma: A Review of Benefits and Risks

    Directory of Open Access Journals (Sweden)

    Robert Schellenberg

    2007-01-01

    Full Text Available Oral corticosteroids (OCS play an integral role in the pharmacological management of asthma, as well as a number of other inflammatory and autoimmune disorders. However, although their broad spectrum of effect is beneficial in controlling inflammation, it can also lead to undesirable effects on other cells, resulting in adverse effects. The purpose of the present review is to discuss the particular benefits of OCS and to outline the optimal role of these agents in the management of asthma, drawing on evidence-based medicine and current clinical practice guidelines. The mandate for the present review also covers an analysis of the risk:benefit ratio as it pertains to OCS use in asthma. The more common adverse effects will be discussed and weighed against the possible benefits.

  7. Oral and inhaled corticosteroids: Differences in P-glycoprotein (ABCB1) mediated efflux

    International Nuclear Information System (INIS)

    There is concern that P-glycoprotein mediated efflux contributes to steroid resistance. Therefore, this study examined bidirectional corticosteroid transport and induction capabilities for P-glycoprotein (P-gp) to understand which of the systemic and inhaled corticosteroids interacted with P-gp to the greatest extent. Hydrocortisone, prednisolone, prednisone, methylprednisolone, and dexamethasone represented systemically active drugs, while fluticasone propionate, beclomethasone dipropionate, ciclesonide and budesonide represented inhaled corticosteroids. Aldosterone and fludrocortisone represented mineralocorticoids. All drugs were detected using individually optimised HPLC protocols. Transport studies were conducted through Caco-2 monolayers. Hydrocortisone and aldosterone had efflux ratios below 1.5, while prednisone showed a P-gp mediated efflux ratio of only 1.8 compared to its active drug, prednisolone, with an efflux ratio of 4.5. Dexamethasone and beclomethasone had efflux ratios of 2.1 and 3.3 respectively, while this increased to 5.1 for methylprednisolone. Fluticasone showed an efflux ratio of 2.3. Protein expression studies suggested that all of the inhaled corticosteroids were able to induce P-gp expression, from 1.6 to 2 times control levels. Most of the systemic corticosteroids had higher passive permeability (> 20 × 10−6 cm/s) compared to the inhaled corticosteroids (> 5 × 10−6 cm/s), except for budesonide, with permeability similar to the systemic corticosteroids. Inhaled corticosteroids are not transported by P-gp to the same extent as systemic corticosteroids. However, they are able to induce P-gp production. Thus, inhaled corticosteroids may have greater interactions with other P-gp substrates, but P-gp itself is less likely to influence resistance to the drugs. -- Highlights: ► Inhaled corticosteroids are only weak substrates for P-gp, including budesonide. ► Inhaled corticosteroid potent P-gp inducers especially fluticasone and

  8. Oral and inhaled corticosteroids: Differences in P-glycoprotein (ABCB1) mediated efflux

    Energy Technology Data Exchange (ETDEWEB)

    Crowe, Andrew, E-mail: a.p.crowe@curtin.edu.au; Tan, Ai May

    2012-05-01

    There is concern that P-glycoprotein mediated efflux contributes to steroid resistance. Therefore, this study examined bidirectional corticosteroid transport and induction capabilities for P-glycoprotein (P-gp) to understand which of the systemic and inhaled corticosteroids interacted with P-gp to the greatest extent. Hydrocortisone, prednisolone, prednisone, methylprednisolone, and dexamethasone represented systemically active drugs, while fluticasone propionate, beclomethasone dipropionate, ciclesonide and budesonide represented inhaled corticosteroids. Aldosterone and fludrocortisone represented mineralocorticoids. All drugs were detected using individually optimised HPLC protocols. Transport studies were conducted through Caco-2 monolayers. Hydrocortisone and aldosterone had efflux ratios below 1.5, while prednisone showed a P-gp mediated efflux ratio of only 1.8 compared to its active drug, prednisolone, with an efflux ratio of 4.5. Dexamethasone and beclomethasone had efflux ratios of 2.1 and 3.3 respectively, while this increased to 5.1 for methylprednisolone. Fluticasone showed an efflux ratio of 2.3. Protein expression studies suggested that all of the inhaled corticosteroids were able to induce P-gp expression, from 1.6 to 2 times control levels. Most of the systemic corticosteroids had higher passive permeability (> 20 × 10{sup −6} cm/s) compared to the inhaled corticosteroids (> 5 × 10{sup −6} cm/s), except for budesonide, with permeability similar to the systemic corticosteroids. Inhaled corticosteroids are not transported by P-gp to the same extent as systemic corticosteroids. However, they are able to induce P-gp production. Thus, inhaled corticosteroids may have greater interactions with other P-gp substrates, but P-gp itself is less likely to influence resistance to the drugs. -- Highlights: ► Inhaled corticosteroids are only weak substrates for P-gp, including budesonide. ► Inhaled corticosteroid potent P-gp inducers especially

  9. Concomitant use of corticosteroid and antimicrobials for liver abscesses in patients with chronic granulomatous disease.

    Science.gov (United States)

    Shin, Kyung-Sue; Lee, Mu Suk

    2016-04-01

    Chronic granulomatous disease (CGD) is a rare inherited disorder caused by defective nicotinamide adenine dinucleotide phosphate oxidase enzyme and characterized by recurrent bacterial and fungal infections. Although liver abscess is a common manifestation of CGD, its management in CGD patients is not well-defined. In addition, the generalized guidelines for treating liver abscesses do not necessarily apply to CGD patients. Corticosteroids are commonly used to control granulomatous complications, such as inflammatory gastrointestinal and genitourinary lesions, in patients with CGD, Corticosteroids have also been used in combination with antimicrobials to treat refractory infections in patients with CGD. Because corticosteroids are capable of suppressing symptomatic inflammation, all potential infections must be adequately controlled prior to corticosteroid initiation. We report 3 typical CGD cases with liver abscesses refractory to conventional treatments that were successfully treated with the concomitant use of corticosteroid and antimicrobials. It remains unclear whether corticosteroid therapy is required for liver abscesses in CGD refractory to conventional treatments. However, based on our observations, use of corticosteroids in combination with optimal antimicrobials should be considered for refractory liver abscesses in CGD. PMID:27186231

  10. A severe case of acute exogenous lipoid pneumonia treated with systemic corticosteroid.

    Science.gov (United States)

    Yasui, Hideki; Yokomura, Koshi; Suda, Takafumi

    2016-01-01

    Acute exogenous lipoid pneumonia is a rare disorder in adults. A treatment of choice for lipoid pneumonia has not been established, and systemic corticosteroid use remains controversial. We report the case of a 32-year-old man with schizophrenia who presented with kerosene-induced acute exogenous lipoid pneumonia that was treated with a systemic corticosteroid. In this case, supportive therapy did not improve the patient's condition, so systemic corticosteroid therapy was commenced four days after he ingested the kerosene. After corticosteroid commencement, the patient's symptoms and hypoxia improved within a few days. Although some radiological characteristics of this disorder have been reported previously, the process of radiological improvement of exogenous lipoid pneumonia is not well known. In this case, computed tomography findings changed dramatically after corticosteroid therapy was initiated. Extensive bilateral consolidations that were observed on admission improved. Although pneumatoceles developed two weeks after corticosteroid commencement, they were nearly gone after two months of the treatment. While corticosteroid therapy is not suitable for all cases, it should be considered for severe or refractory cases. PMID:27222789

  11. A severe case of acute exogenous lipoid pneumonia treated with systemic corticosteroid

    Directory of Open Access Journals (Sweden)

    Hideki Yasui

    2016-01-01

    Full Text Available Acute exogenous lipoid pneumonia is a rare disorder in adults. A treatment of choice for lipoid pneumonia has not been established, and systemic corticosteroid use remains controversial. We report the case of a 32-year-old man with schizophrenia who presented with kerosene-induced acute exogenous lipoid pneumonia that was treated with a systemic corticosteroid. In this case, supportive therapy did not improve the patient's condition, so systemic corticosteroid therapy was commenced four days after he ingested the kerosene. After corticosteroid commencement, the patient's symptoms and hypoxia improved within a few days. Although some radiological characteristics of this disorder have been reported previously, the process of radiological improvement of exogenous lipoid pneumonia is not well known. In this case, computed tomography findings changed dramatically after corticosteroid therapy was initiated. Extensive bilateral consolidations that were observed on admission improved. Although pneumatoceles developed two weeks after corticosteroid commencement, they were nearly gone after two months of the treatment. While corticosteroid therapy is not suitable for all cases, it should be considered for severe or refractory cases.

  12. Cross-reactions to desoximetasone and mometasone furoate in a patient with multiple topical corticosteroid allergies.

    Science.gov (United States)

    Donovan, Jeffrey C H; Dekoven, Joel G

    2006-09-01

    A 60-year-old man developed a bullous contact dermatitis after topical corticosteroid treatment of dermatitis on his lower leg. Subsequent patch testing showed cross-reactions to numerous group B and group D corticosteroids as well as cross-reactions to group C desoximetasone and group D1 mometasone furoate. His patch-test result was negative for the group A corticosteroids hydrocortisone and tixocortol pivalate. We discuss the uncommon finding of cross-reactions to desoximetasone and mometasone furoate. PMID:16956468

  13. Azathioprine as a corticosteroid-sparing agent in air-borne contact dermatitis

    Directory of Open Access Journals (Sweden)

    Verma Kaushal

    1996-01-01

    Full Text Available Two patients having air-borne contact dermatitis (ABCD caused by Parthenium hysterophorus.for 10 and 15 years respectively and without having had complete remissions in spite of oral betamethasone in a dose of 2-3 mg per day, experienced complete relief while taking 50-100 mg azathioprine for 5 and 12 weeks without having to take systemic corticosteroids. There were no side effects of azathioprine. With further experience and standardization of the treatment schedule, it may be possible to use azathioprine as a corticosteroid-sparing agent to reduce the side effects of corticosteroids in patients having ABCD.

  14. Erratum to: Safety Considerations of Inhaled Corticosteroids in the Elderly.

    Science.gov (United States)

    Battaglia, Salvatore; Cardillo, Irene; Lavorini, Federico; Spatafora, Mario; Scichilone, Nicola

    2015-12-01

    Inhaled corticosteroids (ICSs) are widely used in the treatment of patients with chronic obstructive pulmonary diseases. However, high-dose regimens and long-term use of ICSs have the potential to cause a variety of local and systemic side effects such as candidiasis, cataracts, glaucoma, and osteoporosis. The use of ICSs can also be associated with the risk of bone fractures, diabetes mellitus and pneumonia. These ICS-related side effects are of particular importance in elderly patients due to the presence of comorbidities and age-related behavioral, cognitive, and psychological problems, which can all interact with inhaled treatment. We reviewed the available literature on the clinically relevant side effects of ICSs in the elderly to provide practical measures to properly monitor and manage the risk of ICSs in the geriatric population. Inspection of the mouth, monitoring of ocular pressure, and use of bone-protective drugs may be necessary in patients on prolonged ICS therapy. Above all, the use of the lowest possible ICS dose and a careful re-assessment of the inhalation procedure should be recommended. Taken together, these observations suggest that physicians should use ICSs appropriately for those patients in whom the benefit will outweigh the risk, especially chronic obstructive pulmonary disease (COPD) patients with previous frequent exacerbations. Given the paucity of information on the topic and the need to extrapolate the results from studies with broader age ranges, we strongly encourage the design of specifically tailored clinical studies in the elderly. PMID:26578157

  15. Safety considerations of inhaled corticosteroids in the elderly.

    Science.gov (United States)

    Battaglia, Salvatore; Cardillo, Irene; Lavorini, Federico; Spatafora, Mario; Scichilone, Nicola

    2014-11-01

    Inhaled corticosteroids (ICSs) are widely used in the treatment of patients with chronic obstructive pulmonary diseases. However, high-dose regimens and long-term use of ICSs have the potential to cause a variety of local and systemic side effects such as candidiasis, cataracts, glaucoma, and osteoporosis. The use of ICSs can also be associated with the risk of bone fractures, diabetes mellitus and pneumonia. These ICS-related side effects are of particular importance in elderly patients due to the presence of comorbidities and age-related behavioral, cognitive, and psychological problems, which can all interact with inhaled treatment. We reviewed the available literature on the clinically relevant side effects of ICSs in the elderly to provide practical measures to properly monitor and manage the risk of ICSs in the geriatric population. Inspection of the mouth, monitoring of ocular pressure, and use of bone-protective drugs may be necessary in patients on prolonged ICS therapy. Above all, the use of the lowest possible ICS dose and a careful re-assessment of the inhalation procedure should be recommended. Taken together, these observations suggest that physicians should use ICSs appropriately for those patients in whom the benefit will outweigh the risk, especially chronic obstructive pulmonary disease (COPD) patients with previous frequent exacerbations. Given the paucity of information on the topic and the need to extrapolate the results from studies with broader age ranges, we strongly encourage the design of specifically tailored clinical studies in the elderly. PMID:25212953

  16. Inhaled corticosteroids: hazardous effects on voice-an update.

    Science.gov (United States)

    Gallivan, Gregory J; Gallivan, K Holly; Gallivan, Helen K

    2007-01-01

    Inhaled corticosteroids (ICS) have become the prevalent treatment in asthmatics. Hazards to voice are under-recognized. A total of 38 patients with voice complaints associated with the use of ICS were assessed by 79 strobovideolaryngoscopy (SVL) examinations, 24 single and 14 multiple SVL. Hoarseness and dysphonia were the primary reasons for referral. The ICS initially used most frequently was Advair Diskus (fluticasone propionate and salmeterol-inhalation powder-[IP]) in 22 patients, followed by Flovent (fluticasone propionate inhalation aerosol-pressurized metered-dose inhaler-[PMDI]) in 11. Duration of ICS usage varied from 2 weeks to 4-5 years. Higher dosage and frequency of use exacerbated problems. Hazards to voice previously unrecognized by real-time indirect mirror or fiberoptic laryngoscopy were identified by meticulous attention to SVL abnormalities. There was essentially no difference in occurrence of abnormalities whether analyzed from the perspective of the initial 38 or all 79 examinations. These included abnormal mucosal wave symmetry/periodicity (76-63%), phase closure (74-63%), glottic closure (63-59%), mucosal wave amplitude/magnitude (50-35%), supraglottic hyperactivity (39-25%), mucosal quality (34-34%), and glottic plane (10-5%). Candidiasis of the larynx was infrequently observed. Fluticasone ICS were a cause of steroid inhaler laryngitis, and the best treatment was their avoidance or cessation. Further prospective studies ideally might include SVL documented as a pretherapy baseline and then repeated in each ICS patient who developed hoarseness/dysphonia. PMID:16442776

  17. 'Low-dose' corticosteroid prophylaxis against fat embolism.

    Science.gov (United States)

    Kallenbach, J; Lewis, M; Zaltzman, M; Feldman, C; Orford, A; Zwi, S

    1987-10-01

    The effect of 'low-dose' corticosteroids (9 mg/kg methylprednisolone), given after skeletal trauma, on the incidence of the fat embolism syndrome and isolated arterial hypoxemia was studied in 42 controls and 40 steroid-treated subjects. Fat embolism occurred in ten controls (23.8%) and one steroid-treated subject (2.5%) (p = 0.01). A further 44 subjects developed isolated hypoxemia. This was severe (PaO2 less than 50 mm Hg) in seven of 32 controls (21.9%) and one of 39 steroid-treated subjects (2.6%) (p = 0.01). The overall incidence of hypoxemia was 67.1%, affecting 33 controls (78.6%) and 22 steroid-treated patients (55%) (p less than 0.05). The degree of hypoxemia was severe (PaO2 less than 50 mm Hg) in 12 controls (28.6%) and two (5%) of the steroid-treated subjects (p = 0.005). No control subject died or required mechanical ventilation. One steroid-treated subject without fat embolism died of a fulminant infection. Although methylprednisolone in a relatively low dose provides protection against fat embolism and pulmonary dysfunction after skeletal trauma, the safety of this therapy requires further evaluation. PMID:3312625

  18. CT findings in brain edema following the administration of corticosteroids

    International Nuclear Information System (INIS)

    Computed tomography (CT) is the first noninvasive method available for directly visualizing brain edema in man. On CT scans perifocal edema is shown as an area of low density surrounding a lesion. The purpose of this report is to evaluate the effect of corticosteroids on brain edema as seen by CT (HITACHI CT-H 250). Nine patients with brain-tumor and one with brain-abscess were treated with betamethasone for about ten days (dosage started with 12 - 16 mg/day, and tapered). In eight cases, and improvement in the neurological findings was observed. An impressive reduction of peritumoral edema was shown on CT scans in six of these eight cases. There was, however, no significant correlation between the degree of the reduction of edema on CT and that of the improvement in neurological findings. The mode of the CT number in the region of edema did not differ significantly between pre- and post-steroid treatment in the cases showing a recognizable reduction of edema on CT. This failure to change is probably due to the insufficient mechanical accuracy of the CT scanner at the present stage of technology. Through our experiences, it seems that CT is one of the most promising tools for a dynamic study of brain edema in man. (author)

  19. Outcome of Long-Term Corticosteroid Treatment in Duchenne Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-06-01

    Full Text Available The clinical orthopedic effects of chronic daily corticosteroid treatment were evaluated by chart review in boys with genetically confirmed Duchenne muscular dystrophy (DMD followed at the Ohio State University Muscular Dystrophy Clinic between 2000 and 2003.

  20. Outcome of Long-Term Corticosteroid Treatment in Duchenne Muscular Dystrophy

    OpenAIRE

    J Gordon Millichap

    2007-01-01

    The clinical orthopedic effects of chronic daily corticosteroid treatment were evaluated by chart review in boys with genetically confirmed Duchenne muscular dystrophy (DMD) followed at the Ohio State University Muscular Dystrophy Clinic between 2000 and 2003.

  1. Decline in effectiveness of antenatal corticosteroids with time to birth: real or artefact?

    OpenAIRE

    Gates, Simon; Brocklehurst, Peter

    2007-01-01

    The widely accepted notion that the benefits of antenatal corticosteroids decline with time to birth may not be correct, argue Simon Gates and Peter Brocklehurst, as the evidence is based on unsound subgroup analyses

  2. Inhaled Corticosteroids and Risk of Lung Cancer among Patients with Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Parimon, Tanyalak; Chien, Jason W.; Bryson, Chris L.; McDonell, Mary B; Udris, Edmunds M.; Au, David H

    2006-01-01

    Rationale and Objectives: Lung cancer is a frequent cause of death among patients with chronic obstructive pulmonary disease (COPD). We examined whether the use of inhaled corticosteroids among patients with COPD was associated with a decreased risk of lung cancer.

  3. Effects of Acute Administration of Corticosteroids during Mechanical Ventilation on Rat Diaphragm

    OpenAIRE

    Maes, Karen; Testelmans, Dries; Cadot, Pascal; DeRuisseau, Keith; Powers, Scott K.; Decramer, Marc; Gayan-Ramirez, Ghislaine

    2008-01-01

    Rationale: Mechanical ventilation is known to induce ventilator-induced diaphragm dysfunction. Patients submitted to mechanical ventilation often receive massive doses of corticosteroids that may cause further deterioration of diaphragm function.

  4. The Effect of an Inhaled Corticosteroid on Glucose Control in Type 2 Diabetes

    OpenAIRE

    Faul, John L.; Wilson, Sandra R.; Chu, James W.; Canfield, James; Kuschner, Ware G.

    2009-01-01

    Objective: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD).

  5. Adrenal insufficiency as a result of long-term misuse of topical corticosteroids.

    Science.gov (United States)

    Böckle, Barbara C; Jara, David; Nindl, Werner; Aberer, Werner; Sepp, Norbert T

    2014-01-01

    The treatment of chronic inflammatory skin disease is associated with the use of topical corticosteroids. Their efficacy, tolerability and adverse effects depend on several factors, specifically potency, type of preparation, extemporaneous dilutions, quantity used, magnitude of the treated body surface, frequency of application, location, patient age, method of application and condition of the skin barrier. We report on two men suffering from chronic inflammatory skin disease, who presented with fatigue and cushingoid appearance after prolonged self-application of potent corticosteroids. Impairment of the skin barrier due to their underlying skin disease, frequent self-application of topical steroids and repeated application of the entire body led to extensive absorption of these substances, eventually culminating in the suppression of the pituitary-hypothalamic-adrenal axis. In conclusion, topical corticosteroids are effective and well-established therapeutic modalities. However, inappropriate use of topical corticosteroids can cause side effects. PMID:24751677

  6. Comparing the effectiveness of small-particle versus large-particle inhaled corticosteroid in COPD

    NARCIS (Netherlands)

    Postma, Dirkje S.; Roche, Nicolas; Colice, Gene; Israel, Elliot; Martin, Richard J.; van Aalderen, Willem M. C.; Grigg, Jonathan; Burden, Anne; Hillyer, Elizabeth V.; von Ziegenweidt, Julie; Gopalan, Gokul; Price, David

    2014-01-01

    Purpose: Small airway changes and dysfunction contribute importantly to airway obstruction in chronic obstructive pulmonary disease (COPD), which is currently treated with inhaled corticosteroids (ICS) and long-acting bronchodilators at Global initiative for Obstructive Lung Disease (GOLD) grades 2-

  7. The role of inhaled corticosteroids in management of asthma in infants and preschoolers

    DEFF Research Database (Denmark)

    Castro-Rodriguez, Jose A; Pedersen, Søren

    2013-01-01

    This review analyses published data on the treatment of wheezing in infants and preschoolers with inhaled corticosteroids (ICS), including the effect in subgroups of patients such as 'multiple trigger wheeze' and 'episodic viral wheeze'....

  8. Corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Woods JA

    2014-05-01

    Full Text Available J Andrew Woods,1 James S Wheeler,1 Christopher K Finch,2 Nathan A Pinner3 1School of Pharmacy, Wingate University, Wingate, NC, USA; 2Department of Pharmacy, Methodist University Hospital, Memphis, TN, USA; 3Harrison School of Pharmacy, Auburn University, Auburn, AL, USA Background: Chronic obstructive pulmonary disease (COPD is a chronic and progressive disease that affects an estimated 10% of the world's population over the age of 40 years. Worldwide, COPD ranks in the top ten for causes of disability and death. Given the significant impact of this disease, it is important to note that acute exacerbations of COPD (AECOPD are by far the most costly and devastating aspect of disease management. Systemic steroids have long been a standard for the treatment of AECOPD; however, the optimal strategy for dosing and administration of these medications continues to be debated. Objective: To review the use of corticosteroids in the treatment of acute exacerbations of COPD. Materials and methods: Literature was identified through PubMed Medline (1950–February 2014 and Embase (1950–February 2014 utilizing the search terms corticosteroids, COPD, chronic bronchitis, emphysema, and exacerbation. All reference citations from identified publications were reviewed for possible inclusion. All identified randomized, placebo-controlled trials, meta-analyses, and systematic reviews evaluating the efficacy of systemic corticosteroids in the treatment of AECOPD were reviewed and summarized. Results: The administration of corticosteroids in the treatment of AECOPD was assessed. In comparison to placebo, systemic corticosteroids improve airflow, decrease the rate of treatment failure and risk of relapse, and may improve symptoms and decrease the length of hospital stay. Therefore, corticosteroids are recommended by all major guidelines in the treatment of AECOPD. Existing literature suggests that low-dose oral corticosteroids are as efficacious as high

  9. Penetration of topical and sub-conjunctival corticosteroids into human aqueous humour and its therapeutic significance

    OpenAIRE

    Awan, Muhammad Amer; Agarwal, Pankaj Kumar; Watson, D.G.; McGhee, Charles N. J.; Gordon N. Dutton

    2009-01-01

    Abstract Topical and subconjunctival corticosteroids are one of the most effective and compelling treatment options in ocular inflammatory diseases. A systematic review of literature indexed by Ovid MEDLINE & EMBASE was performed up to December 2008. There are few studies on their aqueous penetration in human subjects. In this review article we discussed the penetration of different ocular corticosteroids into human aqueous humour along with the therapeutic implications on managem...

  10. Radiation pneumonitis in mice. Some effects of corticosteroids on mortality and pulmonary physiology.

    OpenAIRE

    Gross, N J

    1980-01-01

    The fall in pulmonary compliance in mice with radiation pneumonitis is associated with increased microvascular leakage of plasma proteins into the alveolar spaces and increased surfactant phospholipids in the lung and alveolar fluid. In the present experiments we examined the effect of corticosteroid adminitration on these two effects and on pulmonary mechanics 16 wk after x irradiation of the thorax. Survival in irradiated animals that received corticosteroids was markedly better during the ...

  11. Corticosteroid Treatments in Males With Duchenne Muscular Dystrophy: Treatment Duration and Time to Loss of Ambulation

    OpenAIRE

    Kim, Sunkyung; Campbell, Kimberly A.; Fox, Deborah J.; Matthews, Dennis J.; Valdez, Rodolfo

    2014-01-01

    This population-based study examines the association between corticosteroid treatment and time to loss of ambulation, stratifying by treatment duration (short: 0.25–3 years, long: >3 years), among 477 Duchenne muscular dystrophy cases identified by the Muscular Dystrophy Surveillance Tracking and Research Network (MDSTARnet). Those cases who received short-term corticosteroid treatment had a time to loss of ambulation that was 0.8 years shorter (t test) and an annual risk of losing ambulation...

  12. A Case of Subacute Encephalopathy Developing After Treatment With Clofarabine and Methotrexate That Resolved With Corticosteroids.

    Science.gov (United States)

    Tzachanis, Dimitrios; Haider, Mintallah; Papazisis, Georgios

    2016-01-01

    This is the case of a 24-year-old woman with relapsed acute undifferentiated leukemia who developed subacute encephalopathy with hemiparesis and dysarthria after treatment with high dose and intrathecal methotrexate, clofarabine, and cytarabine that resolved rapidly and completely after the administration of corticosteroids. We hypothesize that clofarabine might predispose to methotrexate-induced central nervous system toxicity by increasing endothelial permeability (capillary leak syndrome) and suggest that corticosteroids are effective in the treatment of this type of encephalopathy. PMID:24987945

  13. Corticosteroids or non-corticosteroids:a fresh perspective on alcoholic hepatitis treatment

    Institute of Scientific and Technical Information of China (English)

    FeiWang; Bing-YuanWang

    2011-01-01

    BACKGROUND: Alcoholic hepatitis (AH) is a necrotizing inflammatory process caused by alcoholic liver injury. It carries a significant short-term mortality. The management of AH is challenging. Although corticosteroids have been demonstrated to exert anti-inflammatory and antifibrotic effects, their efficacy for the treatment of AH remains debatable. DATA  SOURCES: A literature search was performed of MEDLINE, ScienceDirect, SpringerLink and Wiley InterScience usingthekey words"alcoholichepatitis","alcoholicliverdisease", and "corticosteroids". The available data reported in the relevant literaturewereanalyzed. RESULTS: More than 17 controlled trials and at least 13 meta-analyses have reported the efficacy of corticosteroids in the treatment of AH in the past 40 years. Many were poorly designed and used different inclusion/exclusion criteria, making it difficult to reach a consensus. In this review, we summarized all the controversial data in the past decade and analyzed the potential causes for the varying therapeutic effects of corticosteroids in AH. The focus of the controversy has changed from "whether steroids are beneficial or harmful for AH patients" to "how to accurately identify responders to steroids early and rationalize corticosteroid treatment". An early response to glucocorticoids, as determined by calculating the Lille score after 7 days of treatment, has been shown to be a clinically useful indicator. Moreover, down-regulation of steroid sensitivity, risk of infection, and a rational therapeutic strategy of corticosteroids in AH patients are all crucial for therapeutic effect. CONCLUSIONS: An early and accurate determination of steroid sensitivity is important. Besides, we need to overcome the down-regulation of steroid sensitivity, reduce the infection risk and rationalize the therapeutic strategy of corticosteroids. A fresh perspective is needed on the use of corticosteroids in AH patients.

  14. Morphological correlates of corticosteroid-induced changes in prefrontal cortex-dependent behaviors

    OpenAIRE

    Cerqueira, J; Pêgo, J.; Taipa, R; Bessa, J.; Almeida, O.; Sousa, N

    2005-01-01

    Imbalances in the corticosteroid milieu have been implicated in several neuropsychiatric disorders, including depression and schizo-phrenia. Prefrontal cortex (PFC) dysfunction is also a hallmark of these conditions, causing impairments in executive functions such as behavioral flexibility and working memory. Recent studies have suggested that the PFC might be influenced by corticosteroids released during stress. To test this possibility, we assessed spatial working memory and behavi...

  15. Activity of different desoximetasone preparations compared to other topical corticosteroids in the vasoconstriction assay

    OpenAIRE

    Borelli, Claudia; Gassmueller, J.; Fluhr, J. W.; Nietsch, K. H.; Schinzel, S.; Korting, Hans Christian

    2008-01-01

    Introduction: We report on a double-blind, vehicle-controlled, single-center confirmatory study with random assignment. The purpose of the study was to investigate the topical bioavailability of different topical corticosteroid formulations in healthy human beings focussing on desoximetasone (DM). Materials and Methods: Two DM 0.25% formulations {[}ointment (DM-o) and fatty ointment (DM-fo, water-free); class III corticosteroids], the corresponding active ingredient-free vehicles and three co...

  16. Chronic Plantar Fasciitis: Effect of Platelet-Rich Plasma, Corticosteroid, and Placebo.

    Science.gov (United States)

    Mahindra, Pankaj; Yamin, Mohammad; Selhi, Harpal S; Singla, Sonia; Soni, Ashwani

    2016-01-01

    Plantar fasciitis is a common cause of heel pain. It is a disabling disease in its chronic form. It is a degenerative tissue condition of the plantar fascia rather than an inflammation. Various treatment options are available, including nonsteroidal anti-inflammatory drugs, corticosteroid injections, orthosis, and physiotherapy. This study compared the effects of local platelet-rich plasma, corticosteroid, and placebo injections in the treatment of chronic plantar fasciitis. In this double-blind study, patients were divided randomly into 3 groups. Local injections of platelet-rich plasma, corticosteroid, or normal saline were given. Patients were assessed with the visual analog scale for pain and with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot score before injection, at 3 weeks, and at 3-month follow-up. Mean visual analog scale score in the platelet-rich plasma and corticosteroid groups decreased from 7.44 and 7.72 preinjection to 2.52 and 3.64 at final follow-up, respectively. Mean AOFAS score in the platelet-rich plasma and corticosteroid groups improved from 51.56 and 55.72 preinjection to 88.24 and 81.32 at final follow-up, respectively. There was a significant improvement in visual analog scale score and AOFAS score in the platelet-rich plasma and corticosteroid groups at 3 weeks and at 3-month follow-up. There was no significant improvement in visual analog scale score or AOFAS score in the placebo group at any stage of the study. The authors concluded that local injection of platelet-rich plasma or corticosteroid is an effective treatment option for chronic plantar fasciitis. Platelet-rich plasma injection is as effective as or more effective than corticosteroid injection in treating chronic plantar fasciitis. PMID:26913766

  17. Corticosteroids therapy in the management of infantile cutaneous hemangiomas

    International Nuclear Information System (INIS)

    To determine the effectiveness of systemic and intra-lesional corticosteroids, in the management of infantile cutaneous hemangiomas and to compare the results with untreated lesions. A total of 75 cases with cutaneous hemangiomas were included in the study. Three groups of 25 patients each were made by allocating first patient to control group, every second patient to oral steroid group and every third patient to intralesional steroid group. In control group, patients were managed conservatively with repeated hospital visits in order to note down changes occurring in the lesion. In oral steroid group, tablet prednisolone was given at a dose of 2mg/kg/day on alternate days. The dose was gradually tapered over a period of 8 weeks. In intra-lesional steroid group, injection triamcinolone was given at a dose of 1 to 5 mg/kg, with a maximum dose of 30mg. Six injections of triamcinolone in monthly intervals were given. Outcome measures noted were the change in size before and after treatment, duration of proliferative phase, change in morphology and complications. In the control group,76% lesions showed little or no change, 5.8% had less than 50% reduction and 20% lesions showed actual increase in size. In oral steroid group, 32% lesions showed greater than 50% reduction in size, 44% lesions had less than 50% reduction and 24% lesions had little or no change. In intra-lesional steroid group, 44% lesions showed greater than 50% reduction in size, 32% lesions showed less than 50% reduction and 24% lesions had little or no change. Morphology change in terms of color change, surface bosselation and soft consistency was found in 88% lesions of oral steroid group, 92% in intra-lesional steroid group and 16% in observation group. Complication rate was 16% in observation group, 20% in oral steroid group and 24% in intra-lesional steroid group. (author)

  18. A PAMPA Assay as Fast Predictive Model of Passive Human Skin Permeability of New Synthesized Corticosteroid C-21 Esters

    OpenAIRE

    Katarina D. Karljikovic-Rajic; Vladimirov, Sote M.; Jadranka V. Odovic; Cudina, Olivera A.; Bojan D. Markovic

    2012-01-01

    The permeation properties of twenty newly synthesized α-alkoxyalkanoyl and α-aryloxyalkanoyl C-21 esters of standard corticosteroids: Fluocinolone acetonide, dexamethasone, triamcinolone acetonide and hydrocortisone were established using a PAMPA assay (70% silicone oil and 30% isopropyl myristate). The data were compared with parent corticosteroids with addition of mometasone furoate and hydrocortisone acetate. All newly synthesized corticosteroid C-21 esters have effective permeability coef...

  19. The effect in premature infants of prenatal corticosteroids on endogenous surfactant synthesis as measured with stable isotopes

    OpenAIRE

    Bunt, Jan Erik; Carnielli, Virgilio; Wattimena, Josias; Hop, Wim; Sauer, Pieter; Zimmermann, Luc

    2000-01-01

    textabstractMost in vitro studies show that prenatal administration of corticosteroids stimulates the synthesis of surfactant phosphatidylcholine (PC), but studies in animals are controversial. Whether prenatal corticosteroids stimulate surfactant PC synthesis in humans has not been studied. We studied endogenous surfactant PC synthesis in relation to prenatal corticosteroid treatment in 27 preterm infants with respiratory distress syndrome. Infants received a 24-h infusion of the stable isot...

  20. Combined Effect of Opioids and Corticosteroids for Alleviating Dyspnea in Terminal Cancer Patients: A Retrospective Review.

    Science.gov (United States)

    Maeda, Tsuyoshi; Hayakawa, Toru

    2016-06-01

    Dyspnea is a prognostic factor that affects the quality of life of terminal cancer patients, and many reports have described opioid treatment for dyspnea alleviation. Here, we retrospectively evaluated differences in the effects of various opioids administered concomitantly with corticosteroids on dyspnea in 20 terminal-stage cancer patients (13 men, 7 women; mean age [range]: 71 [49-94] years) who received opioids concomitantly with corticosteroids. Effectiveness was assessed throughout administration using the Support Team Assessment Schedule, Japanese version (STAS-J), particularly the subscale indicating how strongly a patient is affected by symptoms. The effectiveness of combined opioid and corticosteroid therapy against dyspnea and the opioid dose comprised the primary and secondary foci, respectively. Among concomitantly treated patients, STAS-J scores at initiation (mean ± SD: 3.1 ± 0.24) and lowest recorded STAS-J scores (1.4 ± 0.22) differed significantly (P = .0034) among those receiving morphine, but not among those receiving oxycodone (P = .068) or fentanyl (P = .18). Concomitant opioid and corticosteroid treatment was associated with a ≥2-point STAS-J score improvement in 14/20 patients (effectiveness: 70%). The opioid dose did not significantly affect dyspnea alleviation. We conclude that concomitant opioid and corticosteroid treatment can effectively alleviate dyspnea in terminal cancer patients. PMID:27093633

  1. Influence of corticosteroids on chemotactic response and collagen metabolism of human skin fibroblasts.

    Science.gov (United States)

    Hein, R; Mauch, C; Hatamochi, A; Krieg, T

    1988-07-15

    Following chronic administration of corticosteroids in vivo, a number of complications occur, which mainly involve the metabolism of connective tissue cells. Therefore, several attempts have been made to develop corticosteroids, which show less pronounced side effects. Fibroblasts were kept in monolayer cultures and were exposed to corticosteroids demonstrating similar anti-inflammatory activity (prednicarbate, desoximetasone). Chemotaxis of fibroblasts was studied over 4 hr, protein and collagen synthesis were estimated using proteinchemical methods and also by dot blot hybridization. Corticosteroids used in a high dosage (10 microM) affected all biosynthetic capacities of the investigated fibroblasts. Protein synthesis and production of collagen types I and III were reduced and a similar decrease of mRNA levels for collagen type I could be found indicating an influence on the pretranslational control. In the same concentrations desoximetasone was much more active than prednicarbate. Fibroblast migration was dosage dependently inhibited from 10(-9) M to 10(-5) M for desoximetasone, while incubation with prednicarbate did not cause a reduction of the chemotactic response at concentrations lower than 10(-7) M. These data suggest that modifications of corticosteroids might result in a dissociation of some of their biological activities and can specifically influence their effects on biosynthetic capacities of fibroblasts. PMID:3395353

  2. Algorithm development for corticosteroid management in systemic juvenile idiopathic arthritis trial using consensus methodology

    Directory of Open Access Journals (Sweden)

    Ilowite Norman T

    2012-08-01

    Full Text Available Abstract Background The management of background corticosteroid therapy in rheumatology clinical trials poses a major challenge. We describe the consensus methodology used to design an algorithm to standardize changes in corticosteroid dosing during the Randomized Placebo Phase Study of Rilonacept in Systemic Juvenile Idiopathic Arthritis Trial (RAPPORT. Methods The 20 RAPPORT site principal investigators (PIs and 4 topic specialists constituted an expert panel that participated in the consensus process. The panel used a modified Delphi Method consisting of an on-line questionnaire, followed by a one day face-to-face consensus conference. Consensus was defined as ≥ 75% agreement. For items deemed essential but when consensus on critical values was not achieved, simple majority vote drove the final decision. Results The panel identified criteria for initiating or increasing corticosteroids. These included the presence or development of anemia, myocarditis, pericarditis, pleuritis, peritonitis, and either complete or incomplete macrophage activation syndrome (MAS. The panel also identified criteria for tapering corticosteroids which included absence of fever for ≥ 3 days in the previous week, absence of poor physical functioning, and seven laboratory criteria. A tapering schedule was also defined. Conclusion The expert panel established consensus regarding corticosteroid management and an algorithm for steroid dosing that was well accepted and used by RAPPORT investigators. Developed specifically for the RAPPORT trial, further study of the algorithm is needed before recommendation for more general clinical use.

  3. Topical corticosteroid reduces inflammation without compromising the efficacy of photodynamic therapy for actinic keratoses

    DEFF Research Database (Denmark)

    Wiegell, S R; Øager Petersen, Bibi; Wulf, H C

    2014-01-01

    with the treatment. OBJECTIVES: To evaluate in a randomized intraindividual study whether use of a topical corticosteroid just before and just after PDT would reduce treatment-induced erythema compared with conventional PDT. METHODS: Twenty-two patients with multiple AKs in the face and scalp were...... treated with methyl aminolaevulinate PDT in two symmetrical areas. One area was randomized to superpotent corticosteroid (clobetasol propionate) before and just after PDT. Objective and visual erythema, protoporphyrin IX (PpIX) fluorescence and pain were evaluated. RESULTS: Topical corticosteroid......BACKGROUND: Photodynamic therapy (PDT) is an effective and established treatment for actinic keratoses (AK) and nonmelanoma skin cancer. The main side-effects of PDT are post-treatment erythema and oedema, and pain during illumination. Severe erythema after PDT enhances the down time associated...

  4. Adrenal insufficiency and diabetes mellitus secondary to the use of topical corticosteroids for cosmetic purpose.

    Science.gov (United States)

    Sobngwi, E; Lubin, V; Ury, P; Timsit, F-J; Gautier, J-F; Vexiau, P

    2003-06-01

    We report a case of symptomatic topical corticosteroid-induced adrenal insufficiency and diabetes in a 46-yr old HIV 1 positive woman of African descent. Topical Betamethasone dipropionate 0.05%-containing creams were used for the purpose of bleaching over a 2 month period prior to the acute episode. She recovered from her acute onset diabetes with ketosis and adrenal insufficiency a few months after withdrawal of corticosteroids. Despite possible discussion about pathophysiology of diabetes because acute-onset remitting diabetes is not rare in patients of African descent, and diabetes may occur in patients taking anti-retroviral treatments, no other cause of a hypothalamo-pituitary-adrenal axis disorder was found. This case suggests that chronic use of high dose topical corticosteroid containing creams should be ruled out in patients presenting with Hypothalamo-Pituitary-Adrenal hypofunction. PMID:12910062

  5. Production of corticosteroid hormones in vitro by adrenals in rats with streptozotocin-induced diabetes.

    Science.gov (United States)

    Kuznetsova, N V; Pal'chikova, N A; Kuzminova, O I; Selyatitskaya, V G

    2014-05-01

    We studied baseline and ACTH-stimulated in vitro production of corticosteroids by rat adrenals. Production of the basic corticosteroids pregnenolone (early precursor in corticosteroid synthesis), progesterone (intermediate precursor in synthesis of gluco- and mineralocorticoid hormones), and corticosterone (major glucocorticoid hormone in rodents) in animals with streptozotocin-induced diabetes was enhanced by 1.8-2.0 times in comparison with the control animals. Addition of ACTH to the incubation medium stimulated pregnenolone production by the adrenals equally in the control and experimental (diabetic) groups, while the increase in corticosterone production was less pronounced in the experimental group. Stimulation of corticosterone production in response to ACTH after saturation of the incubation medium with pregnenolone was also less pronounced in diabetic rats. PMID:24913572

  6. Sudden hearing loss: Our experiences in treatment with vasoactive and corticosteroid therapy

    Directory of Open Access Journals (Sweden)

    Živić Ljubica

    2012-01-01

    Full Text Available Introduction. Sudden hearing loss is a clinical entity of ambiguously defined aetiology manifested by hearing loss of more than 30 dB on three contiguous frequencies occurring within 72 hours. The lack of standard therapy protocol led to the use of variety of different therapies, thus making difficult objective quantification of their effect. Objective. The aim of the study was to present our experience in the treatment of sudden hearing loss with administration of vasoactive and corticosteroid therapy. Methods. Our research included 59 hospitally treated patients with a sudden hearing loss. During the period 1995-2004, 37 patients were treated using vasoactive agents (xanthinol nicotinate and pentoxifylline, and from 2004-2009, 22 patients were treated using parenteral corticosteroids (dexamethasone. All patients had unilateral sensorineural hearing loss of different level at frequencies from 500-4000 Hz, while other diagnostic procedures (laboratory tests, internist and neurology examinations, X-ray were within normal limits. Evaluation of therapy effect was done by follow-up of hearing threshold changes and subjective complaints. Results. The results showed that full recovery was achieved in patients with a mild and not fully severe hearing loss, with the majority of those (73% under corticosteroid treatment. In these patients recovery was also achieved more rapidly. A partial recovery of hearing was detected in patients with hearing loss of more than 80 dB, and mostly in patients treated with corticosteroids. Conclusion. Although statistical evaluation does not indicate significant differences between the application of vasoactive drugs or corticosteroids, clinical findings support advantages of corticosteroid therapy. Treatment of hearing loss, although controversial, requires change of some up-to-now used agents. Advantages should go in favour of contricosteroids.

  7. Corticosteroids Opportunist Higher Toxoplasma gondii Brain Cysts in Latent Infected Mice

    Directory of Open Access Journals (Sweden)

    Hasan A. Elfadaly

    2015-01-01

    Full Text Available Toxoplasma gondii is an opportunistic zoonotic protozoan, distinguish superior brain parasite load in immune-suppressed patients. Corticosteroids are popular anti-inflammatory with immune-suppressive long course, it possible opportunist higher T. gondii brain parasite load and reverts encephalitis in latent infected personals. The present study concerns this concept and preferred for recognize different levels of T. gondii brain parasite load and immunoglobulin titers in both corticosteroids treated and untreated latent infected mice groups. A total number of 70 Swiss-Webster mice (12-18 g were divided into four groups, the first and second ones are 30 each (infected-untreated and infected-treated group, the third and fourth 5 each (uninfected-untreated and uninfected-treated control. Administration of glucocorticoid (hydrocortisone sodium succinate at a dose of 50 mg kg–1 (I.M injection 3 times a week with oral administration of dexamethasone sodium phosphate in dose of 2.5 mg kg–1 day–1 per mouse in drinking water for sequence 2 months. The 103 bradyzoites from mice brain of cystogenic ME-49 strain was used for inducing latent infected mice groups at 30 days before corticosteroids therapy. Serum and brain tissue samples were collected for serological assay and parasite load estimation from sacrificed mice. The results showed significance elevation of average percent of brain parasite load and IgM/IgG titers. All values exceeds higher and parallel to the progression of corticosteroids term in infected treated group than the infected-untreated one. In conclusion, long-term corticosteroids therapy possible opportunist higher T. gondii brain parasite load and induce encephalitis in latent infected murine model, imitate this serious condition in T. gondii infected patients who received corticosteroids therapy.

  8. Hypertension and other morbidities with Cushing’s syndrome associated with corticosteroids: a review

    Directory of Open Access Journals (Sweden)

    Melpomeni Peppa

    2011-03-01

    Full Text Available Melpomeni Peppa1, Maria Krania1, Sotirios A Raptis2,31Endocrine Unit, 2Second Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, Athens, Greece; 3Hellenic National Diabetes Center for the Prevention, Research, Treatment of Diabetes and its Complications (HNDC, Athens, GreeceAbstract: Corticosteroids constitute an ideal treatment for various inflammatory and autoimmune disorders due to their anti-inflammatory and immunomodulatory actions. However, corticosteroids have a considerable number of side effects, including hypertension, diabetes, lipid disorders, sleep apnea, osteoporosis, myopathy, and disorders of coagulation and fibrinolysis, which are components of Cushing’s syndrome (CS. Corticosteroid-induced side effects are dependent on the formulation, route, dose, and time of exposure. However, the underlying pathogenetic mechanisms have not been clearly defined. A large body of evidence supports the role of an imbalance between vasoconstriction and vasodilation with possible links to nitric oxide, prostanoids, angiotensin II, arginine vasopressin, endothelins, catecholamines, neuropeptide Y, and atrial natriuretic peptide. Increased oxidative stress, renin–angiotensin system activation, increased pressor response, metabolic syndrome, and sleep apnea appear to be pathogenetically involved as well. The ideal treatment is the withdrawal of corticosteroids, which is most often impossible due to the exacerbation of the underlying disease. Alternatively, a careful plan, including the proper selection of the formulation, time, and route, should be made, and each side effect should be treated properly. The focus of the research should be to develop synthetic corticosteroids with anti-inflammatory effects but fewer metabolic effects, which so far has been unsuccessful.Keywords: corticosteroids, hypertension, iatrogenic Cushing’s syndrome

  9. Fresh water acclimation elicits a decrease in plasma corticosteroids in the euryhaline Atlantic stingray, Dasyatis sabina.

    Science.gov (United States)

    Evans, Andrew N; Nunez, B Scott

    2015-10-01

    It is thought that the elasmobranch corticosteroid hormone 1α-hydroxycorticosterone (1α-B) functions as both a glucocorticoid (GC) and mineralocorticoid (MC). Classical antinatriuretic MC activities would run counter to the osmoregulatory strategy of euryhaline elasmobranchs acclimating to fresh water (FW). Therefore we hypothesize that FW acclimation will be accompanied by a decrease in plasma corticosteroids in these animals. However, events that activate the "fight-or-flight" response could mask changes associated with acclimation to lower salinities. To better define the MC role of corticosteroids in elasmobranchs, we designed a transfer system that allows the acclimation of Atlantic stingrays (Dasyatis sabina) from seawater (SW) to FW over 12h while minimizing other extraneous stressors. Blood and interrenal glands were sampled from one group of stingrays 24h after FW transfer, while another group was sampled two weeks after FW transfer. Two other groups served as mock-transfer controls in that they were treated and sampled in the same way, but remained in SW for the entire period. Plasma corticosteroids, osmolality, chloride, and urea were significantly lower in FW-acclimated stingrays (compared to mock-transfer stingrays) 24h after FW transfer. This pattern remained after two weeks in FW, with the exception that plasma corticosteroids returned to pre-acclimation levels. There were no significant differences between experimental groups in interrenal levels of mRNAs encoding key steroidogenic proteins (steroidogenic acute regulatory protein and cholesterol side chain cleavage enzyme). Temporally decreased corticosteroid levels during FW acclimation are consistent with the unique strategy of euryhaline elasmobranchs, whereby lower plasma osmolality is maintained in FW vs. SW environments to reduce hydromineral gradients. PMID:26315386

  10. Corticosteroid Therapy Might be Associated with the Development of Coronary Aneurysm in Children with Kawasaki Disease

    Institute of Scientific and Technical Information of China (English)

    Chun-Na Zhao; Zhong-Dong Du; Ling-Ling Gao

    2016-01-01

    Background:Coronary artery lesions (CALs) are known to be the main complication in children with Kawasaki disease (KD).Instead of intravenous immunoglobulin (IVIG),corticosteroid therapy has been accepted to be used for children with KD who are unresponsive to IVIG.This study aimed to evaluate risk factors for CALs in children with KD.Methods:We retrospectively reviewed the clinical records of 2331 children with KD from January 2005 to December 2014.To identify the independent risk factors for CALs,multivariable logistic regression models were constructed using significant variables identified from univariate logistic regression analysis.Results:The incidence of CALs was 36.0% (840 of 2331),including 625 (26.8%) coronary artery dilations and 215 (9.2%) coronary artery aneurysms (CAAs).Multivariable logistic regression analysis identified that male,incomplete KD,longer fever duration,and C-reactive protein (CRP) > 100 mg/L were independent risk factors for coronary artery dilatations.On the other hand,male,incomplete KD,longer fever duration,prolonged days of illness at the initial treatment,corticosteroid therapy,sodium ≤133 mmol/L,and albumin <35 g/L were the independent risk factors for CAAs.In addition,corticosteroid therapy,prolonged days of illness at the initial treatment,and albumin <35 g/L were the independent risk factors for giant CAAs.Conclusions:CALs might be associated with male sex,incomplete KD,longer fever duration,prolonged days of illness at the initial treatment,albumin <35 g/L,sodium ≤ 133 mmol/L,CRP > 100 mg/L,and corticosteroid therapy.Corticosteroid therapy was an independent risk factor for CAAs and giant CAAs.Thus,corticosteroids should be used with caution in the treatment of KD with the risk for CALs.

  11. Anaphylaxis at image-guided epidural pain block secondary to corticosteroid compound.

    LENUS (Irish Health Repository)

    Moran, Deirdre E

    2012-09-01

    Anaphylaxis during image-guided interventional procedures is a rare but potentially fatal event. Anaphylaxis to iodinated contrast is an established and well-recognized adverse effect. However, anaphylaxis to some of the other frequently administered medications given during interventional procedures, such as corticosteroids, is not common knowledge. During caudal epidural injection, iodinated contrast is used to confirm needle placement in the epidural space at the level of the sacral hiatus. A combination of corticosteroid, local anesthetic, and saline is subsequently injected. We describe a very rare case of anaphylaxis to a component of the steroid medication instilled in the caudal epidural space.

  12. Topical corticosteroids in the treatment of acute sunburn - A randomized, double-blind clinical trial

    DEFF Research Database (Denmark)

    Faurschou, A.; Wulf, Hans Chr.

    2008-01-01

    Objective: To examine the effect of topical corticosteroid treatment on acute sunburn. Design: Randomized, double-blind clinical trial. Setting: University dermatology department. Patients: Twenty healthy volunteers with Fitzpatrick skin types I (highly sensitive, always burns easily, tans...... in the acute sunburn reaction when applied 6 or 23 hours after UV exposure. Clinical Trial Registry: clinicaltrials. gov Identifier: NCT00206882 Udgivelsesdato: 2008/5...... or high-potency corticosteroid 6 hours after UV-B exposure were significantly different from SIFs in areas that received no treatment (SIF 1.1-1.7; P clinically relevant. The areas...

  13. Cadherin 5 is Regulated by Corticosteroids and Associated with Central Serous Chorioretinopathy

    DEFF Research Database (Denmark)

    Schubert, Carl; Pryds, Anders; Zeng, Shemin; Xie, Yajing; Freund, K Bailey; Spaide, Richard F; Merriam, John C; Barbazetto, Irene; Slakter, Jason S; Chang, Stanley; Munch, Inger C; Drack, Arlene V; Hernandez, Jasmine; Yzer, Suzanne; Merriam, Joanna E; Linneberg, Allan; Larsen, Michael; Yannuzzi, Lawrence A; Mullins, Robert F; Allikmets, Rando

    2014-01-01

    Central serous chorioretinopathy (CSC) is characterized by leakage of fluid from the choroid into the subretinal space and, consequently, loss of central vision. The disease is triggered by endogenous and exogenous corticosteroid imbalance and psychosocial stress and is much more prevalent in men....... We studied the association of genetic variation in 44 genes from stress response and corticosteroid metabolism pathways with the CSC phenotype in two independent cohorts of 400 CSC cases and 1,400 matched controls. The expression of cadherin 5 (CDH5), the major cell-cell adhesion molecule in vascular...

  14. Traditional Chinese Medicine Decreases the Stroke Risk of Systemic Corticosteroid Treatment in Dermatitis: A Nationwide Population-Based Study

    Science.gov (United States)

    Tsai, Kao-Sung; Yen, Chia-Sung; Wu, Po-Yuan; Chiang, Jen-Huai; Shen, Jui-Lung; Yang, Chung-Hsien; Chen, Huey-Yi; Chen, Yung-Hsiang; Chen, Wen-Chi

    2015-01-01

    Epidemiological studies have shown a strong association between dermatitis and stroke. Systemic corticosteroid, the mainstay treatment for dermatitis, could enhance the atherosclerotic process. Traditional Chinese Medicine (TCM) has been used for dermatitis to decrease the side effects of corticosteroid. However, the different stroke risk in dermatitis patients treated with systemic corticosteroid or TCM remains unclear. This study identified 235,220 dermatitis patients and same comorbidity matched subjects between 2000 and 2009 from database of NHRI in Taiwan. The two cohorts were followed until December 31, 2011. The primary outcome of interest was new diagnosis of stroke. The crude hazard ratio (HR) for future stroke among dermatitis patients treated with systemic corticosteroid was 1.40 (95% CI, 1.34–1.45; P < 0.0001) and TCM was 1.09 (95% CI, 1.05–1.13; P < 0.0001). The log-rank test showed a higher cumulative incidence of ischemic stroke in the patient treated with only systemic corticosteroid group than that treated with systemic corticosteroid and TCM, only TCM, and neither systemic corticosteroid nor TCM in the matched cohort during the follow-up period (P < 0.0001). We demonstrated that patients treated with systemic corticosteroid had an increased risk of stroke and that the risk probably decreased by TCM treatment. PMID:26508980

  15. Traditional Chinese Medicine Decreases the Stroke Risk of Systemic Corticosteroid Treatment in Dermatitis: A Nationwide Population-Based Study

    Directory of Open Access Journals (Sweden)

    Kao-Sung Tsai

    2015-01-01

    Full Text Available Epidemiological studies have shown a strong association between dermatitis and stroke. Systemic corticosteroid, the mainstay treatment for dermatitis, could enhance the atherosclerotic process. Traditional Chinese Medicine (TCM has been used for dermatitis to decrease the side effects of corticosteroid. However, the different stroke risk in dermatitis patients treated with systemic corticosteroid or TCM remains unclear. This study identified 235,220 dermatitis patients and same comorbidity matched subjects between 2000 and 2009 from database of NHRI in Taiwan. The two cohorts were followed until December 31, 2011. The primary outcome of interest was new diagnosis of stroke. The crude hazard ratio (HR for future stroke among dermatitis patients treated with systemic corticosteroid was 1.40 (95% CI, 1.34–1.45; P<0.0001 and TCM was 1.09 (95% CI, 1.05–1.13; P<0.0001. The log-rank test showed a higher cumulative incidence of ischemic stroke in the patient treated with only systemic corticosteroid group than that treated with systemic corticosteroid and TCM, only TCM, and neither systemic corticosteroid nor TCM in the matched cohort during the follow-up period (P<0.0001. We demonstrated that patients treated with systemic corticosteroid had an increased risk of stroke and that the risk probably decreased by TCM treatment.

  16. Effect of an intranasal corticosteroid on exercise induced bronchoconstriction in asthmatic children

    NARCIS (Netherlands)

    Kersten, Elin T. G.; van Leeuwen, Janneke C.; Brand, Paul L. P.; Duiverman, Eric J.; de Jongh, Frans H. C.; Thio, Bernard J.; Driessen, Jean M. M.

    2012-01-01

    Rationale Allergic rhinitis and exercise induced bronchoconstriction (EIB) are common in asthmatic children. The aim of this study was to investigate whether treatment of allergic rhinitis with an intranasal corticosteroid protects against EIB in asthmatic children. Methods: This was a double-blind,

  17. Oral corticosteroid prescribing in women over 50, use of fracture prevention therapy, and bone densitometry service

    OpenAIRE

    Chantler, I; Davie, M.; Evans, S.; Rees, J

    2003-01-01

    Methods: General practice records from 41 practices in Shropshire identified 62 230 women aged >50 from a population of 80 082. Data on fractures, duration of corticosteroid use, dose in the study year (1 April 1997–31 March 1998), use of fracture prevention therapy and bone densitometry were sampled from one out of three records.

  18. Neutrophil and monocyte adhesion molecules in bronchopulmonary dysplasia, and effects of corticosteroids

    OpenAIRE

    Ballabh, P; Simm, M; Kumari, J; Krauss, A; Jain, A.; Califano, C; Lesser, M.; Cunningham-Rundle..., S

    2004-01-01

    Aims: To study a longitudinal change in the expression of adhesion molecules CD11b, CD18, and CD62L on neutrophils and monocytes in very low birth weight babies who develop respiratory distress syndrome, to compare these levels between bronchopulmonary dysplasia (BPD) and non-BPD infants, and to assess the effect of corticosteroid treatment on these adhesion molecules.

  19. Adjunctive corticosteroid therapy for Pneumocystis carinii pneumonia in AIDS: a randomized European multicenter open label study

    DEFF Research Database (Denmark)

    Nielsen, T L; Eeftinck Schattenkerk, J K; Jensen, B N;

    1992-01-01

    Fifty-nine human immunodeficiency virus type-1-infected patients with a microscopically proven first episode of moderate to severe Pneumocystis carinii pneumonia (PCP) were enrolled into a randomized European multicenter study. The effect of adjunctive corticosteroid (CS) therapy was assessed on ...

  20. A pooled analysis of FEV1 decline in COPD patients randomized to inhaled corticosteroids or placebo

    DEFF Research Database (Denmark)

    Soriano, JB; Sin, DD; Zhang, X; Camp, PG; Anderson, JA; Anthonisen, NR; Buist, AS; Burge, PS; Calverley, PM; Connett, JE; Petersson, S; Postma, DS; Szafranski, W; Vestbo, Jørgen

    2007-01-01

    Background: There is controversy about whether therapy with inhaled corticosteroids (ICSs) modifies the natural history of COPD, characterized by an accelerated decline in FEV1. Methods: The Inhaled Steroids Effect Evaluation in COPD (ISEEC) study is a pooled study of patient-level data from seven...

  1. Inhaled corticosteroids and decline of lung function in community residents with asthma

    DEFF Research Database (Denmark)

    Lange, Peter; Scharling, H; Ulrik, Charlotte Suppli; Vestbo, Jørgen

    2006-01-01

    BACKGROUND: Inhaled corticosteroids (ICS) constitute the cornerstone of treatment for asthma. Many studies have reported beneficial short term effects of these drugs, but there are few data on the long term effects of ICS on the decline in forced expiratory volume in 1 second (FEV(1)). This study...

  2. Corticosteroids and Open-Angle Glaucoma in the Elderly A Population-Based Cohort Study

    NARCIS (Netherlands)

    Marcus, Michael W.; Muskens, Rogier P. H. M.; Ramdas, Wishal D.; Wolfs, Roger C. W.; De Jong, Paulus T. V. M.; Vingerling, Johannes R.; Hofman, Albert; Stricker, Bruno H. C.; Jansonius, Nomdo M.

    2012-01-01

    Background It is largely unknown if corticosteroid-induced open-angle glaucoma (OAG) is an entity that is limited to a few susceptible individuals or whether it contributes significantly to the overall population burden of OAG. Objective The aim of this study was to determine whether there is an ass

  3. Inhaled corticosteroids should be the first line of treatment for children with asthma

    NARCIS (Netherlands)

    Brand, Paul L. P.

    2011-01-01

    Although montelukast is claimed to be preferable to inhaled corticosteroids in children with asthma and allergic rhinitis, virus-induced exacerbations, exercise induced asthma, and in those experiencing difficulties with inhalation therapy, there is no scientific evidence to support any of these cla

  4. Experimental radiation pneumonitis. Corticosteroids increase the replicative activity of alveolar type 2 cells

    International Nuclear Information System (INIS)

    Corticosteroid administration during radiation pneumonitis in mice markedly improves the physiologic abnormalities and decreases mortality, an effect that has been attributed to the stimulation of surfactant synthesis and secretion by type 2 alveolar epithelial cells. In the present experiments we explored the effects of corticosteroids on the replicative activity of type 2 cells of lethally irradiated lungs at the height of the radiation reaction. The labeling index of type 2 cells of irradiated mice was increased threefold above that of sham-irradiated controls. Corticosteroids given continuously from 10 weeks after thoracic irradiation further increased the type 2 cell labeling index another threefold above that of irradiated untreated mice. The enhanced reproductive activity of type 2 cells following thoracic irradiation is seen as a protective response that is augmented by corticosteroids, whose effect may be both to improve the physiology of the alveolar surface and to maintain the population of alveolar epithelial cells. The bearing of this result on the controversial role of the type 2 cell as a target in radiation pneumonitis is discussed

  5. Chronic hyperammonemia alters the circadian rhythms of corticosteroid hormone levels and of motor activity in rats.

    Science.gov (United States)

    Ahabrach, Hanan; Piedrafita, Blanca; Ayad, Abdelmalik; El Mlili, Nisrin; Errami, Mohammed; Felipo, Vicente; Llansola, Marta

    2010-05-15

    Patients with liver cirrhosis may present hepatic encephalopathy with a wide range of neurological disturbances and alterations in sleep quality and in the sleep-wake circadian rhythm. Hyperammonemia is a main contributor to the neurological alterations in hepatic encephalopathy. We have assessed, in an animal model of chronic hyperammonemia without liver failure, the effects of hyperammonemia per se on the circadian rhythms of motor activity, temperature, and plasma levels of adrenal corticosteroid hormones. Chronic hyperammonemia alters the circadian rhythms of locomotor activity and of cortisol and corticosterone levels in blood. Different types of motor activity are affected differentially. Hyperammonemia significantly alters the rhythm of spontaneous ambulatory activity, reducing strongly ambulatory counts and slightly average velocity during the night (the active phase) but not during the day, resulting in altered circadian rhythms. In contrast, hyperammonemia did not affect wheel running at all, indicating that it affects spontaneous but not voluntary activity. Vertical activity was affected only very slightly, indicating that hyperammonemia does not induce anxiety. Hyperammonemia abolished completely the circadian rhythm of corticosteroid hormones in plasma, completely eliminating the peaks of cortisol and corticosterone present in control rats at the start of the dark period. The data reported show that chronic hyperammonemia, similar to that present in patients with liver cirrhosis, alters the circadian rhythms of corticosteroid hormones and of motor activity. This suggests that hyperammonemia would be a relevant contributor to the alterations in corticosteroid hormones and in circadian rhythms in patients with liver cirrhosis. PMID:19998493

  6. Adverse effects of extra-articular corticosteroid injections: A systematic review

    NARCIS (Netherlands)

    A. Brinks (Tineke); B.W. Koes (Bart); A.C. Volkers (Aloysius); J.A.N. Verhaar (Jan); S.M. Bierma-Zeinstra (Sita)

    2010-01-01

    textabstractBackground. To estimate the occurrence and type of adverse effects after application of an extra-articular (soft tissue) corticosteroid injection. Methods. A systematic review of the literature was made based on a PubMed and Embase search covering the period 1956 to January 2010. Case re

  7. The effectiveness of corticosteroid injection in the treatment of plantar fasciitis.

    Science.gov (United States)

    Ang, Teck Wee Andrew

    2015-08-01

    Plantar fasciitis is a common cause of heel pain in adults. Although it is usually a self-limiting condition, the pain may become prolonged and severe enough to cause significant distress and disruption to the patient's daily activities and work. PubMed and Cochrane Central Register of Controlled Trials databases were searched for randomised controlled trials (RCTs) and a total of ten RCTs were selected for evaluation. These RCTs involved the use of either palpation- or ultrasonography-guided corticosteroid injections in patients diagnosed with plantar fasciitis. All placebo-controlled RCTs showed a significant reduction in pain with the use of corticosteroid injections. Some studies also showed that corticosteroid injections yielded better results than other treatment modalities. However, it is evident from these studies that the effects of corticosteroid injections are usually short-term, lasting 4-12 weeks in duration. Complications such as plantar fascia rupture are uncommon, but physicians need to weigh the treatment benefits against such risks. PMID:26311907

  8. Prophylactic corticosteroid injection in ulnar wrist pain in distal radius fracture

    Directory of Open Access Journals (Sweden)

    Alireza Saied

    2015-01-01

    Conclusion: Based on the findings of the present study it seems that prophylactic corticosteroid injection will be associated with a decrease in the severity of wrist pain in patients with acute distal radius fractures. With regard to the decrease in the number of painless individuals, it seems that the decrease is not persistent. Overall the need for a study with longer followup is obvious.

  9. Corticosteroid injection for tennis elbow or lateral epicondylitis: a review of the literature

    OpenAIRE

    Saccomanni, Bernardino

    2010-01-01

    Lateral epicondylitis or tennis elbow is a painful and functionally limiting entity affecting the upperextremity and is frequently treated by hand surgeons. Corticosteroid injection is one of the most common interventions for lateral epicondylitis or tennis elbow. Here, a review of the medical literature on this treatment is presented.

  10. Corticosteroid administration alters the mechanical properties of isolated collagen fascicles in rat-tail tendon

    DEFF Research Database (Denmark)

    Haraldsson, B T; Aagaard, P; Crafoord-Larsen, D;

    2009-01-01

    L of 40 mg/mL mixed with 1.0 mL 9% saline (n=12), and (B) a control group that was injected with 9% saline (n=12). Three days after the injections, the animals were sacrificed and single individual collagen fascicles were collected and underwent displacement to failure. Corticosteroid administration...

  11. Central serous chorioretinopathy misdiagnosed as posterior uveitis and the vicious circle of corticosteroid therapy

    Directory of Open Access Journals (Sweden)

    Marina Papadia

    2015-01-01

    Conclusion: CSCR is a rare but not negligible misdiagnosis in posterior uveitis representing approximately 1% of subjects from a collective series of uveitis cases at a referral center. Investigative measures such as FA, ICGA and OCT are crucial for reaching a correct diagnosis and avoiding disease aggravation due to corticosteroid therapy.

  12. Cadherin 5 is regulated by corticosteroids and associated with central serous chorioretinopathy.

    Science.gov (United States)

    Schubert, Carl; Pryds, Anders; Zeng, Shemin; Xie, Yajing; Freund, K Bailey; Spaide, Richard F; Merriam, John C; Barbazetto, Irene; Slakter, Jason S; Chang, Stanley; Munch, Inger C; Drack, Arlene V; Hernandez, Jasmine; Yzer, Suzanne; Merriam, Joanna E; Linneberg, Allan; Larsen, Michael; Yannuzzi, Lawrence A; Mullins, Robert F; Allikmets, Rando

    2014-07-01

    Central serous chorioretinopathy (CSC) is characterized by leakage of fluid from the choroid into the subretinal space and, consequently, loss of central vision. The disease is triggered by endogenous and exogenous corticosteroid imbalance and psychosocial stress and is much more prevalent in men. We studied the association of genetic variation in 44 genes from stress response and corticosteroid metabolism pathways with the CSC phenotype in two independent cohorts of 400 CSC cases and 1,400 matched controls. The expression of cadherin 5 (CDH5), the major cell-cell adhesion molecule in vascular endothelium, was downregulated by corticosteroids which may increase permeability of choroidal vasculature, leading to fluid leakage under the retina. We found a significant association of four common CDH5 SNPs with CSC in male patients in both cohorts. Two common intronic variants, rs7499886:A>G and rs1073584:C>T, exhibit strongly significant associations with CSC; P = 0.00012; odds ratio (OR) = 1.5; 95%CI [1.2;1.8], and P = 0.0014; OR = 0.70; 95%CI [0.57;0.87], respectively. A common haplotype was present in 25.4% male CSC cases and in 35.8% controls (P = 0.0002; OR = 0.61, 95% CI [0.47-0.79]). We propose that genetically predetermined variation in CDH5, when combined with triggering events such as corticosteroid treatment or severe hormonal imbalance, underlie a substantial proportion of CSC in the male population. PMID:24665005

  13. Treatment with corticosteroids and the risk of anastomotic leakage following lower gastrointestinal surgery

    DEFF Research Database (Denmark)

    Eriksen, Tina Fransgård; Lassen, Cecilie Brandt; Gögenur, Ismail

    2014-01-01

    Anastomotic leakage is a serious complication in colorectal surgery. Treatment with corticosteroids is known to impair wound healing but their influence on the healing of a colorectal anastomosis remains unclear, and studies have reported conflicting results. The aim of this study was to evaluate...

  14. 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.

  15. Binding Procurement

    Science.gov (United States)

    Rao, Gopalakrishna M.; Vaidyanathan, Hari

    2007-01-01

    This viewgraph presentation reviews the use of the binding procurement process in purchasing Aerospace Flight Battery Systems. NASA Engineering and Safety Center (NESC) requested NASA Aerospace Flight Battery Systems Working Group to develop a set of guideline requirements document for Binding Procurement Contracts.

  16. The effects of topical corticosteroids and a coal tar preparation on dithranol-induced irritation in patients with psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Swinkels, O.Q.J.; Kucharekova, M.; Prins, M.; Gerritsen, M.J.P.; van der Valk, P.G.M.; van de Kerkhof, P.C.M. [University of Nijmegen, Nijmegen (Netherlands). Medical Center

    2003-02-01

    Dithranol has been a mainstay in the treatment of psoriasis for more than 80 years. Although a safe approach, the irritation of the clinically uninvolved perilesional skin remains a major limitation of this treatment. Corticosteroids and coal tar solution have an anti-inflammatory potential. The aim of the present study was to investigate the clinical and cell-biological effects of two topical corticosteroids and a coal tar preparation on dithranol-irritated skin. The expression of epidermal proliferation, differentiation and inflammation markers and the clinical irritation scores indicate that the application of a high potency corticosteroid is the best approach to minimise dithranol irritation.

  17. Uso de corticosteroide na síndrome do desconforto respiratório agudo em pacientes pediátricos Corticosteroids therapy in pediatric acute respiratory distress syndrome

    OpenAIRE

    Maria Clara de Magalhães Barbosa; Arnaldo Prata Barbosa; Patricia Rieken Macêdo Rocco

    2010-01-01

    A terapia com corticosteroide na lesão pulmonar aguda e na síndrome do desconforto respiratório agudo é um dos temas mais controversos na literatura. Apesar de o corticosteroide ser amplamente utilizado na faixa etária pediátrica, os estudos com corticosteroide na lesão pulmonar aguda/síndrome do desconforto respiratório agudo são restritos a adultos. Esse artigo realiza uma revisão crítica dos estudos experimentais e clínicos sobre a utilização de corticosteroide na síndrome do desconforto r...

  18. Repeat prenatal corticosteroid prior to preterm birth: a systematic review and individual participant data meta-analysis for the PRECISE study group (prenatal repeat corticosteroid international IPD study group: assessing the effects using the best level of evidence) - study protocol

    OpenAIRE

    Crowther Caroline A; Aghajafari Fariba; Askie Lisa M; Asztalos Elizabeth V; Brocklehurst Peter; Bubner Tanya K; Doyle Lex W; Dutta Sourabh; Garite Thomas J; Guinn Debra A; Hallman Mikko; Hannah Mary E; Hardy Pollyanna; Maurel Kimberly; Mazumder Premasish

    2012-01-01

    Abstract Background The aim of this individual participant data (IPD) meta-analysis is to assess whether the effects of repeat prenatal corticosteroid treatment given to women at risk of preterm birth to benefit their babies are modified in a clinically meaningful way by factors related to the women or the trial protocol. Methods/Design The Prenatal Repeat Corticosteroid International IPD Study Group: assessing the effects using the best level of Evidence (PRECISE) Group will conduct an IPD m...

  19. Effect of Corticosteroid Therapy in Esophageal Stricture of a Child with Chronic Granulomatous Disease

    Directory of Open Access Journals (Sweden)

    Alborzi Abdolvahab

    2008-12-01

    Full Text Available In chronic granulomatous disease (CGD patients, esophageal stricture is a rare complication and the treatment of choice is still controversial. There are few reports of successful therapy with antibiotics, corticosteroids, multiple balloon dilatations or their combination.We report a 3-three-year-old Iranian boy with recurrent esophageal obstruction due to CGD. The patient transiently responded to dilatation in one occasion and at another time to short term steroid therapy. We observed an excellent response when long term and high dose of corticosteroid was administered. It showed that a long term and high dose steroid therapy is more effective than a short term in a patient with CGD and esophageal stricture.

  20. Montelukast versus inhaled corticosteroids in the management of pediatric mild persistent asthma

    Directory of Open Access Journals (Sweden)

    Scaparrotta Alessandra

    2012-07-01

    Full Text Available Abstract International guidelines recommend the use of inhaled corticosteroids (ICSs as the preferred therapy, with leukotriene receptor antagonists (LTRAs as an alternative, for the management of persistent asthma in children. Montelukast (MLK is the first LTRA approved by the Food and Drug Administration for the use in young asthmatic children. Therefore, we performed an analysis of studies that compared the efficacy of MLK versus ICSs. We considered eligible for the inclusion randomized, controlled trials on pediatric populations with Jadad score > 3, with at least 4 weeks of treatment with MLK compared with ICS. Although it is important to recognize that ICSs use is currently the recommended first-line treatment for asthmatic children, MLK can have consistent benefits in controlling asthmatic symptoms and may be an alternative in children unable to use ICSs or suffering from poor growth. On the contrary, low pulmonary function and/or high allergic inflammatory markers require the corticosteroid use.

  1. Plasma corticosteroid levels in rats maintained on a long-acting naltrexone delivery system.

    Science.gov (United States)

    Misra, A L; Pontani, R B; Vadlamani, N L

    1978-04-01

    A long-acting delivery system for naltrexone has been described, which blocked the antinociceptive action of 10 mg kg-1 s.c. dose of morphine in rats for a period of 2 to 3 months. Male Wistar rats implanted s.c. with such a delivery system showed highly significant depression of plasma corticosteroid levels (40.2% in one week and 22.4 to 27.2% in 3 months) as compared to placebo pellet-implanted animals. Morphine-dependent male rats implanted with 75 mg morphine pellets showed a small (17.5%) but significant increase in plasma corticosteroid levels as compared to the placebo controls 72 hr. after pellet implantation. PMID:663407

  2. Eight Years Follow-up of a Case with Idiopathic Pulmonary Hemosiderosis After Corticosteroid Therapy.

    Science.gov (United States)

    Kahraman, Hasan; Köksal, Nurhan; Ozkan, Fuat

    2012-01-01

    Idiopathic pulmonary hemosiderosis is characterized by recurrent episodes of alveolar hemorrhage, hemoptysis, and secondary iron deficiency anemia with unknown etiology. It generally emerges in childhood and adolescence periods but rarely found in adulthood. Definite diagnosis is established by appearing the hemosiderin-laden macrophages at sputum, bronchoalveolar lavage, or open lung biopsy. We reported a male patient who was born in 1975, expectorated blood since 1995, and was diagnosed in 1998. He received many blood replacements. He admitted to our clinic in 2003 with complaints of coughing up blood, shortness of breath, and tiredness. We gave the corticosteroid therapy to patient for 6-month period. After treatment, the patient did not have any complaints. Clinicians should keep in mind that idiopathic pulmonary hemosiderosis may differ in localization on chest X-ray and corticosteroid treatment should be started when diagnosis is established. PMID:22393549

  3. Eight years follow-up of a case with idiopathic pulmonary hemosiderosis after corticosteroid therapy

    Directory of Open Access Journals (Sweden)

    Hasan Kahraman

    2012-01-01

    Full Text Available Idiopathic pulmonary hemosiderosis is characterized by recurrent episodes of alveolar hemorrhage, hemoptysis, and secondary iron deficiency anemia with unknown etiology. It generally emerges in childhood and adolescence periods but rarely found in adulthood. Definite diagnosis is established by appearing the hemosiderin-laden macrophages at sputum, bronchoalveolar lavage, or open lung biopsy. We reported a male patient who was born in 1975, expectorated blood since 1995, and was diagnosed in 1998. He received many blood replacements. He admitted to our clinic in 2003 with complaints of coughing up blood, shortness of breath, and tiredness. We gave the corticosteroid therapy to patient for 6-month period. After treatment, the patient did not have any complaints. Clinicians should keep in mind that idiopathic pulmonary hemosiderosis may differ in localization on chest X-ray and corticosteroid treatment should be started when diagnosis is established.

  4. Short-term assessment of periradicular corticosteroid injections in lumbar radiculopathy associated with disc pathology

    Energy Technology Data Exchange (ETDEWEB)

    Viton, J.M.; Rubino, T.; Delarque, A. [Departement Universitaire de Reeducation et Readaptation, Marseille (France); Peretti-Viton, P.; Salamon, N. [Service de Neuroradiologie, C. H. U. de la Timone, 264 Rue Saint-Pierre, F-13385 Marseille Cedex 05 (France)

    1998-01-01

    We evaluated periradicular injection of corticosteroids performed by neuroradiologists under fluoroscopic guidance in the treatment of lumbosacral nerve root pain in 40 patients (average age 48 years) presenting with lumbosciatica or radiculopathy not responding to conservative treatment. Patients with root pain due to infectious, neoplastic or inflammatory diseases were excluded, as were patients who needed immediate surgery. Pain was evaluated using a visual analogue scale (VAS) 10 and 90 days after the injection. After 10 days a substantial decrease in root pain was observed, with a statistically significant decrease in mean VAS. This decrease was observed in 90 % of patients, and it persisted after 90 days in 85 %. Side effects were rare, mild and disappeared spontaneously. They were related to the drug injected (corticosteroids). (orig.) With 2 figs., 3 tabs., 24 refs.

  5. Short-term assessment of periradicular corticosteroid injections in lumbar radiculopathy associated with disc pathology

    International Nuclear Information System (INIS)

    We evaluated periradicular injection of corticosteroids performed by neuroradiologists under fluoroscopic guidance in the treatment of lumbosacral nerve root pain in 40 patients (average age 48 years) presenting with lumbosciatica or radiculopathy not responding to conservative treatment. Patients with root pain due to infectious, neoplastic or inflammatory diseases were excluded, as were patients who needed immediate surgery. Pain was evaluated using a visual analogue scale (VAS) 10 and 90 days after the injection. After 10 days a substantial decrease in root pain was observed, with a statistically significant decrease in mean VAS. This decrease was observed in 90 % of patients, and it persisted after 90 days in 85 %. Side effects were rare, mild and disappeared spontaneously. They were related to the drug injected (corticosteroids). (orig.)

  6. Flare-up of ulcerative colitis after systemic corticosteroids:A strong case for Strongyloides

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Super-imposed infection with intestinal organisms can mimic a flare-up of underlying disease in patients with inflammatory bowel disease (IBD). We report a case of patient with long standing ulcerative colitis (UC), who presented with abdominal pain, diarrhea and low- grade fever after receiving systemic corticosteroids for an unrelated disorder. Despite a negative stool examination, a peripheral eosinophilia reappeared upon tapering down of a corticosteroid dose. Subsequently, duodenal biopsies showed evidence for Strongyloides, presumably acquired 20 years ago when the patient was residing in Brazil. The patient fully recovered following anti-helmintic therapy. This case underscores the importance of considering Strongyloides in the work-up of flaring-up IBD patients, even if a history of residing or traveling to endemic areas is in the distant past.

  7. Inhaled corticosteroids and HPA axis suppression: how important is it and how should it be managed?

    Science.gov (United States)

    Rao Bondugulapati, L N; Rees, D A

    2016-08-01

    Inhaled corticosteroids (ICS) are established as a cornerstone of management for patients with bronchoconstrictive lung disease. However, systemic absorption may lead to suppression of the hypothalamic-pituitary-adrenal (HPA) axis in a significant minority of patients. This is more likely in 'higher risk' patients exposed to high cumulative ICS doses, and in those treated with frequent oral corticosteroids or drugs which inhibit cytochrome p450 3A4. Hypothalamic-pituitary-adrenal axis suppression is frequently unrecognized, such that some patients, notably children, only come to light when an adrenal crisis is precipitated by physical stress. To minimize this risk, 'higher risk' patients and those with previously identified suppressed cortisol responses to Synacthen testing should undergo an education programme to inform them about sick day rules. A review of ICS therapy should also be undertaken to ensure that the dose administered is the minimum required to control symptoms. PMID:27038017

  8. Inhaled corticosteroid effects both eosinophilic and non-eosinophilic inflammation in asthmatic patients.

    OpenAIRE

    2004-01-01

    AIM: To determine induced sputum cell counts and interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-alpha) and leukotriene B4 (LTB4) levels as markers of neutrophilic inflammation in moderate persistent asthma, and to evaluate the response to inhaled steroid therapy. METHODS: Forty-five moderate asthmatic patients and 10 non-smoker controls were included in this study. All patients received inhaled corticosteroid (800 microg of budesonide) for 12 weeks. Before and after treatment pulmonar...

  9. Concomitant use of corticosteroid and antimicrobials for liver abscesses in patients with chronic granulomatous disease

    OpenAIRE

    Shin, Kyung-Sue; Lee, Mu Suk

    2016-01-01

    Chronic granulomatous disease (CGD) is a rare inherited disorder caused by defective nicotinamide adenine dinucleotide phosphate oxidase enzyme and characterized by recurrent bacterial and fungal infections. Although liver abscess is a common manifestation of CGD, its management in CGD patients is not well-defined. In addition, the generalized guidelines for treating liver abscesses do not necessarily apply to CGD patients. Corticosteroids are commonly used to control granulomatous complicati...

  10. Corticosteroid modulation of Na(+)-K+ pump-mediated relaxation in maturing airway smooth muscle.

    OpenAIRE

    Schramm, C. M.; Grunstein, M. M.

    1996-01-01

    1. The ontogeny of the relaxant influence of the airway electrogenic Na(+)-K+ pump and its potential modulation by corticosteroids were examined in airway smooth muscle (ASM) segments isolated from newborn and adult rabbits. 2. Control and methylprednisolone-treated (MP) ASM segments were half-maximally contracted with methacholine in K(+)-free buffer and the ASM relaxant responses to Na(+)-K+ pump activation were subsequently evaluated. Relative to adult ASM, control newborn ASM showed signi...

  11. Serial CT findings of cryptogenic organizing pneumonia and changes after corticosteroid therapy

    International Nuclear Information System (INIS)

    Objective: To review the serial CT findings of cryptogenic organizing pneumonia (COP) and semi-quantitatively analyze the changes after corticosteroid therapy. Methods: The clinical and radiological features of 13 patients with COP confirmed by pathology were retrospectively collected and analyzed. The lung lesions extent on CT scans was estimated using semi-quantitative method. Changes of overall disease extent were evaluated by comparing the initial CT images and the follow-up CT scans after corticosteroid therapy. Results: CT images of all cases revealed diffuse and bilateral lesions, mainly located in lower zone, distributed as predominantly subpleural and (or) along the bronchovascular bundle. The two most common manifestations of lung abnormality on initial scans were ground-glass opacity (GGO) (13 cases) and consolidation (12 cases), the average areas of which were 13% and 10% respectively. The treatment with antibiotics was ineffective. After treatment with corticosteroid, the lesions resolved completely in 2 patients; the disease was decreased in extent in 8 patients; and the lesion showed no change in extent in one patient, while the disease progressed in extent in 2 patients on follow-up CT. The most common CT findings were GGO (10 cases) and reticulation (5 cases), followed by consolidation (4 cases), the average areas of which were 19%, 2% and 1% respectively. Conclusion: The CT features of the patients with COP are characteristic. The most lesions resolved or improved after corticosteroid therapy on follow-up CT scans. The estimation of disease extent with semi-quantitative method is helpful for the clinicians to evaluate the therapeutic effect. (authors)

  12. Intra-articular Corticosteroid Injection for the Treatment of Idiopathic Adhesive Capsulitis of the Shoulder

    OpenAIRE

    Marx, Robert G.; Malizia, Robert W.; Kenter, Keith; Wickiewicz, Thomas L.; Hannafin, Jo A.

    2007-01-01

    Treatment for idiopathic adhesive capsulitis or frozen shoulder of the shoulder is controversial. The hypothesis of the study is that intra-articular corticosteroid injection in the early stages of idiopathic adhesive capsulitis will lead to a razpid resolution of stiffness and symptoms. This is a retrospective cohort study of only patients with stage 1 or stage 2 adhesive capsulitis. The diagnosis was made by history and physical examination and only when other causes of pain and motion loss...

  13. Albendazole and Corticosteroids for the Treatment of Solitary Cysticercus Granuloma: A Network Meta-analysis.

    Directory of Open Access Journals (Sweden)

    Bing-Cheng Zhao

    2016-02-01

    Full Text Available Solitary cysticercus granuloma (SCG is the commonest form of neurocysticercosis in the Indian subcontinent and in travelers. Several different treatment options exist for SCG. We conducted a Bayesian network meta-analysis of randomized clinical trials (RCTs to identify the best treatment option to prevent seizure recurrence and promote lesion resolution for patients with SCG.PubMed, EMBASE and the Cochrane Library databases (up to June 1, 2015 were searched for RCTs that compared any anthelmintics or corticosteroids, alone or in combination, with placebo or head to head and reported on seizure recurrence and lesion resolution in patients with SCG. A total of 14 RCTs (1277 patients were included in the quantitative analysis focusing on four different treatment options. A Bayesian network model computing odds ratios (OR with 95% credible intervals (CrI and probability of being best (Pbest was used to compare all interventions simultaneously. Albendazole and corticosteroids combination therapy was the only regimen that significantly decreased the risk of seizure recurrence compared with conservative treatment (OR 0.32, 95% CrI 0.10-0.93, Pbest 73.3%. Albendazole and corticosteroids alone or in combination were all efficacious in hastening granuloma resolution, but the combined therapy remained the best option based on probability analysis (OR 3.05, 95% CrI 1.24-7.95, Pbest 53.9%. The superiority of the combination therapy changed little in RCTs with different follow-up durations and in sensitivity analyses. The limitations of this study include high risk of bias and short follow-up duration in most studies.Dual therapy of albendazole and corticosteroids was the most efficacious regimen that could prevent seizure recurrence and promote lesion resolution in a follow-up period of around one year. It should be recommended for the management of SCG until more high-quality evidence is available.

  14. Corticosteroid induced remission of oesophageal involvement in mixed connective tissue disease

    OpenAIRE

    Pines, Amos; Goldhammer, Ehud; Kaplinsky, Naomi; Bregman, Joseph; Frankl, Otto

    1982-01-01

    Oesophageal involvement is known to be one of the most severe and resistant manifestations of connective tissue diseases, mainly progressive systemic sclerosis (PSS). A patient who had manifestations of systemic lupus erythematosus, PSS and polymyositis is described. Since some features of mixed connective tissue disease (MCTD) respond to corticosteroid treatment, fluocortolone was administered and both clinical and radiological remission of the oesophageal involvement were observed. At the s...

  15. Studying Intense Pulsed Light Method Along With Corticosteroid Injection in Treating Keloid Scars

    OpenAIRE

    Shamsi Meymandi, Simin; Rezazadeh, Azadeh; Ekhlasi, Ali

    2014-01-01

    Background: Results of various studies suggest that the hypertrophic and keloid scars are highly prevalent in the general population and are irritating both physically and mentally. Objective: Considering the variety of existing therapies, intense pulsed light (IPL) method along with corticosteroid injection was evaluated in treating these scars. Materials and Methods: 86 subjects were included in this clinical trial. Eight sessions of therapeutic intervention were done with IPL along with co...

  16. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy

    DEFF Research Database (Denmark)

    Kongsgaard, M; Kovanen, V; Aagaard, P;

    2009-01-01

    A randomized-controlled single-blind trial was conducted to investigate the clinical, structural and functional effects of peritendinous corticosteroid injections (CORT), eccentric decline squat training (ECC) and heavy slow resistance training (HSR) in patellar tendinopathy. Thirty-nine male......, with HSR being most satisfied. Conclusively, CORT has good short-term but poor long-term clinical effects, in patellar tendinopathy. HSR has good short- and long-term clinical effects accompanied by pathology improvement and increased collagen turnover....

  17. Evaluation of the patients with Grave’s ophthalmopathy after the corticosteroids treatment

    Directory of Open Access Journals (Sweden)

    Janićijević-Petrović Mirjana

    2012-01-01

    Full Text Available Background/Aim. Graves’ ophthalmopthy is one of the most common causes of exophthalmos as well as the most common manifestation of Graves’ disease. The treatment of Graves’ ophthalmopathy includes ophthalmological and endocrinological therapy. The aim of this study was to clinically evaluate the patients with Graves’ ophthalmopathy treated with corticosteroids. Methods. Evaluation of 21 patients was performed in the Ophthalmology Clinic and Endocrinology Clinic, Clinical Centre Kragujevac, in the period from 2009 to 2010. They were treated with pulse doses of intravenous corticosteroids. They were referred to ophthalmologist by endocrinologist in euthyroid condition in the active phase of Graves’ ophthalmopathy (ultrasonography of orbit findings and positive findings of antithyroid stimulating hormone receptor antibody - anti-TSH R Ab. The clinical activity score (CAS and NO SPECS classification for evaluation of disease severity were used. Ophthalmological examination includes: best corrected visual acuity, slit-lamp exam, Hertels’ test, direct ophthalmoscopy and ultrasonography of the orbit. Results. According to our results 76.19% of the patients were female; mean age of the patients was 35.2 ± 5.6 years. According to CAS classification after 6 months of the treatment recovery was shown in 23.81% of the patients, partial amelioration in 47.62% and no clinical amelioration in 28.57% of the patients. We achieved better results with male, young patients with high clinical activity score. Good results were observed after the first dose of corticosteroids, much better CAS after the third dose, which maintained until 6 months after the first treatment. Conclusion. Our results signify that intravenous pulse dose of corticosteroids treatment of the patients with Graves’ ophthalmopthy is safe, comfortable, clinically justified and accessible for the clinicians and patients. Positive results are achieved after the first dose with

  18. Evaluation of the patients with Grave’s ophthalmopathy after the corticosteroids treatment

    OpenAIRE

    Janićijević-Petrović Mirjana; Šarenac Tatjana; Srećković Sunčica; Petrović Marko; Vulović Dejan; Janićijević Katarina

    2012-01-01

    Background/Aim. Graves’ ophthalmopthy is one of the most common causes of exophthalmos as well as the most common manifestation of Graves’ disease. The treatment of Graves’ ophthalmopathy includes ophthalmological and endocrinological therapy. The aim of this study was to clinically evaluate the patients with Graves’ ophthalmopathy treated with corticosteroids. Methods. Evaluation of 21 patients was performed in the Ophthalmology Clinic and Endocrinology Clinic, Clinical Centre Kragujev...

  19. The action of corticosteroids on orthodontic tooth movement: a literature review

    Directory of Open Access Journals (Sweden)

    Luegya Amorim Henriques Knop

    2012-12-01

    Full Text Available INTRODUCTION: Tooth movement is initially characterized by an acute sterile inflammation, followed by sequential multiple reactions in the periodontal ligament in response to biomechanical forces. Pharmacological agents such as corticosteroids may affect the course of orthodontic movement. Scientific studies show antagonistic actions of these drugs on bone resorption during tooth movement. OBJECTIVE: To review the literature about the effect of corticosteroids on orthodontic tooth movement. CONCLUSION: Patients should be questioned regarding the use of these drugs in the orthodontic practice and for those who use them, the orthodontic treatment should be differentiated, with longer intervals between visits and periodic X-rays due to the delay in bone formation observed in some scientific studies.INTRODUÇÃO: a movimentação dentária é caracterizada, inicialmente, por uma inflamação aguda estéril, seguida por reações múltiplas sequenciais no ligamento periodontal em resposta às forças biomecânicas. Agentes farmacológicos, como os corticosteroides, podem alterar o curso da movimentação ortodôntica. Os estudos científicos demonstram ações antagonistas dessas drogas sobre a reabsorção óssea durante a movimentação dentária. OBJETIVO: realizar revisão de literatura sobre a ação dos corticosteroides no movimento dentário ortodôntico. CONCLUSÃO: os pacientes devem ser questionados quanto ao uso dessas drogas na clínica ortodôntica e, para aqueles que fazem uso, o tratamento ortodôntico deve ser diferenciado, com intervalos maiores entre as consultas e solicitação periódica de radiografias devido ao atraso na neoformação óssea observado em alguns estudos científicos.

  20. Outcomes of Ultrasound-guided Glen Humeral Corticosteroid Injections in Adhesive Capsulitis

    OpenAIRE

    Song, Amos; Katz, Jeffrey N; Higgins, Laurence D; Newman, Joel; Gomoll, Andreas; Jain, Nitin B.

    2014-01-01

    Aims To assess short and longer-term outcomes of ultrasound-guided glenohumeral corticosteroid injections for adhesive capsulitis. Study Design A mixed prospective and retrospective study design Place and Duration of Study Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Department of Orthopaedic Surgery, Brigham and Women’s Hospital, between June 2011 and July 2012. Methodology Using medical records, we first retrospectively identified patients who had r...

  1. Cryptogenic fibrosing alveolitis: response to corticosteroid treatment and its effect on survival

    OpenAIRE

    Turner-Warwick, M.; Burrows, B; Johnson, A

    1980-01-01

    We have studied retrospectively 220 patients with cryptogenic fibrosing alveolitis (CFA) who were first seen between 1955-73 and had been followed up for at least four years until 1977. Seventy-seven patients had received no treatment and 143 had received corticosteroids. The only clinical difference between the groups was the age at presentation (untreated mean age 61 years±11 SD; treated mean age 56 years±11 SD p

  2. Severe renal failure in acute bacterial pyelonephritis: Do not forget corticosteroids

    Directory of Open Access Journals (Sweden)

    Sqalli Tarik

    2010-01-01

    Full Text Available Acute renal failure (ARF is a rare complication of acute pyelonephritis in adult immunocompetent patients. Recovery of renal function usually occurs if antibiotics are promptly initiated. However, long-term consequences of renal scarring due to acute pyelonephritis are probably underestimated, and some patients present with prolonged renal failure despite adequate antibiotic therapy. We report two cases of severe ARF complicating bacterial pyelonephritis successfully treated with corticosteroids in association with conventional antibiotics.

  3. Subacromial Injections of Corticosteroids and Xylocaine for Painful Subacromial Impingement Syndrome

    OpenAIRE

    Chung-Ming Yu; Chih-Hwa Chen; Hsien-Tao Liu; Ming-Hsun Dai; I-Chun Wang; Kun-Chung Wang

    2006-01-01

    Background: Subacromial impingement syndrome, with pain and limited motion, is acommon disease encountered daily in clinics. This study determined the efficacyof subacromial injections of corticosteroids and local anesthesia fortreatment of painful subacromial impingement syndrome.Methods: A total of 238 shoulders in 209 patients, with regular follow-up, wereenrolled in this study. Mean patient age was 51 years (range 31-72 years).Each patient complained of shoulder pain with progressive moti...

  4. Osteonecrosis of the femoral head in lymphoma patients treated with combined chemotherapy including corticosteroids

    International Nuclear Information System (INIS)

    Osteonecrosis of the femoral head developed in two patients with malignant lymphoma treated with combined chemotherapy. Pain was the main symptom. It was not possible to radiographically distinguish the necrotic lesions from metastatic tumour growth, and in both cases only histological examination revealed the true nature of bone destruction. The large doses of corticosteroids included in the treatment regiments were most likely of more importance in the etiology of the necrosis than the cytostatic drugs proper. (orig.)

  5. Adverse effects of extra-articular corticosteroid injections: a systematic review

    Directory of Open Access Journals (Sweden)

    Brinks Aaltien

    2010-09-01

    Full Text Available Abstract Background To estimate the occurrence and type of adverse effects after application of an extra-articular (soft tissue corticosteroid injection. Methods A systematic review of the literature was made based on a PubMed and Embase search covering the period 1956 to January 2010. Case reports were included, as were prospective and retrospective studies that reported adverse events of corticosteroid injection. All clinical trials which used extra-articular corticosteroid injections were examined. We divided the reported adverse events into major (defined as those needing intervention or not disappearing and minor ones (transient, not requiring intervention. Results The search yielded 87 relevant studies:44 case reports, 37 prospective studies and 6 retrospective studies. The major adverse events included osteomyelitis and protothecosis; one fatal necrotizing fasciitis; cellulitis and ecchymosis; tendon ruptures; atrophy of the plantar fat was described after injecting a neuroma; and local skin effects appeared as atrophy, hypopigmentation or as skin defect. The minor adverse events effects ranged from skin rash to flushing and disturbed menstrual pattern. Increased pain or steroid flare after injection was reported in 19 studies. After extra-articular injection, the incidence of major adverse events ranged from 0-5.8% and that of minor adverse events from 0-81%. It was not feasible to pool the risk for adverse effects due to heterogeneity of study populations and difference in interventions and variance in reporting. Conclusion In this literature review it was difficult to accurately quantify the incidence of adverse effects after extra-articular corticosteroid injection. The reported adverse events were relatively mild, although one fatal reaction was reported.

  6. Hypertension, high-dose corticosteroids, and renal infiltration in children with acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Andry Juliansen

    2014-11-01

    Full Text Available Background Hypertension is a rarely recognized complication of acute lymphoblastic leukemia (ALL. The incidence of hypertension in ALL patients in Indonesia remains unknown, but the most common risk factors are corticosteroid use during induction-phase chemotherapy and renal leukemic infiltration. Objective To determine the incidence of hypertension in children with ALL, and to assess for associations of high-dose corticosteroids, renal infiltration, and hyperleukocytosis to hypertension. Methods This was a cross-sectional study involving 100 children aged 2-18 years. Subjects were newly diagnosed ALL patients and those underwent induction-phase chemotherapy in the Pediatric Ward or Outpatient Clinic at Cipto Mangunkusumo or Dharmais Hospitals. Results Hypertension occurred in 6 (10% of 60 newly diagnosed ALL patients and 8 (20% of 40 patients who had received high-dose corticosteroids, but the difference was not statistically significant (OR=2.25; 95%CI 0.72 to 7.07; P=0.239. Hypertension was reported in 8 of 29 subjects who received dexamethasone, but in none of the subjects who received prednisone. However, the difference in these subgroups was also not statistically significant. Renal enlargement was found in 1 of 14 hypertensive patients, but it was not associated with hypertension (OR=0.80; 95%CI 0.52 to 1.24; P=0.417. Hyperleukocytosis was also not associated with hypertension (OR= 0.79; 95% CI 0.20 to 3.11; P=1.000. Conclusion The incidence of hypertension in ALL patients was 14%. Hypertension is not associated with renal infiltration or hyperleukocytosis. Furthermore, hypertension is not associated with corticosteroid dose, though is found only in subjects who receive dexamethasone. [Paediatr Indones. 2014;54:372-6.].

  7. The influence of direct intramuscular corticosteroid therapy on parameters of venous circulation in hypoxaemic fetuses

    OpenAIRE

    Babović Ivana; Plešinac Snežana; Opalić Jasna; Plećaš Darko; Ljubić Aleksandar

    2007-01-01

    Introduction: The influence of glucocorticosteroid therapy on fetal lung maturation is evident but little is known about its effects on parameters of fetal venous circulation. Objective. The aim of the study was to assess the influence of direct intramuscular (i.m.) fetal corticosteroid therapy (CST) on parameters of fetal venous circulation which indicates a degree of fetal hypoxia. Method. The prospective study was conducted at the Institute of Gynaecology and Obstetrics during 2001. We eva...

  8. 24 hour and fractionated profiles of adrenocortical activity in asthmatic patients receiving inhaled and intranasal corticosteroids

    OpenAIRE

    Wilson, A.; LIPWORTH, B.

    1999-01-01

    BACKGROUND—As both rhinitis and asthma are allergic conditions, they frequently occur together. The objective of this study was to assess the diurnal adrenocortical activity in asthmatics receiving inhaled (inh) and intranasal (n) formulations of two different corticosteroids, fluticasone propionate (FP) and triamcinolone acetonide (TAA), both given at clinically recommended doses.
METHODS—Twelve stable moderately severe asthmatic subjects of mean age 23.9 years and mean ...

  9. Juvenile stress enhances anxiety and alters corticosteroid receptor expression in adulthood

    OpenAIRE

    Brydges, Nichola M.; Jin, Rowen; Seckl, Jonathan,; Holmes, Megan C; Drake, Amanda J.; Hall, Jeremy

    2013-01-01

    BackgroundExposure to stress in early life is correlated with the development of anxiety disorders in adulthood. The underlying mechanisms are not fully understood, but an imbalance in corticosteroid receptor (CR) expression in the limbic system, particularly the hippocampus, has been implicated in the etiology of anxiety disorders. However, little is known about how prepubertal stress in the so called “juvenile” period might alter the expression of these receptors.AimsTherefore, the aim of t...

  10. Successful corticosteroid-sparing effect of rituximab in the treatment of refractory idiopathic orbital inflammatory disease.

    OpenAIRE

    Shao, EH; Karydis, A; Gemenetzi, M; Taylor, SR

    2013-01-01

    Idiopathic orbital inflammatory disease (IOID) is an idiopathic inflammatory process within the orbit that can result in permanent visual impairment. Although high-dose oral corticosteroids are currently the mainstay of therapy, their long-term usage can cause significant toxicity. We present a case of IOID that was successfully treated with the anti-CD20 monoclonal antibody rituximab following failed steroid sparing with conventional second-line immunosuppressive agents.

  11. Are corticosteroids useful in all degrees of severity and rapid recovery of Bell's palsy?

    Science.gov (United States)

    Ferreira, Margarida; Firmino, Machado J; Marques, Elisa A; Santos, Paula C; Duarte, José A

    2016-07-01

    Conclusions The results provide preliminary evidence that corticosteroids were not effective in all grades of dysfunction and for achieving a rapid remission in the early phase of BP, highlighting the need to define standard and rigorous criteria to prescribe corticosteroids in these patients. Objectives The main aim of this study was to investigate whether the use of corticosteroids better associated than paralleled with neuromuscular training (C + FNT) is more effective than facial neuromuscular training (FNT) applied alone, in terms of recovery degree and facial symmetry during the early phase of Bell's palsy (BP). Patients and methods A prospective single-blinded study involved 73 patients: the C + FNT group (n = 42; median age = 37.5 years) and FNT group (n = 31; median age = 49.0 years). Patients were assessed before and 6 weeks after treatment by House-Brackmann (HB-FGS) and Sunnybrook Facial Grading System (SB-FGS). Results Recovery degree and facial symmetry improved significantly in both groups (p  0.05). However, the C + FNT group displayed better outcomes for cheek (p = 0.004) and mouth (p = 0.022) resting symmetry at SB-FGS, instead of compared to the FNT group. The corticosteroids had no significant effect on all recovery degrees (p = 0.992) and rapid remission (p = 0.952). Multiple linear regression analysis showed that the type of intervention was not a significant predictor for recovery degree (p = 0.917). PMID:27003272

  12. Effect of intranasal corticosteroid on pre-onset activation of eosinophils and mast cells in experimental Japanese cedar pollinosis

    Directory of Open Access Journals (Sweden)

    Yasuyuki Noyama

    2016-07-01

    Conclusions: These results suggest that pre-onset activation of eosinophils and mast cells is present in experimental JCP, and that prophylactic treatment with intranasal corticosteroids has the potential to control such activation.

  13. Juvenile idiopathic arthritis (JIA): a screening study to measure class II skeletal pattern, TMJ PDS and use of systemic corticosteroids.

    LENUS (Irish Health Repository)

    Mandall, Nicky A

    2010-03-01

    To screen patients with oligoarticular and polyarticular forms of Juvenile Idiopathic Arthritis (JIA) to determine (i) the severity of their class II skeletal pattern; (ii) temporomandibular joint signs and symptoms and (iii) use of systemic corticosteroids.

  14. MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy

    Energy Technology Data Exchange (ETDEWEB)

    Cakirer, Sinan E-mail: scakirer@yahoo.com

    2003-02-01

    Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia due to a granulomatous inflammation in the cavernous sinus. Corticosteroid therapy dramatically resolves both the clinical and radiological findings of THS. We present MRI findings of six patients with a clinical history of at least one episode of unilateral or bilateral orbital-periorbital pain, clinical findings of associated paresis of one or more of 3rd, 4th, 5th or 6th cranial nerves. All of the patients revealed an enlargement of the symptomatic cavernous sinus on magnetic resonance imaging (MRI) scans. Five patients revealed total resolution of the clinical findings within 1-8 weeks, following systemic corticosteroid treatment. One patient revealed only minor regression of clinical findings within 2 weeks after the initiation of the treatment, so the cavernous sinus lesion was reevaluated as meningioma on MRI, and the patient underwent surgical resection of the mass with resultant histopathological finding of cavernous sinus meningioma. A follow-up MRI scan was performed for five patients at the end of 8-weeks of steroid therapy. Three of these five patients showed total resolution of the cavernous sinus lesions whereas two of them revealed a partial regression of the cavernous sinus lesions. MRI findings before and after systemic corticosteroid therapy are important diagnostic criteria to put the definitive diagnosis of THS and to differentiate it from other cavernous sinus lesions that simulate THS both clinically and radiologically.

  15. Confirmation of protein biomarkers of corticosteroids treatment in veal calves sampled under field conditions.

    Science.gov (United States)

    Stella, Roberto; Arrigoni, Giorgio; Biancotto, Giancarlo; Krogh, Morten; Vascellari, Marta; Lega, Francesca; Pozza, Giandomenico; Angeletti, Roberto; Andrighetto, Igino; James, Peter

    2014-04-01

    In veal calf production, growth promoters are still illicitly used. Surveillance of misuse of such molecules is necessary to preserve human health. Methods currently adopted for their analysis are based on liquid chromatography-tandem mass spectrometry, but their efficacy can be affected by undetectable residual concentrations in biological matrices due to treatments at low-dosage or based on unknown anabolic compounds. The development of screening methods to identify the indirect biological effects of administration of growth promoters can improve the efficiency of drug residue monitoring. To this purpose, an integrated approach has been used to further validate the set of protein biomarkers defined in a previous controlled study to detect the use of corticosteroids through the changes caused in muscle protein expression. The thymus morphology of 48 samples collected under field conditions was evaluated to assess the presence of potential corticosteroids treatment. Animals were divided on the basis of their thymus characteristics in negative or suspected for illegal corticosteroids treatment. Drug residue analyses were performed on the liver, giving a satisfactory correlation with the histological examination (∼85%). Finally, the proteomics analysis of muscle protein extracts was carried out by 2D differential in gel electrophoresis, and proteins that were differentially expressed between the two animal groups (p value meat production. PMID:24559242

  16. Alzheimer's disease: pathophysiological implications of measurement of plasma cortisol, plasma dehydroepiandrosterone sulfate, and lymphocytic corticosteroid receptors.

    Science.gov (United States)

    Armanini, Decio; Vecchio, Franco; Basso, Alfonso; Milone, Francesco Ferro; Simoncini, Maria; Fiore, Cristina; Mattarello, Mee Joung; Sartorato, Paola; Karbowiak, Isabella

    2003-11-01

    Alzheimer's disease is often characterized by an increase in plasma cortisol without clinical evidence of hypercorticism. Twenty-three consecutive patients with Alzheimer's disease and 23 age- and sex-matched healthy controls were studied by measuring plasma cortisol and dehydroepiandrosterone sulfate (DHEAS) (by enzyme immunoassay), the number of type I and type II corticosteroid receptors in mononuclear leukocytes (by radio-receptor-assay), and the lymphocyte subpopulations (by cytofluorimetry). Results are expressed in terms of median and range. In Alzheimer's disease, plasma cortisol was higher than in controls (median 0.74, range 0.47-1.21 vs 0.47, 0.36-0.77 mmol/L; p < 0.001). Plasma DHEAS, the DHEAS/cortisol ratio, and the number of type II corticosteroid receptors were significantly lower in AD than in controls (DHEAS: median 1.81, range 0.21-3.69 vs 3.51, 1.35-9.07 micromol/L; DHEAS/ cortisol: 2.04, range 0.3-5.8 vs 6.8, range 2.7-24 and type II receptors: 1219, 1000-2700 vs 1950, 1035- 2750 receptors per cell; p < 0.001). No correlation was found between the hormonal parameters, age, and mini-mental test score. These data support the hypothesis of a dysregulation of the adrenal pituitary axis in Alzheimer's disease, which is probably the consequence of damage to target tissues by corticosteroids. PMID:14665714

  17. Parenteral corticosteroids followed by early surgical resection of large amblyogenic eyelid hemangiomas in infants

    Directory of Open Access Journals (Sweden)

    El Essawy R

    2013-05-01

    Full Text Available Rania El Essawy,1 Rasha Essameldin Galal21Department of Ophthalmology, 2Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, EgyptBackground: The purpose of this study was to evaluate the results and complications of early surgical resection of large amblyogenic subdermal eyelid hemangiomas in infants after prior short-term parenteral administration of corticosteroids.Methods: Sixteen infants were given dexamethasone 2 mg/kg/day in two divided doses for three consecutive days prior to scheduled surgical excision of large eyelid hemangiomas. The lesions were accessed via an upper eyelid crease, subeyebrow incision, or a lower eyelid subciliary incision.Results: In all cases, surgical excision of the entire lesion was possible with no significant intraoperative or postoperative complications. The levator muscle/aponeurosis complex was involved in 31.25% of cases and was managed by reinsertion or repositioning without resection. A satisfactory lid position and contour with immediate clearing of the visual axis was achieved in all but one case (93.8%.Conclusion: Parenteral corticosteroids helped in reducing volume and blood flow from the hemangiomas, allowing for very early total excision of large subdermal infantile hemangiomas without significant intraoperative hemorrhage. This resulted in immediate elimination of any reason for occlusion amblyopia. Long-term follow-up of visual development in these patients would help to demonstrate the effectiveness of this strategy compared with more conservative measures.Keywords: large eyelid hemangiomas, early surgical resection, parenteral corticosteroids

  18. Devastating Effect of Uncontrolled Corticosteroid Usage: Severe Growth Retardation in Juvenile Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Yusuf Aydın

    2008-08-01

    Full Text Available A 22-year-old male patient was admitted to the hospital with complaints of retardation in physical and sexual development. He had been diagnosed with juvenile rheumatoid arthritis 15 years previously and treated with salicylazosulfapyridine 2x2 g and 30 mg prednisolone daily since diagnosis. His height was 109 cm (less than 3rd percentile, and his weight was 24 kg (less than 3rd percentile. He had no beard, mustache, axillary, or pubic hair, and had a cushingoid appearence. He had neither erection nor ejaculation. Growth retardation has been shown in patients with juvenile rheumatoid arthritis. This undesired effect may be due to both severe chronic inflammation and to long-term usage of corticosteroids. Corticosteroids can cause inhibition of pubertal and sexual development by affecting directly or indirectly all components of brain-pituitary-gonad axis. We report this patient to emphasize that although corticosteroids are effective in the treatment of juvenile rheumatoid arthritis, they may have devastating effects on the physical, sexual, and psychological development when used in high doses.Turk Jem 2008; 12: 57-9

  19. Improved outcome of bacterial meningitis associated with use of corticosteroid treatment

    DEFF Research Database (Denmark)

    Baunbæk-Knudsen, Gertrud; Sølling, Mette; Farre, Annette; Benfield, Thomas; Brandt, Christian T

    2016-01-01

    were included in the study. The population had a median age of 62 years and 31% had an immunosuppressive co-morbidity. Eighty-nine patients had an unfavourable outcome (GOS score = 1-4). Adjuvant treatment with corticosteroids (RR = 0.48; 95% CI = 0.30-0.76) was associated with a favourable outcome...... (GOS score = 5), while altered mental status (RR = 2.36; 95% CI = 1.17-4.78) and age (RR = 1.03; 95% CI = 1.01-1.04) per year increment was associated with an unfavourable outcome. Adjuvant corticosteroid treatment did not affect short- or long-term survival. Short-term mortality was influenced by age...... (RR = 1.06; 95% CI = 1.04-1.09). Long-term mortality was influenced by age (RR = 1.06; 95% CI = 1.03-1.08) and female sex (RR = 1.81; 95% CI = 1.05-3.14). CONCLUSION: This study indicated that adjuvant corticosteroid treatment in acute bacterial meningitis improves the outcome and can safely be...

  20. Intra-Articular Corticosteroids in Addition to Exercise for Reducing Pain Sensitivity in Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Soriano-Maldonado, Alberto; Klokker, Louise; Bartholdy, Cecilie;

    2016-01-01

    OBJECTIVE: To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). DESIGN: Randomized, masked, parallel, placebo-controlled trial involving 100 particip......OBJECTIVE: To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). DESIGN: Randomized, masked, parallel, placebo-controlled trial involving 100...... the injections all participants undertook a 12-week supervised exercise program. Main outcomes were changes from baseline in pressure-pain sensitivity (pressure-pain threshold [PPT] and temporal summation [TS]) assessed using cuff pressure algometry on the calf. These were exploratory outcomes from a...... analyzed. The mean group difference in changes from baseline at week 14 was 0.6 kPa (95% CI: -1.7 to 2.8; P = 0.626) for PPT and 384 mm×sec (95% CI: -2980 to 3750; P = 0.821) for TS. CONCLUSIONS: These results suggest that adding intra-articular corticosteroid injection 2 weeks prior to an exercise program...

  1. Ultrasound- versus palpation-guided injection of corticosteroid for plantar fasciitis: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Zonghuan Li

    Full Text Available BACKGROUND: It is controversial whether ultrasound-guided injection of corticosteroid is superior to palpation-guided injection for plantar fasciitis. This meta-analysis was performed to compare the effectiveness of ultrasound-guided and palpation-guided injection of corticosteroid for the treatment of plantar fasciitis. METHODS: Databases (MEDLINE, Cochrane library and EMBASE and reference lists were searched from their establishment to August 30, 2013 for randomized controlled trials (RCTs comparing ultrasound-guided with palpation-guided injection for plantar fasciitis. The Cochrane risk of bias (ROB tool was used to assess the methodological quality. Outcome measurements were visual analogue scale (VAS, tenderness threshold (TT, heel tenderness index (HTI, response rate, plantar fascia thickness (PFT, hypoechogenicity and heel pad thickness (HPT. The statistical analysis was performed with software RevMan 5.2 and Stata 12.0. When I2<50%, the fixed-effects model was adopted. Otherwise the randomized-effects model was adopted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE system was used to assess the quality of evidence. RESULTS: Five RCTs with 149 patients were identified and analyzed. Compared with palpation-guided injection, ultrasound-guided injection was superior with regard to VAS, TT, response rate, PFT and hypoechogenicity. However, there was no statistical significance between the two groups for HPT and HTI. CONCLUSION: Ultrasound-guided injection of corticosteroid tends to be more effective than palpation-guided injection. However, it needs to be confirmed by further research.

  2. MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy

    International Nuclear Information System (INIS)

    Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia due to a granulomatous inflammation in the cavernous sinus. Corticosteroid therapy dramatically resolves both the clinical and radiological findings of THS. We present MRI findings of six patients with a clinical history of at least one episode of unilateral or bilateral orbital-periorbital pain, clinical findings of associated paresis of one or more of 3rd, 4th, 5th or 6th cranial nerves. All of the patients revealed an enlargement of the symptomatic cavernous sinus on magnetic resonance imaging (MRI) scans. Five patients revealed total resolution of the clinical findings within 1-8 weeks, following systemic corticosteroid treatment. One patient revealed only minor regression of clinical findings within 2 weeks after the initiation of the treatment, so the cavernous sinus lesion was reevaluated as meningioma on MRI, and the patient underwent surgical resection of the mass with resultant histopathological finding of cavernous sinus meningioma. A follow-up MRI scan was performed for five patients at the end of 8-weeks of steroid therapy. Three of these five patients showed total resolution of the cavernous sinus lesions whereas two of them revealed a partial regression of the cavernous sinus lesions. MRI findings before and after systemic corticosteroid therapy are important diagnostic criteria to put the definitive diagnosis of THS and to differentiate it from other cavernous sinus lesions that simulate THS both clinically and radiologically

  3. Corticosteroid in the Treatment of Moderate to Severe Thrombocytopenia Due to Leptospirosis

    Science.gov (United States)

    Alian, Shahriar; Asghari, Hasan; Najafi, Narges; Davoudi, Alireza; Yazdani, Jamshid

    2014-01-01

    Background: Thrombocytopenia is associated with a bad prognosis in Leptospirosis. Objectives: We investigated the effect of corticosteroids to improve thrombocytopenia due to leptospirosis. Patients and Methods: In a clinical trial, all patients admitted with leptospirosis in Razi Hospital of Ghaemshahr, north of Iran were enrolled in a 2-year study. Totally, 56 patients with moderate to severe thrombocytopenia were randomized to control and treatment groups. The treatment group received corticosteroid (prednisolone 1 mg/kg/day for maximum one week) in addition to the standard antibiotic therapy. Results: There was no significant difference regarding age and gender between the two groups (P = 0.254, P = 0.789, respectively). The mean duration to improve thrombocytopenia was 4.41 ± 0.197 days in the treatment group and 5.72 ± 0.318 days in the control group, which was significantly different (P = 0.003). Duration of hospitalization in the treatment group was 5.24 ± 0.244 days and 6.23 ± 0.329 days in the control group, which was significantly different (P = 0.028). The two groups had no significant difference regarding mortality, intubation, level of platelet, duration of ICU admission and pulmonary, renal or hepatic involvement. Conclusions: Corticosteroid therapy decreased the length of hospitalization only in severe subgroup thrombocytopenia, but not in the moderate subgroup. PMID:25763200

  4. Prescribing Practices of Topical Corticosteroids in the Outpatient Dermatology Department of a Rural Tertiary Care Teaching Hospital

    OpenAIRE

    Suvarna S. Rathod; Vijay M. Motghare; Vinod S. Deshmukh; Rushikesh P Deshpande; Chetanraj G. Bhamare; Patil, Jyoti R

    2013-01-01

    Background: Inappropriate or excessive use of topical corticosteroids can lead to cutaneous and systemic adverse effects which occur more commonly with the use of very potent steroids. Monitoring and analysis of the prescription practices of topical steroids can help to achieve rational prescription of these drugs. Aim: The present study was carried out to study and analyze the pattern of prescribing topical corticosteroids among outpatients attending the dermatology clinic in a rural tertiar...

  5. Intravenous pamidronate in the treatment of osteoporosis associated with corticosteroid dependent lung disease: an open pilot study.

    OpenAIRE

    Gallacher, S. J.; Fenner, J A; Anderson, K.; Bryden, F M; Banham, S W; Logue, F C; Cowan, R. A.; Boyle, I T

    1992-01-01

    BACKGROUND: Bisphosphonates have been shown to be effective agents in the treatment of postmenopausal osteoporosis. Because corticosteroid associated osteoporosis is often associated with increased bone turnover, the effect of intermittent intravenous infusions of pamidronate on this condition has been investigated. METHODS: Seventeen patients (five male) with chronic corticosteroid dependent lung disease (15 asthma, two sarcoidosis) were treated with infusions of 30 mg pamidronate once every...

  6. Identification and characterization of a monocyte-derived neutrophil-activating factor in corticosteroid-resistant bronchial asthma.

    OpenAIRE

    Wilkinson, J R; Crea, A E; Clark, T J; Lee, T. H.

    1989-01-01

    Peripheral blood mononuclear cells (PBMC) were isolated from seven normal subjects, eight asthmatic subjects clinically sensitive to corticosteroids (CS), and eight asthmatic subjects clinically resistant to corticosteroids (CR). PBMC were cultured at 37 degrees C for 24 h in the absence or presence of 10(-16) to 10(-4) M hydrocortisone. Calcium ionophore (A23187)-activated neutrophils (PMN) primed by supernatants of PBMC from asthmatic subjects cultured in the absence of hydrocortisone gener...

  7. Corticosteroid Therapy, Vitamin D Status, and Inflammatory Cytokine Profile in the HIV-Tuberculosis Immune Reconstitution Inflammatory Syndrome

    OpenAIRE

    Conesa-Botella, Anali; Meintjes, Graeme; Coussens, Anna K.; van der Plas, Helen; Goliath, Rene; Schutz, Charlotte; Moreno-Reyes, Rodrigo; Mehta, Meera; Martineau, Adrian R.; Wilkinson, Robert J.; Colebunders, Robert; Wilkinson, Katalin A.

    2012-01-01

    Background . Tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS) in patients coinfected with human immunodeficiency virus (HIV) and tuberculosis starting antiretroviral therapy (ART) is associated with hypercytokinemia. As adjunctive corticosteroid therapy and vitamin D have immunomodulatory properties, we investigated the relationship between cytokine/chemokine profiles, corticosteroid use, and vitamin D deficiency in TB-IRIS patients. Methods . Plasma from 39 TB-IRIS and 42 n...

  8. Risk of miscarriage among users of corticosteroid hormones: a population-based nested case-control study

    OpenAIRE

    Bjørn AM; Nielsen RB; Nørgaard M; Nohr EA; Ehrenstein V

    2013-01-01

    Anne-Mette B Bjørn,1 Rikke B Nielsen,1 Mette Nørgaard,1 Ellen A Nohr,2 Vera Ehrenstein11Department of Clinical Epidemiology, 2Section for Epidemiology, Department of Public Health, Aarhus University Hospital, Aarhus, DenmarkBackground: The purpose of this nested case-control study in Denmark was to study the association between use of corticosteroids and risk of miscarriage.Methods: We identified prescriptions for corticosteroids before the miscarriage/index date. We est...

  9. Pulmonary and Meningeal Cryptococcosis after Corticosteroid Therapy for Autoimmune Hepatitis: Coexistence of Cryptococci within Pulmonary Cancer Nodule

    OpenAIRE

    Airo Tsubura; Yuichi Kinoshita; Katsuhiko Yoshizawa; Yuko Emoto; Ayako Kimura; Takashi Yuri

    2013-01-01

    A case of autoimmune hepatitis complicated with pulmonary and meningeal cryptococcosis during long-term treatment with corticosteroid is reported. An 84-year-old woman who received long-term corticosteroid therapy (40 mg/day prednisolone for two years) for autoimmune hepatitis developed a headache, slight fever, and anorexia and was diagnosed with cryptococcal meningitis two months prior to hospital admission. Due to deterioration of her condition, the patient was transferred to our universit...

  10. A PAMPA Assay as Fast Predictive Model of Passive Human Skin Permeability of New Synthesized Corticosteroid C-21 Esters

    Directory of Open Access Journals (Sweden)

    Katarina D. Karljikovic-Rajic

    2012-01-01

    Full Text Available The permeation properties of twenty newly synthesized α-alkoxyalkanoyl and α-aryloxyalkanoyl C-21 esters of standard corticosteroids: Fluocinolone acetonide, dexamethasone, triamcinolone acetonide and hydrocortisone were established using a PAMPA assay (70% silicone oil and 30% isopropyl myristate. The data were compared with parent corticosteroids with addition of mometasone furoate and hydrocortisone acetate. All newly synthesized corticosteroid C-21 esters have effective permeability coefficients higher then -6, mostly followed with high values of retention factors and low permeation. The examined compounds were grouped through relationship between obtained retention factors and permeation parameters (groups I–III. The classification confirmed group I (membrane retentions as well as permeation lower then 30% for all corticosteroid standards except mometasone furoate, a potent topical corticosteroid which, with high membrane retention (81% and low permeation (7.7% fits into group III. The largest number of new synthesized corticosteroids C-21 esters, among them all fluocinolone acetonide C-21 esters, have high membrane retentions (32.4%–86.5% and low permeations (1.3%–27.1%, fitting in group III. The classification was related to previously obtained anti-inflammatory activity data for the fluocinolone acetonide C-21 esters series. According to the PAMPA results the new synthesized esters could be considered as potential new prodrugs with useful benefit/risk ratio.

  11. What Is the Evidence for Harm of Neuromuscular Blockade and Corticosteroid Use in the Intensive Care Unit?

    Science.gov (United States)

    Annane, Djillali

    2016-02-01

    Neuromuscular blocking agents and corticosteroids are widely used in medicine and in particular in the intensive care unit (ICU). Neuromuscular blockade is commonly used to ease tracheal intubation, to optimize mechanical ventilation and oxygenation in acute respiratory disorders such as status asthmaticus and acute respiratory distress syndrome (ARDS), to prevent shivering during therapeutic hypothermia, and also in patients with elevated intracranial pressure. In the ICU, patients with sepsis, ARDS, community-acquired pneumonia, exacerbation of chronic obstructive pulmonary disease, severe asthma, or trauma may receive corticosteroids. It is not rare that ICU patients receive concomitantly neuromuscular blocking drugs and corticosteroids. Among the various serious adverse reactions to these drugs, secondary infection and ICU-acquired weakness may place a burden to the health-care system by resulting in substantial cost and long-term morbidity. Both superinfections and ICU-acquired paresis are more likely when high doses of fluorinated corticosteroids are combined with prolonged treatment with a long-acting non-depolarizing neuromuscular blocker. Modern ICU practices favor lower dose of corticosteroids and very short course of short-acting curare for the management of sepsis or ARDS. Recent trials provided no evidence for increased risk of secondary infections or critical illness neuromyopathy in patients with sepsis or ARDS with the use of corticosteroids or neuromuscular blockers. PMID:26820274

  12. Corticosteroids as a therapy for bacterial keratitis: an evidence-based review of 'who, when and why'.

    Science.gov (United States)

    Tallab, Raghad T; Stone, Donald U

    2016-06-01

    Corticosteroids have been proposed as an adjunct to antibiotics for the treatment of bacterial keratitis, with significant controversy regarding the appropriate use of this therapy. Recent prospective randomised controlled trials have provided additional evidence to guide clinical decision-making. A review of the epidemiology and mechanisms of pathogenesis, preliminary animal studies, retrospective human studies and prospective randomised clinical trials that address the potential risks and benefits of corticosteroids in patients with bacterial keratitis was performed. Four prospective randomised controlled trials were identified. Three small studies found no benefit of topical corticosteroids, but were underpowered to evaluate adverse events. The Steroids for Corneal Ulcers Trial (SCUT) study and subgroup analyses provide evidence for a relative gain of one line of best spectacle-corrected visual acuity in patients with non-Nocardia bacterial keratitis, especially when corticosteroids were initiated within 3 days of presentation; no increase in adverse events was noted. No evidence was found to support the concern for corneal thinning attributable to corticosteroids in the absence of an inadequately treated infectious process. In patients with culture-proven non-Nocardia bacterial keratitis, corticosteroids provide one line of vision improvement over antimicrobials alone, with no increase in adverse events. This benefit should not be extrapolated to patients with other aetiologies of keratitis, such as fungus, herpes viruses, acanthamoeba or atypical mycobacteria, and these entities should be excluded before considering adjunctive steroid therapy. PMID:26743622

  13. Early treatment of chlorine-induced airway hyperresponsiveness and inflammation with corticosteroids

    Energy Technology Data Exchange (ETDEWEB)

    Jonasson, Sofia, E-mail: sofia.jonasson@foi.se [Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå (Sweden); Wigenstam, Elisabeth [Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå (Sweden); Department of Public Health and Clinical Medicine, Unit of Respiratory Medicine, Umeå University, Umeå (Sweden); Koch, Bo [Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå (Sweden); Bucht, Anders [Swedish Defence Research Agency, Division of CBRN Defence and Security, Umeå (Sweden); Department of Public Health and Clinical Medicine, Unit of Respiratory Medicine, Umeå University, Umeå (Sweden)

    2013-09-01

    Chlorine (Cl{sub 2}) is an industrial gas that is highly toxic and irritating when inhaled causing tissue damage and an acute inflammatory response in the airways followed by a long-term airway dysfunction. The aim of this study was to evaluate whether early anti-inflammatory treatment can protect against the delayed symptoms in Cl{sub 2}-exposed mice. BALB/c mice were exposed by nose-only inhalation using 200 ppm Cl{sub 2} during 15 min. Assessment of airway hyperresponsiveness (AHR), inflammatory cell counts in bronchoalveolar lavage, occurrence of lung edema and lung fibrosis were analyzed 24 h or 14 days post-exposure. A single dose of the corticosteroid dexamethasone (10 or 100 mg/kg) was administered intraperitoneally 1, 3, 6, or 12 h following Cl{sub 2} exposure. High-dose of dexamethasone reduced the acute inflammation if administered within 6 h after exposure but treated animals still displayed a significant lung injury. The effect of dexamethasone administered within 1 h was dose-dependent; high-dose significantly reduced acute airway inflammation (100 mg/kg) but not treatment with the relatively low-dose (10 mg/kg). Both doses reduced AHR 14 days later, while lung fibrosis measured as collagen deposition was not significantly reduced. The results point out that the acute inflammation in the lungs due to Cl{sub 2} exposure only partly is associated with the long-term AHR. We hypothesize that additional pathogenic mechanisms apart from the inflammatory reactions contribute to the development of long-term airway dysfunction. By using this mouse model, we have validated early administration of corticosteroids in terms of efficacy to prevent acute lung injury and delayed symptoms induced by Cl{sub 2} exposure. - Highlights: • Inhalation of Cl{sub 2} may lead to a long-standing airway hyperresponsiveness. • The symptoms in Cl{sub 2}-exposed mice are similar to those described for RADS in humans. • Corticosteroids prevent delayed symptoms such as AHR in

  14. Corticosteroid therapy in the treatment of pediatric patients with atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Leopold, Christine

    2007-09-01

    Full Text Available Health political background: In developed countries 2.5% of the population - mainly children - are affected by atopic dermatitis. During the past few years its prevalence amongst school children has risen decisively and now lies between 8% to 16%. It is the most frequent chronic skin disease amongst school-aged children. Scientific background: Current methods of treating atopic dermatitis among children focus on containing and preventing the illness’s further progression. Preventing dry skin, relieving symptoms (such as pruritis and inflammation of the skin and identifying and avoiding provocating factors are elementary goals of treatment. Successful treatment can substantially increase the children’s quality of life. Possible therapies of children affected by atopic dermatitis include both topically and systemically applied pharmaceuticals. During the past ten years the use of corticosteroids has been the standard topical anti-inflammatory therapy in case of aggravating inflammations. In 2002 a new group of pharmaceutical substances (topical calcineurin inhibitors tacrolimus and pimecrolimus was authorised in Germany for topical anti-inflammatory treatment of patients. Because of its high prevalence atopic dermatitis represents a major expense factor to the German health care system. In 1999 the costs of the treatment of atopic dermatitis with corticosteroids in Germany amounted to 230 million Euro. If other direct costs for the treatment are included, for example hospitalisation or doctor appointments, the total costs amount to 3.57 billion Euro. Research question: How effective and efficient are topical anti-inflammatory treatments of children with atopic dermatitis? Methods: A systematic literature search was performed in 35 international databases which yielded 1335 articles. Following a two-part selection process according to predefined criteria 24 publications were included in the assessment. Results: Of 19 randomised controlled

  15. Withdrawal of corticosteroids in inflammatory bowel disease patients after dependency periods ranging from 2 to 45 years: a proposed method.

    LENUS (Irish Health Repository)

    Murphy, S J

    2012-02-01

    BACKGROUND: Even in the biologic era, corticosteroid dependency in IBD patients is common and causes a lot of morbidity, but methods of withdrawal are not well described. AIM: To assess the effectiveness of a corticosteroid withdrawal method. METHODS: Twelve patients (10 men, 2 women; 6 ulcerative colitis, 6 Crohn\\'s disease), median age 53.5 years (range 29-75) were included. IBD patients with quiescent disease refractory to conventional weaning were transitioned to oral dexamethasone, educated about symptoms of the corticosteroid withdrawal syndrome (CWS) and weaned under the supervision of an endocrinologist. When patients failed to wean despite a slow weaning pace and their IBD remaining quiescent, low dose synthetic ACTH stimulation testing was performed to assess for adrenal insufficiency. Multivariate analysis was performed to assess predictors of a slow wean. RESULTS: Median durations for disease and corticosteroid dependency were 21 (range 3-45) and 14 (range 2-45) years respectively. Ten patients (83%) were successfully weaned after a median follow-up from final wean of 38 months (range 5-73). Disease flares occurred in two patients, CWS in five and ACTH testing was performed in 10. Multivariate analysis showed that longer duration of corticosteroid use appeared to be associated with a slower wean (P = 0.056). CONCLUSIONS: Corticosteroid withdrawal using this protocol had a high success rate and durable effect and was effective in patients with long-standing (up to 45 years) dependency. As symptoms of CWS mimic symptoms of IBD disease flares, gastroenterologists may have difficulty distinguishing them, which may be a contributory factor to the frequency of corticosteroid dependency in IBD patients.

  16. Modelling the binding affinity of steroids to zebrafish sex hormone-binding globulin.

    Science.gov (United States)

    Saxena, A K; Devillers, J; Pery, A R R; Beaudouin, R; Balaramnavar, V M; Ahmed, S

    2014-01-01

    The circulating endogenous steroids are transported in the bloodstream. These are bound to a highly specific sex hormone-binding globulin (SHBG) and in lower affinity to proteins such as the corticosteroid-binding protein and albumin in vertebrates, including fish. It is generally believed that the glycoprotein SHBG protects these steroids from rapid metabolic degradation and thus intervenes in its availability at the target tissues. Endocrine disrupters binding to SHBG affect the normal activity of natural steroids. Since xenobiotics are primarily released in the aquatic environment, there is a need to evaluate the binding affinity of xenosteroid mimics on fish SHBG, especially in zebrafish (Danio rerio), a small freshwater fish originating in India and widely employed in ecotoxicology, toxicology, and genetics. In this context, a zebrafish SHBG (zfSHBG) homology model was developed using the human SHBG (hSHBG) receptor structure as template. It was shown that interactions with amino acids Ser-36, Asp-59 and Thr-54 were important for binding affinity. A ligand-based pharmacophore model was also developed for both zfSHBG and hSHBG inhibitors that differentiated binders from non-binders, but also demonstrated structural requirements for zfSHBG and hSHBG ligands. The study provides insights into the mechanism of action of endocrine disruptors in zebrafish as well as providing a useful tool for identifying anthropogenic compounds inhibiting zfSHBG. PMID:24874994

  17. Capability of hypertonic saline cough provocation test to predict the response to inhaled corticosteroids in chronic cough: a prospective, open-label study

    OpenAIRE

    Koskela, Heikki O; Purokivi, Minna K

    2013-01-01

    Background Many patients with chronic cough respond to treatment with inhaled corticosteroids but it is difficult to predict which patients are likely to respond. The primary aim of the present study was to define the capability of hypertonic saline cough provocation test to predict the responsiveness to inhaled corticosteroids in chronic cough. The secondary aim was to assess the ability of the saline test to monitor the healing of cough during corticosteroid treatment. Methods Forty-three p...

  18. The Effect of Corticosteroids on Urinary Calcium Excretion. A Pilot Study

    Directory of Open Access Journals (Sweden)

    Semra Soylu Gungor

    2014-12-01

    Full Text Available Aim: Corticosteroids are the main drugs in the treatment of nephrotic syndrome and bronchial hyperreactivity and can be used for long periods in high doses. From clinical use and experiments, systemic corticosteroids are known to cause hypercalciuria. In this study we aim to determine the effect of corticosteroids on urinary calcium excretion and to assess related parameters in children with chronic disease. Material and Method: Thirty-nine children with nephrotic syndrome and bronchial hyperreactivity from ages 1-15 and 15 same-aged healthy controls of the same sex are included in the study. Nineteen patients with nephrotic syndrome using 2 mg/kg/day oral prednisolone are included in group 1, and 20 patients with bronchial hyperreactivity who use inhaled 2x200 µgr budesonide are included in group 2. All children%u2019s bone formation (serum osteocalcin and alkaline phosphatase, resorption (urine deoxypyridinoline crosslinks/creatinine, and metabolism markers (parathyroid hormone, calcium, and phosphate were analyzed. Results: Post-treatment urinary calcium/creatinine ratio was increased in the nephrotic syndrome group. Osteocalcine levels were found decreased in nephrotic syndrome patients who take oral prednisolone treatment. Urine deoxypyridinoline crosslinks/creatinine ratio levels were found low in both nephrotic syndrome and bronchial hyperreactivity patients, contrary to expectations.Discussion: In this study we found that oral prednisolone usage increased renal calcium excretion while inhaled budesonide did not increase renal calcium excretion. We believe that oral prednisolone repressed the bone formation. To further investigate low urine deoxypyridinoline crosslinks/creatinine ratio, more prospective studies with a greater number of participants are required.

  19. Impact of the Topical Ophthalmic Corticosteroid Loteprednol Etabonate on Intraocular Pressure.

    Science.gov (United States)

    Sheppard, John D; Comstock, Timothy L; Cavet, Megan E

    2016-04-01

    Corticosteroids are a mainstay therapeutic option for the treatment of ocular inflammation. However, safety remains a concern for clinicians, particularly with long-term use. Though highly effective at suppressing inflammatory and allergic responses, topical ophthalmic corticosteroids carry an inherent risk of side effects, including elevated intraocular pressure (IOP), a risk factor for the development of glaucoma. The corticosteroid loteprednol etabonate (LE) contains an ester rather than a ketone at the C-20 position, minimizing the potential for side effects, including IOP elevation. In early pivotal clinical trials of LE ophthalmic suspension for conjunctivitis (allergic, giant papillary), anterior uveitis, and post-operative inflammation, LE had minimal impact on IOP over short-term (gel, an ointment, and a suspension of LE in combination with tobramycin-have become commercially available. Multiple studies evaluating the safety and efficacy of LE for inflammatory conditions have been reported, including those requiring longer-term treatment such as photorefractive keratectomy, corneal transplantation, and dry eye disease. We review the available published data on the effect of LE on IOP and report on the cumulative incidence of clinically significant IOP elevations (≥10 mm Hg from baseline) with short-term and long-term LE use. In all studies, LE consistently demonstrated a low propensity to elevate IOP, regardless of formulation, dosage regimen, or treatment duration, including in known steroid responders. The cumulative proportion of patients exhibiting clinically significant IOP increases was 0.8% (14/1725 subjects) in studies evaluating short-term LE treatment and 1.5% (21/1386 subjects) in long-term studies. Furthermore, use of LE was associated with significantly lower rates of IOP elevation ≥10 mm Hg as compared to prednisolone acetate or dexamethasone (when used in combination with tobramycin). The cumulative data to date substantiates a

  20. Corticosteroids overdose

    Science.gov (United States)

    ... Fluocinonide Flurandrenolide Fluticasone propionate Halcinonide Halobetasol propionate Hydrocortisone Hydrocortisone acetate Hydrocortisone butyrate Hydrocortisone sodium phosphate Hydrocortisone valerate Methylprednisolone ...

  1. Fatal varicella hepatitis in an asthmatic adult after short-term corticosteroid treatment.

    Science.gov (United States)

    Hyvernat, Hervé; Roger, Pierre-Marie; Pereira, Cécile; Saint-Paul, Marie Christine; Vandenbos, Frédéric; Bernardin, Gilles

    2005-09-01

    A 28-year-old male patient, treated with prednisone for bronchitis with sibilant rales, developed fever with abdominal pain and generalized vesicular rash after coming in contact with varicella-infected children. He was hospitalized after having a seizure. Laboratory values revealed hepatitis and rapidly fulminant hepatic insufficiency with disseminated intravascular coagulation. Despite acyclovir treatment, the patient died 4 days after admission. Clinical presentation could evoke a Reye's syndrome, but liver biopsy showed massive coagulative necrosis. This report demonstrates the increased risk of complicated varicella associated with the use of corticosteroids, even for a short period of time. PMID:16137553

  2. Contrast medium injected into juvenile bone cysts to analyze interior morphology and guide intracavity corticosteroid treatment

    International Nuclear Information System (INIS)

    In connection with treating juvenile bone cysts with intracavital corticosteroid injections, the interior cyst anatomy was analyzed at cystography in 13 children aged 4 to 15 years. Only 4 children had a true unicameral cyst; the others had 2 or more cysts or had compartments with free or restricted communication to the main cyst. Cysts and compartments which had not been reached by steroids may continue to grow. Optimum treatment may therefore require injections at different sites guided by cystography. Neither conventional criteria of cyst activity nor repeated bone scintigraphy 3 months after treatment could predict whether the treatment would lead to final healing. (orig.)

  3. Takayasu's arteritis: low corticosteroid dosage and pregnancy--a case report.

    Science.gov (United States)

    Del Corso, L; De Marco, S; Vannini, A; Pentimone, F

    1993-10-01

    The authors describe a case of Takayasu's arteritis in a twenty-five-year-old Italian woman, characterized by nonspecific symptoms (weakness, arthralgias, fever) and elevated erythrocyte sedimentation rate early onset of these symptoms at the age of about twenty-three years early diagnosis, only eighteen months after the onset of symptomatology absence of progression of the disease under corticosteroid therapy with a follow-up of three years uneventful pregnancy ending in cesarean section and birth of a baby without maternal and neonatal complications. PMID:8105731

  4. Combined Beta-Agonists and Corticosteroids Do Not Inhibit Extracellular Matrix Protein Production In Vitro

    OpenAIRE

    Qi Ge; Poniris, Maree H; Moir, Lyn M.; Black, Judith L; Burgess, Janette K.

    2012-01-01

    Background. Persistent asthma is characterized by airway remodeling. Whereas we have previously shown that neither β 2-agonists nor corticosteroids inhibit extracellular matrix (ECM) protein release from airway smooth muscle (ASM) cells, the effect of their combination is unknown and this forms the rationale for the present study. Methods. ASM cells from people with and without asthma were stimulated with TGFβ1 (1 ng/ml) with or without budesonide (10−8 M) and formoterol (10−10 and 10−8 M), a...

  5. Combined Beta-agonists and corticosteroids do not inhibit extracellular matrix protein production in vitro

    OpenAIRE

    Ge, Qi; Poniris, Maree H; Moir, Lyn M.; Black, Judith L; Burgess, Janette K.

    2012-01-01

    Background. Persistent asthma is characterized by airway remodeling. Whereas we have previously shown that neither β(2)-agonists nor corticosteroids inhibit extracellular matrix (ECM) protein release from airway smooth muscle (ASM) cells, the effect of their combination is unknown and this forms the rationale for the present study. Methods. ASM cells from people with and without asthma were stimulated with TGFβ1 (1 ng/ml) with or without budesonide (10(-8) M) and formoterol (10(-10) and 10(-8...

  6. Herpetic Brachial Plexopathy: Application of Brachial Plexus Magnetic Resonance Imaging and Ultrasound-Guided Corticosteroid Injection.

    Science.gov (United States)

    Kim, Jeong-Gil; Chung, Sun G

    2016-05-01

    Herpes zoster, commonly known as shingles, is an infectious viral disease characterized by painful, unilateral skin blisters occurring in specific sensory dermatomes. Motor paresis is reported in 0.5% to 5% of patients. Although the mechanism of zoster paresis is still unclear, the virus can spread from the dorsal root ganglia to the anterior horn cell or anterior spinal nerve roots. It rarely involves the brachial plexus. We report a case of brachial plexitis following herpes zoster infection in which pathological lesions were diagnosed using brachial plexus magnetic resonance imaging and treated with ultrasound-guided perineural corticosteroid injection. PMID:26829085

  7. A bone cyst treated with corticosteroid installation in an osteopetrotic child

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid; Pedersen, Niels Wisbech

    2010-01-01

    Bone cysts in patients suffering from osteopetrosis are uncommon. A pathologic fracture might cause therapeutic difficulties because of the osteosclerotic bone. We describe a patient with an autosomal dominant osteopetrosis suffering from a large bone cyst in the proximal femur. The cyst was trea...... treated with local injections of corticosteroid and healed completely after 2 injections. To our knowledge, this is the first time that the occurrence of bone cysts has been reported in osteopetrotic patients, which responds effectively and lastingly to steroid injection....

  8. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy

    DEFF Research Database (Denmark)

    Kongsgaard, M.; Kovanen, V.; Aagaard, P.;

    2009-01-01

    A randomized-controlled single-blind trial was conducted to investigate the clinical, structural and functional effects of peritendinous corticosteroid injections (CORT), eccentric decline squat training (ECC) and heavy slow resistance training (HSR) in patellar tendinopathy. Thirty-nine male...... patients were randomized to CORT, ECC or HSR for 12 weeks. We assessed function and symptoms (VISA-p questionnaire), tendon pain during activity (VAS), treatment satisfaction, tendon swelling, tendon vascularization, tendon mechanical properties and collagen crosslink properties. Assessments were made at 0...

  9. Desoximetasone--a new topical corticosteroid: short- and long-term experiences.

    Science.gov (United States)

    Savin, R C

    1978-03-01

    A new potent topical corticosteroid, desoximetasone, was clinically evaluated in several hundred patients with steroid-responsive dermatoses. Both short-term and long-term comparative studies showed desoximetasone emollient cream (0.25 percent) to be highly effective. Studies comparing betamethasone valerate cream C0. p1 percent) with desoximetasone emollient cream (0.25 percent) showed the new topical steroid to be clinically superior in the relief of moderate and severe inflammatory manifestations of psoriasis and atopic dermatitis. In addition, desoximetasone was found to be safe, well tolerated, and accepted by the patients. PMID:344003

  10. Influence of corticosteroids and vitamin E deficiency on onset of radiation-induced cataract

    Science.gov (United States)

    Junk, A. K.; Worgul, B. W.

    Cataracts characteristic of those arising from radiation exposure have been reported among the astronaut and cosmonaut corps. This being the case it is critical to appreciate how radiogenic cataracts relate to those arising from other exogenous causes such as therapeutics, which may, one day, have to be administered on an extended mission. Because they produce precisely the same clinical picture, corticosteroids are examples of a class of drugs that potentially can exacerbate damage to the lens from radiation. On the other hand, Vitamin E, a free radical scavenger, has been shown to ameliorate oxidative damage as caused by ionizing radiation and evidence is accumulating that it may constitute protection from radiogenic damage. An experimental study was conducted to understand if corticosteroids with, and in the absence of Vitamin E deficiency modulate the onset of cataract induced by ionizing radiation. The right eyes of seventy-two 28-day-old Brown-Norway rats were irradiated with 6 Gy of 240 kV X-rays, the shielded left eyes served as controls. Half of the animals were maintained on a Vitamin E free diet after irradiation, the others were kept on standard chow. Fifty per cent of the animals in each nutritional group received dexamethasone. The initial daily dose of 10 mg/kg body weight injected subcutaneously was reduced to 0.5 mg/kg over the course of six months. Cataract onset and development were followed by weekly slit-lamp exam. After six month the lenses were harvested for microscopic analyses. Irradiated eyes in all treatment subgroups showed early cataract onset [5 wks vs. 11 wks in controls ( p < 0.0001)]. Corticosteroids accounted for accelerated cataract development in both irradiated ( p < 0.0005) and non-irradiated eyes ( p < 0.0001) relative to respective control eyes. Vitamin E deficiency did not affect cataract incidence in combination with radiation or steroids alone. Unexpectedly, when compared to irradiated controls, cataract development was

  11. Influence of Corticosteroids and Vitamin E Deficiency on Onset and Cytopathology of Radiation-Induced Cataract

    Science.gov (United States)

    Junk, A. K.; Worgul, B. V.

    Cataracts characteristic of those arising from radiation exposure have been reported among the astronaut and cosmonaut corps. This being the case it is critical to appreciate how radiogenic cataracts relate to those arising from other exogenous causes such as therapeutics, which may, one day, have to be administered on an extended mission. Because they produce precisely the same clinical picture, corticosteroids are examples of a class of drugs that potentially can exacerbate damage to the lens from radiation. On the other hand, Vitamin E, a free radical scavenger, has been shown to ameliorate oxidative damage as caused by ionizing radiation and evidence is accumulating that it may constitute protection from radiogenic damage. An experimental study was conducted to understand if corticosteroids with and in the absence of Vitamin E deficiency modulate the onset of cataract induced by ionizing radiation. The right eyes of 72 28-day-old Brown-Norway rats were irradiated with 6 Gy of 240 kV X-rays, the shielded left eyes served as controls. Half of the animals were maintained on a Vitamin E free diet after irradiation, the others were kept on regular chow. In each nutritional group 18 rats additionally received dexamethasone. The initial daily dose of 10 mg/kg body weight injected subcutaneously was reduced to 0.5 mg/kg over the course of 6 months. Cataract onset and development were followed by weekly slit-lamp exam. After 6 month the lenses were harvested for microscopic analyses. Irradiated eyes in all treatment subgroups showed early cataract onset [5 wks versus 11 wks in controls (p<0.0001)]. Corticosteroids accounted for accelerated cataract development in both irradiated (p<0.0005) and non-irradiated eyes (p<0.0001) relative to respective control eyes. Vitamin E deficiency did not affect cataract incidence in combination with radiation or steroids alone. Unexpectedly, when compared to irradiated controls, cataract development was inhibited in the group that

  12. Effects of corticosteroids and hyaluronic acid on torn rotator cuff tendons in vitro and in rats.

    Science.gov (United States)

    Nakamura, Hidehiro; Gotoh, Masafumi; Kanazawa, Tomonoshin; Ohta, Keisuke; Nakamura, Keiichirou; Honda, Hirokazu; Ohzono, Hiroki; Shimokobe, Hisao; Mitsui, Yasuhiro; Shirachi, Isao; Okawa, Takahiro; Higuchi, Fujio; Shirahama, Masahiro; Shiba, Naoto; Matsueda, Satoko

    2015-10-01

    Corticosteroids (CS) or hyaluronic acid (HA) is used in subacromial injection for the conservative treatment of rotator cuff tears (RCT); this study addresses the question of how CS and HA affect the tendon tissue and fibroblasts in vitro and in rats. Cell proliferation assays were performed in human tendon fibroblasts from RCT. Rats underwent surgery to create RCT, and the surgical sites were injected with CS or HA. The rotator cuff tendons were subjected to biomechanical testing, microscopic and immunohistochemical analysis of proliferating cell nuclear antigen (PCNA), and ultrastructural analysis. Cell proliferation was significantly decreased with CS in vitro (p site. PMID:26174562

  13. Anaphylactoid reaction to corticosteroid: case report and review of the literature.

    Science.gov (United States)

    Peller, J S; Bardana, E J

    1985-04-01

    It has been suggested that corticosteroids can cause allergic reactions including anaphylaxis. Thirty-five patients have been reported to have anaphylaxis-like reactions following exposure to hydrocortisone in topical and parenteral preparations. We describe a further case of a nonatopic woman who developed urticaria during intravenous infusion of hydrocortisone. A review of the literature reveals that IgE-mediated immediate hypersensitivity has not been definitely proven in any case. We conclude that the clinical manifestations occasionally experienced after receiving hydrocortisone are most likely pseudoallergic reactions. PMID:3985425

  14. Randomised trial of once-daily vilanterol in children with asthma on inhaled corticosteroid therapy

    OpenAIRE

    Oliver, Amanda J.; Covar, Ronina A.; Goldfrad, Caroline H.; Klein, Ryan M.; Pedersen, Søren E.; Sorkness, Christine A.; Tomkins, Susan A.; Villarán, César; Grigg, Jonathan

    2016-01-01

    Background Inhaled corticosteroids (ICS) are effective maintenance treatments for childhood asthma; however, many children remain uncontrolled. Vilanterol (VI) is an inhaled long-acting beta-2 agonist which, in combination with the ICS fluticasone furoate, is being explored as a once-daily treatment for asthma in children. We evaluated the dose–response, efficacy, and safety of once-daily VI (6.25 μg, 12.5 μg and 25 μg) administered in the evening over 4 weeks, on background fluticasone propi...

  15. Midchildhood acne associated with inhaled corticosteroids: report of two cases and review of the literature.

    Science.gov (United States)

    Liu, Kristina J; Antaya, Richard J

    2014-01-01

    Midchildhood acne has been attributed to a number of causes in the literature, including adrenocortical tumor, hyperandrogenemia due to hypothalamic dysfunction, and contact with greasy topical skin care products. There are only a few case reports of inhaled steroids causing acneiform eruptions, all of which occurred in adults and with symptoms suggesting that the acne resulted from systemic absorption. We present two cases of comedonal and inflammatory midchildhood acne temporally associated with the use of inhaled corticosteroids administered through face masks, implicating a causative relationship between topical steroid exposure and midchildhood acne that does not necessitate systemic absorption. PMID:23437845

  16. Corticosteroids and surfactant change lung function and protein leaks in the lungs of ventilated premature rabbits.

    OpenAIRE

    Ikegami, M; Berry, D.(University of Illinois at Chicago (UIC), Chicago, USA); elKady, T; Pettenazzo, A; Seidner, S; Jobe, A

    1987-01-01

    Fetal rabbits were treated with corticosteroids by maternal administration for 48 h before delivery at 27 d gestational age. The treated and control rabbits were placed on ventilator-plethysmographs so that ventilation could be adjusted by regulation of tidal volumes to 10-13 ml/kg body wt. [125I]albumin was mixed with fetal lung fluid at birth, alternate rabbits from each litter were treated with Surfactant-TA, and [131I]albumin was injected intravascularly. The movement of the labeled album...

  17. A Case Report: Red Skin Syndrome- as the Rebound Effect of Using a Long Term Potent Topical Corticosteroid

    Directory of Open Access Journals (Sweden)

    Cristine D. Octaviani

    2014-06-01

    Full Text Available 31 years old male suffered from a rare skin disorder, diagnosed of red skin syndrome. Seven years ago, symptoms was begun with a light itching on skin area of body as well as face, and visited a general practitioner, diagnosed of light allergic rhinitis. He was prescribed oral corticosteroid, methyl prednisolone 4 mg b.i.d and very potent topical corticosteroid, clobetasol. The symptoms was significantly disappeared and being rebound after stopping the prescription. To maintain this rebound effect, for seven years in on-off unhealed conditions, he used topical cream corticosteroid, clobetasol, that fully masked this worst rebound condition. When application of the topical cream was stopped, rebound effect relapsed and even red skin syndrome became worse than before. After 20 months of being fully stopped from corticosteroid, the symptoms finally slowly reduced. He almost fully recovered and had a normal life until now December 2013. By this case, we can learn that this red skin syndrome, resulted from side effect of corticosteroid, will be stopped by fully stopping administering orally or topically, and this will take quite long time for skin to recover.

  18. Beyond corticosteroids: future prospects in the management of inflammation in COPD

    Directory of Open Access Journals (Sweden)

    N. Roche

    2011-09-01

    Full Text Available Inflammation plays a central role in the pathophysiology of chronic obstructive pulmonary disease (COPD. Exposure to cigarette smoke induces the recruitment of inflammatory cells in the airways and stimulates innate and adaptive immune mechanisms. Airway inflammation is involved in increased bronchial wall thickness, increased bronchial smooth muscle tone, mucus hypersecretion and loss of parenchymal elastic structures. Oxidative stress impairs tissue integrity, accelerates lung ageing and reduces the efficacy of corticosteroids by decreasing levels of histone deacetylase-2. Protease–antiprotease imbalance impairs tissues and is involved in inflammatory processes. Inflammation is also present in the pulmonary artery wall and at the systemic level in COPD patients, and may be involved in COPD-associated comorbidities. Proximal airways inflammation contributes to symptoms of chronic bronchitis while distal and parenchymal inflammation relates to airflow obstruction, emphysema and hyperinflation. Basal levels of airways and systemic inflammation are increased in frequent exacerbators. Inhaled corticosteroids are much less effective in COPD than in asthma, which relates to the intrinsically poor reversibility of COPD-related airflow obstruction and to molecular mechanisms of resistance relating to oxidative stress. Ongoing research aims at developing new drugs targeting more intimately COPD-specific mechanisms of inflammation, hypersecretion and tissue destruction and repair. Among new anti-inflammatory agents, phosphodiesterase-4 inhibitors have been the first to emerge.

  19. Corticosteroids prevent acute lung dysfunction caused by thoracic irradiation in unanesthetized sheep

    International Nuclear Information System (INIS)

    We sought to determine the effect of corticosteroid therapy in a new acute model of oxidant lung injury, thoracic irradiation in awake sheep. Sheep were irradiated with 1,500 rads to the whole chest except for blocking the heart and adjacent ventral lung. Seven experimental sheep were given methylprednisolone (1 g intravenously every 6 h for four doses) and thoracic irradiation; control sheep received only irradiation. In irradiated control sheep, lung lymph flow increased from baseline (7.6 ml/h) to peak at 3 h (13.2), and lung lymph protein clearance increased from 5.1 to 9.7 ml/h. Mean pulmonary artery pressure increased in the irradiated control sheep from 19 to 32.4 cm H2O, whereas the lung lymph thromboxane concentration increased from 0.09 to 6.51 ng/ml at 3 h. Arterial oxygen tension in irradiated control sheep fell gradually from 86 mm Hg at baseline to 65 mm Hg at 8 h. Methylprednisolone administration significantly prevented the increase in lung lymph protein clearance, mean pulmonary artery pressure, and lung lymph thromboxane concentration. Methylprednisolone also prevented the fall in arterial oxygen tension after thoracic irradiation, but did not prevent a further decrease in lymphocytes in blood or lung lymph after radiation. We conclude that corticosteroid therapy prevents most of the acute physiologic changes caused by thoracic irradiation in awake sheep

  20. Photocarcinogenicity of selected topically applied dermatological drugs: calcineurin inhibitors, corticosteroids, and vitamin D analogs

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    Catharina Margrethe Lerche

    2010-09-01

    Full Text Available Topical therapies constitute the mainstay of dermatological treatments for skin disorders, such as atopic dermatitis, contact dermatitis, psoriasis, or acne. Since some of these diseases are often chronic, treatment duration may last for years and may even last the patient’s entire lifetime. Obviously, such long-term therapy may raise safety concerns, which also include the potential photocarcinogenic effect. Most patients are exposed to ultraviolet radiation (UVR during leisure, work, vacations, or in tanning beds. Additionally, the patients may receive UVR via UVB phototherapy or psoralens plus UVA radiation (PUVA. The use of immunosuppressant’s, such as corticosteroids and calcineurin inhibitors, has markedly increased. Patients with skin diseases have benefited from both systemic and topical treatment of both new and established drugs. The issue of a black box warning by the US Food and Drug Administration has increased concerns about photocarcinogenesis, which raises the question: “Are these drugs safe?” This review focuses on the mechanism of action and photocarcinogenic potential of commonly used topical treatments, such as corticosteroids, calcineurin inhibitors, and vitamin D analogs.

  1. The efficacy of low-dose oral corticosteroids in the treatment of vitiligo patient

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    Banerjee K

    2003-03-01

    Full Text Available Autoimmunity is one of the most probable pathogenesis of vitiligo. Systemic corticosteroids may arrest the progression of vitiligo and lead to repigmentation by suppressing immunity. The clinical efficacy of low-dose oral corticosteroids was assessed to minimize the side-effects in actively spreading vitiligo patients. One hundred (100 patients with vitiligo were evaluated. The patients took daily doses of oral prednisolone (0.3mg/kg body weight initially as a single oral dose after breakfast for the first 2 months. The dosage was then reduced to half the initial dose during the 3rd month and was halved again for the 4th and final month. After 4 months of treatment, 76% showed repigmentation while the arrest of progression (both repigmentation and stationary was noted in 90% of patients. Male sex, and patients under 15 years of age showed pronounced repigmentation with statistical significance. According to this study low-dose oral prednisolone is an effective method in preventing progression and inducing repigmentation of fast-spreading vitiligo without the associated serious side-effects.

  2. Combination total lymphoid irradiation and low-dose corticosteroid therapy for progressive multiple sclerosis

    International Nuclear Information System (INIS)

    Total lymphoid irradiation (TLI) has been reported to delay deterioration in patients with progressive multiple sclerosis and other autoimmune disorders. Methods - In an open trial, the effect of TLI combined with a one year course of low dose prednisone was compared to the effect of sham TLI and TLI only in a prior double-blind study of patients with progressive multiple sclerosis. Results - Twenty-seven patients receiving TLI combined with corticosteroids had significantly greater lymphocytopenia in the year post-therapy than those receiving TLI only or sham TLI and Kaplan Meier product-limit survival analysis showed significantly less progression in the TLI plus steroid group over 4 years of follow-up. No difference in lymphocytopenia or progression was found with TLI plus corticosteroid therapy when the spleen was removed from the field of irradiation. Conclusion - These results lend further support to the hypothesis that TLI may be effective in progressive MS, and indicates that adding low-dose prednisone may enhance this effect. The study also suggests that TLI may be equally effective whether or not the spleen is irradiated. (au) (14 refs.)

  3. Topical corticosteroid abuse on the face: a prospective, study on outpatients of dermatology

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    Hariharasubramony Ambika

    2014-01-01

    Full Text Available Introduction: Topical corticosteroids (TCS are widely misused. Uncontrolled use of steroids can cause undesirable adverse effects especially on face. Aim: The aim of this study was to assess the skin manifestations of TCS misuse over the face in the patients attending dermatology outpatient and to analyze various factors contributing to such misuse. Material and Methods: A total of 200 patients with facial dermatoses using topical steroids over face for minimum period of 1 month, reported between June 2010 and May 2011 were enrolled in the study. Details about the usage of topical corticosteroids and their side effects were recorded. The patients were educated about the misuse. Results: Majority of the patients were females (71%. The most common reason for misuse was acne (61% followed by use as a fairness cream (23%. The average duration of usage was 6 months to 1 year, longest being 8 years. The drug most commonly misused was Betamethaone Valerate (71%. The commonest side effect noted was acne form eruptions (52% followed by steroid dependent face (SDF (36%. There were no cases of allergic contact dermatitis or perioral dermatitis. The exacerbation of the lesions on stoppage of steroid cream (90% fairness effect (10% were the reasons for continued use. (100% were unaware of side effects of topical steroids. Conclusions: Steroids have been misused by patients on their own or by doctors for various reasons. Hence the awareness about their correct usage is essential.

  4. Posterior Reversible Encephalopathy Syndrome due to High Dose Corticosteroids for an MS Relapse

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    Sarah A. Morrow

    2015-01-01

    Full Text Available Increased blood pressure is a known adverse effect associated with corticosteroids but little is published regarding the risk with the high doses used in multiple sclerosis (MS. A 53-year-old female with known relapsing remitting MS presented with a new brainstem relapse. Standard of care treatment for an acute MS relapse, 1250 mg of oral prednisone for 5 days, was initiated. She developed an occipital headache and dizziness and felt generally unwell. These symptoms persisted after treatment was complete. On presentation to medical attention, her blood pressure was 199/110 mmHg, although she had no history of hypertension. MRI changes were consistent with posterior reversible encephalopathy syndrome (PRES, demonstrating abnormal T2 signal in both thalami, the posterior occipital and posterior parietal white matter with mild sulcal effacement. As her pressure normalized with medication, her symptoms resolved and the MRI changes improved. No secondary cause of hypertension was found. This is the first reported case of PRES secondary to high dose corticosteroid use for an MS relapse without a history of hypertension and with no other secondary cause of hypertension identified. This rare complication should be considered in MS patients presenting with a headache or other neurological symptoms during treatment for a relapse.

  5. Posterior Reversible Encephalopathy Syndrome due to High Dose Corticosteroids for an MS Relapse.

    Science.gov (United States)

    Morrow, Sarah A; Rana, Robina; Lee, Donald; Paul, Terri; Mahon, Jeffrey L

    2015-01-01

    Increased blood pressure is a known adverse effect associated with corticosteroids but little is published regarding the risk with the high doses used in multiple sclerosis (MS). A 53-year-old female with known relapsing remitting MS presented with a new brainstem relapse. Standard of care treatment for an acute MS relapse, 1250 mg of oral prednisone for 5 days, was initiated. She developed an occipital headache and dizziness and felt generally unwell. These symptoms persisted after treatment was complete. On presentation to medical attention, her blood pressure was 199/110 mmHg, although she had no history of hypertension. MRI changes were consistent with posterior reversible encephalopathy syndrome (PRES), demonstrating abnormal T2 signal in both thalami, the posterior occipital and posterior parietal white matter with mild sulcal effacement. As her pressure normalized with medication, her symptoms resolved and the MRI changes improved. No secondary cause of hypertension was found. This is the first reported case of PRES secondary to high dose corticosteroid use for an MS relapse without a history of hypertension and with no other secondary cause of hypertension identified. This rare complication should be considered in MS patients presenting with a headache or other neurological symptoms during treatment for a relapse. PMID:26101676

  6. Patient compliance with inhaled medication: does combining beta-agonists with corticosteroids improve compliance?

    Science.gov (United States)

    Bosley, C M; Parry, D T; Cochrane, G M

    1994-03-01

    Patient compliance with an inhaled corticosteroid may be greater if it is combined with a beta-agonist. This study compared compliance with an inhaled corticosteroid (budesonide), and a short-acting inhaled beta-agonist (terbutaline sulphate), and a Turbuhaler inhaler containing a combination of the two drugs. In an open, multicentre, parallel group study 102 asthmatic patients were randomly divided into two groups, either receiving the two drugs in separate Turbuhalers or combined into one Turbuhaler. A twice daily regimen was prescribed and a preweighed metered-dose inhaler (MDI) of salbutamol was provided for rescue use. Compliance was measured using the Turbuhaler Inhalation Computer (TIC), which recorded the time and date of each inhalation over a 12 week period. Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) measurements were carried out at week 0, 6 and 12. Results from 72 patients were analysed. The average compliance was 60-70%. Treatment was taken as prescribed on 30-40% of the study days, and over-usage occurred on less than 10% of days. Only 15% of patients took the drugs as prescribed for more than 80% of the days. Compliance was no greater in patients using the combined inhalers. Other ways of improving patient self-management need further investigation. PMID:8013609

  7. Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement.

    Science.gov (United States)

    Mooney, Emma; Rademaker, Marius; Dailey, Rebecca; Daniel, Ben S; Drummond, Catherine; Fischer, Gayle; Foster, Rachael; Grills, Claire; Halbert, Anne; Hill, Sarah; King, Emma; Leins, Elizabeth; Morgan, Vanessa; Phillips, Roderic J; Relic, John; Rodrigues, Michelle; Scardamaglia, Laura; Smith, Saxon; Su, John; Wargon, Orli; Orchard, David

    2015-11-01

    Atopic eczema is a chronic inflammatory disease affecting about 30% of Australian and New Zealand children. Severe eczema costs over AUD 6000/year per child in direct medical, hospital and treatment costs as well as time off work for caregivers and untold distress for the family unit. In addition, it has a negative impact on a child's sleep, education, development and self-esteem. The treatment of atopic eczema is complex and multifaceted but a core component of therapy is to manage the inflammation with topical corticosteroids (TCS). Despite this, TCS are often underutilised by many parents due to corticosteroid phobia and unfounded concerns about their adverse effects. This has led to extended and unnecessary exacerbations of eczema for children. Contrary to popular perceptions, (TCS) use in paediatric eczema does not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines. In rare cases, prolonged and excessive use of potent TCS has contributed to striae, short-term hypothalamic-pituitary-adrenal axis alteration and ophthalmological disease. TCS use can also exacerbate periorificial rosacea. TCS are very effective treatments for eczema. When they are used to treat active eczema and stopped once the active inflammation has resolved, adverse effects are minimal. TCS should be the cornerstone treatment of atopic eczema in children. PMID:25752907

  8. Antigen-induced pleural eosinophilia is suppressed in diabetic rats: role of corticosteroid hormones

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    Bruno L Diaz

    1997-12-01

    Full Text Available Previous studies have evidenced for the existence of interactive regulatory mechanisms between insulin and steroid hormones in different systems. In this study, we have investigated whether endogenous corticosteroids could be implicated in the hyporeactivity to antigen challenge observed in sensitized diabetic rats. Alloxinated rats showed a long-lasting increase in the blood glucose levels and a reduction in the number of pleural mast cells at 48 and 72 hr, but not at 24 hr after alloxan administration. In parallel, they also showed a significant elevation in the plasma levels of corticosterone together with an increase in the adrenal/body weight ratio. Antigen-evoked eosinophil accumulation appeared significantly reduced in rats pretreated with dexamethasone as well as in those rendered diabetic 72 hr after alloxan. In the same way, naive animals treated with dexamethasone also responded with a significant decrease in the number of pleural mast cells. Interestingly, when sensitized diabetic rats were pretreated with the steroid antagonist RU 38486 a reversion of the reduction in the allergen-induced eosinophil accumulation was noted. We conclude that the down-regulation of the allergic inflammatory response in diabetic rats is close-related to reduction in mast cell numbers and over expression of endogenous corticosteroids.

  9. Angiomatous reaction Kaposi-sarcoma-like as a side effect of topical corticosteroid therapy in lichen sclerosus of the penis.

    Science.gov (United States)

    Catricalà, Caterina; Marenda, Samantha; Muscardin, Luca Maria; Donati, Pietro; Lepri, Andrea; Eibenschutz, Laura

    2009-01-01

    Lichen sclerosus (LS) is a chronic inflammatory skin condition usually located in the anogenital area. Topical corticosteroid therapy is the first choice treatment which may arrest or delay the progression of the disorder. We report the case of a 74-year-old man presented with a 6-month history of nodular lesions localized on penis. The man had a previous history of genital lesions that had been diagnosed as LS and treated with long-term topical corticosteroid therapy. After 3 months of corticosteroid therapy, the patient observed the appearance of several nodular erythematous lesions on the penis with progressive disappearance of the clinical symptoms of LS. These purple to red asymptomatic angiomatoid nodules resembled the clinical features of Kaposi sarcoma. PMID:19580581

  10. Pharmacogenomic test that predicts response to inhaled corticosteroids in adults with asthma likely to be cost-saving

    Science.gov (United States)

    Wu, Ann Chen; Gay, Charlene; Rett, Melisa D; Stout, Natasha; Weiss, Scott T; Fuhlbrigge, Anne L

    2015-01-01

    Aim To identify the clinical and economic circumstances under which a pharmacogenomic test that predicts response to inhaled corticosteroids might be a cost-effective option for individuals with asthma. Materials & methods We synthesized published data on clinical and economic outcomes to project 10-year costs, quality-adjusted life-years and cost–effectiveness of pharmacogenomic testing for inhaled corticosteroid response. We assumed the pharmacogenomic test cost was $500 with a sensitivity and specificity of 84 and 98%, respectively. These were varied in sensitivity analyses. Results Both strategies, pharmacogenomic testing for inhaled corticosteroid response and no testing conferred 7.1 quality-adjusted life-years. Compared with no testing, pharmacogenomic testing costs less. Conclusion Pharmacogenomic testing for asthma is cost-saving and noninferior in improving health. PMID:25880024

  11. Physical Therapy Combined with Corticosteroid Intervention for Systemic Lupus Erythematosus with Central Nervous System Involvement: A Case Report

    Science.gov (United States)

    Lee, In-Hee; Ryu, Young Uk

    2014-01-01

    [Purpose] Systemic lupus erythematosus (SLE) is a chronic, immune-mediated disease, affecting 0.1% of the general population. To date, few studies have investigated the efficacy of physical therapy for SLE patients with CNS involvement. The aim of this study was to report whether the combined use of corticosteroids and physical therapy, consisting of reflex inhibition and functional training, was beneficial to functional recovery. [Subjects and Methods] A 22-year-old male SLE patient with CNS involvement requested physical therapy due to strong spasticity of the trunk and limbs in a bedridden state. Corticosteroid intervention and physical therapy were undertaken for 16 days. [Result] After 16 days of the interventions, the patient demonstrated stabilized and alleviated neurological symptoms and an improved functional level. [Conclusion] The present case indicates that physical therapy combined with corticosteroids might be a possible treatment and rehabilitation method to effectively recover motor function for SLE patients who have strong spasticity due to CNS involvement. PMID:25435712

  12. Low-dose vincristine in the treatment of corticosteroid-refractory idiopathic thrombocytopenic purpura (ITP) in non-splenectomized patients.

    Science.gov (United States)

    Cervantes, F.; Montserrat, E.; Rozman, C.; Diumenjo, C.; Feliu, E.; Grañena, A.

    1980-01-01

    Eight non-splenectomized patients with corticosteroid-refractory idiopathic thrombocytopenic purpura (ITP) were treated with low-dose vincristine (1 mg/week up to a total dose of 4 mg). Complete remission was achieved in 2 cases and partial remission in 3. Bleeding stopped in one patient who failed to remit. No statistical relationship was found between the response to vincristine and the duration of the disease or the corticosteroid-therapy. Side effects were only observed in one patient. By comparing these results with those reported in the literature, it can be inferred that low-dose vincristine may be useful in the management of corticosteroid-refractory ITP. PMID:7194478

  13. New-onset psychiatric disorders after corticosteroid therapy in systemic lupus erythematosus: an observational case-series study.

    Science.gov (United States)

    Nishimura, Katsuji; Omori, Masako; Sato, Eri; Katsumata, Yasuhiro; Gono, Takahisa; Kawaguchi, Yasushi; Harigai, Masayoshi; Yamanaka, Hisashi; Ishigooka, Jun

    2014-11-01

    The objective of this study was to clarify the incidence, clinical characteristics, and courses of new-onset psychiatric manifestations after corticosteroid therapy in patients with systemic lupus erythematosus (SLE), including possible ways of differentiating between corticosteroid-induced psychiatric disorders (CIPDs) and central nervous system manifestations of SLE (CNS-SLE). We prospectively followed for 8 weeks 139 consecutive episodes in 135 in-patients who had a non-CNS-SLE flare treated with corticosteroids. Psychiatric events were evaluated once a week using DSM-IV criteria. We then conducted a post hoc etiological analysis of any newly developed psychiatric events during this follow-up period. In the 8 weeks of corticosteroid administration, new psychiatric events occurred in 20 (14.4 %) of the 139 episodes. The mean dosage of corticosteroids administered was prednisolone at 0.98 (range 0.24-1.39) mg/kg/day. Of the 20 psychiatric events, 14 (10.1 %) were suitable for the strict definition of CIPDs, accompanied by mood disorders in 13 (depressive in 2, manic in 9, and mixed in 2) and psychotic disorder in one. Two (1.4 %), both presenting delirium, were diagnosed as CNS-SLE on the basis of evidence of abnormal CNS findings even before psychiatric manifestations, all of which improved in parallel with these patients' recoveries through augmentation of immunosuppressive therapy. The other four events (2.9 %) could not be etiologically identified. This study suggests that corticosteroid therapy triggers CIPDs and CNS-SLE in patients with SLE. Delirium may be suggestive of CNS-SLE, while mood disorders may be more suggestive of CIPDs. Electroencephalographic abnormalities may possibly be predictive of CNS-SLE. PMID:25142268

  14. IntravenousCorticosteroid Use Is Associated With Reduced Early Recurrence of Atrial Fibrillation Immediately Following Radiofrequency Catheter Ablation

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    Nitesh A. Sood MD

    2011-09-01

    Full Text Available Background Early recurrence of atrial fibrillation (ERAF occurs in up to 40% of patients after radiofrequency catheter ablation for atrial fibrillation (RFCA, increasing hospital stay, need for anti-arrhythmic medications (AADs and cardioversion, and, possibly, the risk of future AF. It has been postulated that inflammation plays a key role in developing ERAF. Short term postoperative use of corticosteroids to reduce ERAF post-RFCA has not been vigorously studied. Methods This was a case-control study of consecutive patients undergoing RFCA for the management of AF at a single-institution. RFCA was performed by a single operator from October 2005 through July 2009. Patients receiving intravenous corticosteroids immediately following the ablation and for 48 hours (6 doses constituted the treatment group. Controls received no intravenous corticosteroids during their hospitalization. All other management strategies were similar between the 2 groups, including the administration of AADs post- operatively. All patients had continuous electrocardiographic monitoring throughout their hospitalization. Multivariable logistic regression analysis was used to determine the impact of intravenous corticosteroids on ERAF defined as any AF>10 minutes during hospitalization. Results A total of 68 patients undergoing RFCA for the management of AF were included in this analysis. The overall ERAF rate, irrespective of intravenous corticosteroid use, was 23.5%. The administration of intravenous corticosteroids (n=37; mean±SD dexamethasone mean dose 11.9±4.6 mg/day; range 4-16 mg/day was associated with an 82% reduction in patients’ odds of ERAF (adjusted odds ratio; 0.18, 95% confidence interval [CI] 0.04 to 0.78 compared with those who did not receive corticosteroids (n=31. A dose-response effect was also observed, with a 17% reduction in ERAF odds for each dexamethasone mg-equivalent administered (adjusted odds ratio; 0.83, 95%CI 0.73 to 0.96. Conclusions The

  15. Dapsone in the treatment of pemphigus vulgaris: adverse effects and its importance as a corticosteroid sparing agent.

    Science.gov (United States)

    Quaresma, Maria Victória; Bernardes Filho, Fred; Hezel, Janaína; Peretti, Murilo Calvo; Kac, Bernard Kawa; Azulay-Abulafia, Luna

    2015-01-01

    Pemphigus vulgaris is an autoimmune disease characterized by suprabasal blisters with acantholysis, which has a fatal course in a large number of untreated patients. Systemic corticosteroid therapy is considered first-line therapy. Adjuvant treatment with the goal of sparing corticosteroids include, among others, dapsone. This drug is not without side effects and its use requires clinical and laboratory control. We present a patient with PV initially managed with suboptimal dose of prednisone, evolving into drug-induced hepatitis after introduction of dapsone. PMID:26312673

  16. Dapsone in the treatment of pemphigus vulgaris: adverse effects and its importance as a corticosteroid sparing agent*

    Science.gov (United States)

    Quaresma, Maria Victória; Bernardes Filho, Fred; Hezel, Janaína; Peretti, Murilo Calvo; Kac, Bernard Kawa; Azulay-Abulafia, Luna

    2015-01-01

    Pemphigus vulgaris is an autoimmune disease characterized by suprabasal blisters with acantholysis, which has a fatal course in a large number of untreated patients. Systemic corticosteroid therapy is considered first-line therapy. Adjuvant treatment with the goal of sparing corticosteroids include, among others, dapsone. This drug is not without side effects and its use requires clinical and laboratory control. We present a patient with PV initially managed with suboptimal dose of prednisone, evolving into drug-induced hepatitis after introduction of dapsone. PMID:26312673

  17. Zonal corticosteroid hormone biosynthesis in the adrenal cortex in rats exposed to emotional stress combined with salt loading

    International Nuclear Information System (INIS)

    The authors study the pattern of biosynthesis of corticosteroid hormones in the zona glomerulosa and the combined zona fasciculata + zona reticularis of the adrenals, which are responsible for the mineralocorticoid and glucocorticoid function of the glands, during simultaneous exposure of animals to salt loading and emotional stress. Experiments were carried out on rats. The adrenals were divided into parts and samples were incubated in vitro with the addition of 3H-progesterone to each sample. The specific activity of the 3H-labeled corticosteroids decreased significantly in rats with a normal salt intake exposed to emotional stress

  18. Montelukast as Add-On Therapy with Inhaled Corticosteroids or Inhaled Corticosteroids and Long-Acting Beta-2-Agonists in the Management of Patients Diagnosed with Asthma and Concurrent Allergic Rhinitis (The RADAR Trial

    Directory of Open Access Journals (Sweden)

    Paul K Keith

    2009-01-01

    Full Text Available OBJECTIVE: To evaluate the effectiveness of montelukast as add-on therapy for patients diagnosed with asthma and concurrent allergic rhinitis who remain uncontrolled while receiving inhaled corticosteroid (ICS monotherapy or ICS/long-acting beta-2-agonist (LABA therapy in a community practice setting.

  19. Corticosteroids reverse cytokine-induced block of survival and differentiation of oligodendrocyte progenitor cells from rats

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    Marx Romy

    2008-09-01

    Full Text Available Abstract Background Periventricular leukomalacia (PVL is a frequent complication of preterm delivery. Proinflammatory cytokines, such as interferon-γ (IFN-γ and tumor necrosis factor α (TNF-α released from astrocytes and microglia activated by infection or ischemia have previously been shown to impair survival and maturation of oligodendrocyte progenitors and could thus be considered as potential factors contributing to the generation of this disease. The first goal of the present study was to investigate whether exposure of oligodendrocyte precursors to these cytokines arrests the maturation of ion currents in parallel to its effects on myelin proteins and morphological maturation. Secondly, in the search for agents, that can protect differentiating oligodendrocyte precursor cells from cytokine-induced damage we investigated effects of coapplications of corticosteroids with proinflammatory cytokines on the subsequent survival and differentiation of oligodendrocyte progenitor cells. Methods To exclude influences from factors released from other cell types purified cultures of oligodendrocyte precursors were exposed to cytokines and/or steroids and allowed to differentiate for further 6 days in culture. Changes in membrane surface were investigated with capacitance recordings and Scanning Ion Conductance Microscopy. Na+- and K+- currents were investigated using whole cell patch clamp recordings. The expression of myelin specific proteins was investigated using western blots and the precursor cells were identified using immunostaining with A2B5 antibodies. Results Surviving IFN-γ and TNF-α treated cells continued to maintain voltage-activated Na+- and K+ currents characteristic for the immature cells after 6 days in differentiation medium. Corticosterone, dihydrocorticosterone and, most prominently dexamethasone, counteracted the deleterious effects of IFN-γ and TNF-α on cell survival, A2B5-immunostaining and expression of myelin basic

  20. Intra-articular Corticosteroid Injection for the Treatment of Idiopathic Adhesive Capsulitis of the Shoulder

    Science.gov (United States)

    Malizia, Robert W.; Kenter, Keith; Wickiewicz, Thomas L.; Hannafin, Jo A.

    2007-01-01

    Treatment for idiopathic adhesive capsulitis or frozen shoulder of the shoulder is controversial. The hypothesis of the study is that intra-articular corticosteroid injection in the early stages of idiopathic adhesive capsulitis will lead to a razpid resolution of stiffness and symptoms. This is a retrospective cohort study of only patients with stage 1 or stage 2 adhesive capsulitis. The diagnosis was made by history and physical examination and only when other causes of pain and motion loss were eliminated. Stage 1 adhesive capsulitis was defined as significant improvement in pain and normalization of motion following intra-articular injection. Stage 2 included patients who had significant improvement in pain and partial improvement in motion following injection. Seven patients with stage 1 and 53 patients with stage 2 comprised the baseline cohort. The mean age was 52 years (range: 30 to 78); 46 patients were female and nine patients had diabetes mellitus. Patients completed a physical examination as well as a shoulder rating questionnaire for symptoms and disability. Criteria for resolution were defined as forward flexion and external rotation to within 15° of the contralateral side and internal rotation to within three spinal levels of the contralateral side. Forty-four of the patients out of 60 met the criteria for recovery at a mean of 6.7 months. The mode and median time to recovery was 3 months. The mean score at final follow-up for 41 patients using the shoulder-rating questionnaire of L’Insalata was 90 (range 52–100). The mean time to recovery for the stage 1 patients was 6 weeks (range: 2 weeks to 3 months), and it was 7 months for stage 2 patients (range: 2 weeks to 2 years). Glenohumeral corticosteroid injection for early adhesive capsulitis may have allowed patients to recover motion at a median time of 3 months. In many cases, the patients had improvement prior to the 3-month mark; however, that was the routine time for follow

  1. The use of corticosteroids in patients with chronic obstructive pulmonary disease: epidemiological and economic aspects

    Directory of Open Access Journals (Sweden)

    Pablo M. Katz

    2009-12-01

    Full Text Available Objective: this study aimed at assessing the level of compliance to GOLD guidelines regarding the use of ICS containing drugs for the treatment of patients with COPD in the GPs setting in Italy and at evaluating the economic consequences that the use of corticosteroids may have, specifically in mild and moderate COPD patients where it is inappropriate. Methods: the retrospective GPs database study has analyzed patients with at least one diagnosis of COPD during the period January 2005 – December 2008 who had a report of VEMS and at least one prescription of a drug from ATC R03 class within two months from the date of spirometric exam, who were 40 years or older and that have been followed for at least 9 months. Patients were classified in four disease severity groups according to GOLD (2008. Compliance to GOLD guidelines regarding the use of corticosteroids was evaluated on the basis of the first treatment prescribed after spirometric exam. The analysis evaluated exacerbations as well, assuming their occurrence when one prescription of either antibiotic, oxygen or systemic corticosteroid was found. The cost of the first prescription of treatments containing ICS in mild and moderate patients was calculated. Then the “Hypothetic cost” was built for those patients in order to estimate the cost that would have been created in case the considered treatments had been ICS free. The difference between these two costs represents inappropriate cost that could have been avoided by using an ICS free treatment, more appropriate according to GOLD. Results: a cohort of 2,103 Italian patients with the diagnosis of COPD, followed by 700 GPs all over Italy was analyzed. An ICS-containing treatment was prescribed to more than 50% of patients within each disease severity group. The percentage of patients who experienced an exacerbation within 6 months from the first prescription was not found to be different among patients prescribed with an ICS

  2. Sputum eosinophils and the response of exercise-induced bronchoconstriction to corticosteroid in asthma

    DEFF Research Database (Denmark)

    Duong, MyLinh; Subbarao, Padmaja; Adelroth, Ellinor;

    2008-01-01

    BACKGROUND: The relationship between eosinophilic airway inflammation and exercise-induced bronchoconstriction (EIB), and the response to inhaled corticosteroid (ICS) therapy was examined. METHODS: Twenty-six steroid-naïve asthmatic patients with EIB were randomized to two parallel, double...... week of high-dose ICS therapy and increased with time. CONCLUSIONS: These results suggest that eosinophilic airway inflammation may be important in modifying the severity of EIB and the response to ICS therapy. Measurements of sputum eosinophil percentage may, therefore, be useful in predicting the...... and sputum analysis were performed. RESULTS: Data were pooled and demonstrated that 10 subjects had baseline sputum eosinophilia >or= 5%. Only high-dose ICS therapy (ie, 160 and 320 microg) significantly attenuated the sputum eosinophil percentage. Sputum eosinophil percentage significantly correlated...

  3. Induction of interleukin-6 by ionizing radiation in a human epithelial cell line. Modulation by corticosteroids

    Energy Technology Data Exchange (ETDEWEB)

    Beetz, A.; Oppel, T.; Lu-Hesselmann, J.; Peter, R.U. [Federal Armed Forces Medical Academy, Munich (Germany). Institute of Radiobiology; Messer, G.; Kind, P.; Peter, R.U. [Munich Univ., Ludwig-Maximilians (Germany). Dept. of Dermatology

    1997-03-01

    To overcome the detrimental effects of an uncontrolled rise of pro-inflammatory cytokines as an acute response to ionizing radiations, therapeutic drugs capable of inhibiting the pathway leading to transcriptional activation of cytokine genes are of particular interest. Here is described the potency of hydrocortisone, dexamethasone and mometasone furoate to inhibit radiation-induced IL-6 (interleukin) expression. Mometasone furoate and dexamethasone were shown to be much more effective than hydrocortisone. Finally, the reported low atrophogenic potential of mometasone furoate after topical application, together with the strongest capacity of IL-6 down-regulation in ionizing radiations treated cells points to this drug as the most promising derivative of the three investigated corticosteroids. (N.C.)

  4. A prospective study of atopic dermatitis managed without topical corticosteroids for a 6-month period

    Science.gov (United States)

    Fukaya, Mototsugu; Sato, Kenji; Yamada, Takahiro; Sato, Mitsuko; Fujisawa, Shigeki; Minaguchi, Satoko; Kimata, Hajime; Dozono, Haruhiko

    2016-01-01

    Topical corticosteroids (TCS) are regarded as the mainstay treatment for atopic dermatitis (AD). As AD has a tendency to heal naturally, the long-term efficacy of TCS in AD management should be compared with the outcomes seen in patients with AD not using TCS. However, there are few long-term studies that consider patients with AD not using TCS. We designed a prospective multicenter cohort study to assess the clinical outcomes in patients with AD who did not use TCS for 6 months and then compared our results with an earlier study by Furue et al which considered AD patients using TCS over 6 months. Our patients’ clinical improvement was comparable with the patients described in Furue’s research. In light of this, it is reasonable for physicians to manage AD patients who decline TCS, as the expected long-term prognosis is similar whether they use TCS or not. PMID:27445501

  5. SD-OCT features of laser pointer maculopathy before and after systemic corticosteroid therapy.

    Science.gov (United States)

    Hossein, Mohammad; Bonyadi, Jabbarpour; Soheilian, Roham; Soheilian, Masoud; Peyman, Gholam A

    2011-01-01

    The authors report spectral-domain optical coherence tomography findings of laser pointer-induced maculopathy in a 25-year-old man after accidental laser pointer exposure of less than 1 second. The Class 3R laser pointer (output wavelength 532 nm and output power 3.5 to 4.5 mW [continuous wave]) had U.S. Food and Drug Administration certification. One day after exposure, he had visual blurring and metamorphopsia of his right eye. He was treated with a systemic high-dose corticosteroid. Spectral-domain optical coherence tomography disclosed a hyperreflective band in the foveal region. After 1 week of treatment, disappearance of hyperreflectivity was observed on spectral-domain optical coherence tomography. At 6 months, residual disruption of the outer retinal layer at the fovea remained unchanged. Spectral-domain optical coherence tomography was a useful and sensitive tool for evaluating retinal damage and subsequent resolution after treatment. PMID:22165950

  6. Combination anti-VEGF and corticosteroid therapy for idiopathic retinal vasculitis, aneurysms, and neuroretinitis syndrome.

    Science.gov (United States)

    Sawhney, Gagan K; Payne, John F; Ray, Robin; Mehta, Sonia; Bergstrom, Chris S; Yeh, Steven

    2013-11-01

    Vision loss associated with the idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome most commonly occurs from macular edema or complications related to neovascularization. The authors present a case of advanced IRVAN associated with a massive exudative response characterized by peripheral retinal telangiectasias, exudative retinal detachment, and macular edema with lipid maculopathy. The patient was managed successfully with visual acuity from hand motion to 20/150 using a combination of local corticosteroids, intravitreal bevacizumab, panretinal photocoagulation, and eventually pars plana vitrectomy for progressive vitreomacular traction. VEGF- and non-VEGF-mediated mechanisms appear to be involved in the pathogenesis of IRVAN given the efficacy of combination therapy. [ophthalmic surg lasers imaging retina. 2013;44:599-602.]. PMID:24221466

  7. Fatal Cytomegalovirus Disease after Combination Therapy with Corticosteroids and Rituximab for Granulomatosis with Polyangiitis

    Directory of Open Access Journals (Sweden)

    Talal Hilal

    2015-01-01

    Full Text Available The association of cytomegalovirus (CMV with autoimmune disease is poorly understood with suggested causality and reported viral reactivation coinciding with active inflammation. We report a case of a patient who presented with diffuse alveolar hemorrhage and acute renal failure from rapidly progressive glomerulonephritis ultimately diagnosed with granulomatosis with polyangiitis (GPA. She was acutely managed with plasmapheresis to reduce antibody-mediated end-organ damage, hemodialysis for worsening hyperkalemia and acidosis, and high-dose intravenous methylprednisolone. She was transitioned to oral prednisone and started on weekly rituximab with resultant remission induction over a three-week period at which point she developed reactivation of CMV causing severe fatal lung disease and viremia. The case highlights the multiple factors associated with CMV reactivation in cases of severe systemic inflammatory states and the need for further research to help establish practice guidelines regarding antimicrobial prophylaxis in patients with autoimmune diseases on prolonged courses of corticosteroids and biologic agents.

  8. A pooled analysis of FEV1 decline in COPD patients randomized to inhaled corticosteroids or placebo

    DEFF Research Database (Denmark)

    Soriano, JB; Sin, DD; Zhang, X;

    2007-01-01

    Background: There is controversy about whether therapy with inhaled corticosteroids (ICSs) modifies the natural history of COPD, characterized by an accelerated decline in FEV1. Methods: The Inhaled Steroids Effect Evaluation in COPD (ISEEC) study is a pooled study of patient-level data from seven...... long-term randomized controlled trials of ICS vs placebo lasting 12 months in patients with moderate-to-severe COPD. We have previously reported a survival benefit for ICS therapy in COPD patients using ISEEC data. We aimed to determine whether the regular use of ICSs vs placebo improves FEV1 decline...... in COPD patients, and whether this relationship is modified by gender and smoking. Results: There were 3,911 randomized participants (29.2% female) in this analysis. In the first 6 months after randomization, ICS use was associated with a significant mean (± SE) relative increase in FEV1 of 2.42 ± 0...

  9. The effect of short-term corticosteroid treatment on the CT appearance of experimental brain abscesses

    International Nuclear Information System (INIS)

    The effect of short-term corticosteroid treatment on contrast enhancement was investigated in an experimental brain abscess model. The degree of enhancement was reduced in the cerebritis stage, unaffected in the capsule stage, and intermediate in the transitional stage. The area and pattern of enhancement were also altered in the cerebritis stage. Although the magnitude of the entire cerebritis time-density curve (extended for 60 minutes) was decreased by the steroids, its configuration was unchanged. Prior to steroid administration, the 10- and 60-minute components of the curve discriminated between cerebritis and capsule stages, with the latter exhibiting a far lower 60-minute value. Implications for treatment of brain abscesses are discussed

  10. Effect of corticosteroid injection for trochanter pain syndrome: Design of a randomised clinical trial in general practice

    NARCIS (Netherlands)

    A. Brinks (Tineke); R.M. van Rijn (Rogier); A.M. Bohnen (Arthur); G.L.J. Slee (Gabriël); J.A.N. Verhaar (Jan); B.W. Koes (Bart); S.M. Bierma-Zeinstra (Sita)

    2007-01-01

    textabstractBackground. Regional pain in the hip in adults is a common cause of a general practitioner visit. A considerable part of patients suffer from (greater) trochanteric pain syndrome or trochanteric bursitis. Local corticosteroid injections is one of the treatment options. Although clear evi

  11. Tc-99m technegas scintigraphy to evaluate the lung ventilation in patients with oral corticosteroid-dependent bronchial asthma

    Energy Technology Data Exchange (ETDEWEB)

    Fujita, Jiro; Okada, Hiroki; Momoi, Atsuko; Yamadori, Ichiro; Takahara, Jiro; Tanabe, Masatada [Kagawa Medical Univ., Miki (Japan); Takahashi, Kazue; Satoh, Katashi; Ohkawa, Motoomi

    1999-08-01

    Bronchial asthma is a clinical syndrome characterized by the reversibility of airway obstruction. Recently it has been suggested that remodeling of the airway causes irreversible airway obstruction which may be responsible for the patient's symptoms. With this background, the purpose of the present study was to assess patients with corticosteroid-dependent asthma by Tc-99m Technegas scintigraphy (Technegas) in both planar and SPECT images. Twelve patients (7 females and 5 males aged 36-72 years with a median age of 60 years: 4 smokers and 8 non-smokers) with oral corticosteroid-dependent asthma were enrolled in this study. Lung ventilation scanning with Technegas in both planar and SPECT images, high-resolution computed tomography, and pulmonary function tests were performed in all patients. The results of Technegas scanning were graded and correlations with other clinical parameters were evaluated. Significant abnormalities were detected by ventilation scintigraphy with Technegas in patients with corticosteroid-dependent bronchial asthma even during remission. Our data demonstrate that airflow obstruction took place in patients with corticosteroid-dependent asthma even during remission. Technegas scanning appears to be a useful radiopharmaceutical for demonstrating airflow obstruction in patients with bronchial asthma. (author)

  12. Formoterol used as needed improves health-related quality of life in asthmatic patients uncontrolled with inhaled corticosteroids

    NARCIS (Netherlands)

    Stahl, E; Postma, DS; Svensson, K; Tattersfield, AE; Eivindson, A; Schreurs, A; Lofdahl, CG

    2003-01-01

    Clinical benefits have been shown to occur when using the long-acting beta(2)-agonist formoterol 4.5 mug for as-needed medication rather than terbutaline 500 mug in patients with unstable asthma taking an inhaled corticosteroid. This study compared their effects on health-related quality of Life and

  13. The use of corticosteroid for the prophylaxis of fat embolism syndrome in patients with long bone fracture.

    Science.gov (United States)

    Silva, Douglas Fini; Carmona, César Vanderlei; Calderan, Thiago Rodrigues Araújo; Fraga, Gustavo Pereira; Nascimento, Bartolomeu; Rizoli, Sandro

    2013-01-01

    The "Evidence-based Telemedicine - Trauma & Acute Care Surgery" (EBT-TACS) Journal Club conducted a critical review of the literature and selected three recent studies on the use of corticosteroids for the prophylaxis of fat embolism syndrome. The review focused on the potential role of corticosteroids administration to patients admitted to the intensive care unit (ICU) at risk of developing post-traumatic fat embolism. The first study was prospective and aimed at identifying reliable predictors, which occurred early and were associated with the onset of fat embolism syndrome in trauma patients. The second manuscript was a literature review of the role of corticosteroids as a prophylactic measure for fat embolism syndrome (FES). The last manuscript was a meta-analysis on the potential for corticosteroids to prophylactically reduce the risk of fat embolism syndrome in patients with long bone fractures. The main conclusions and recommendations reached were that traumatized patients should be monitored with non-invasive pulse oximetry and lactate levels since these factors may predict the development of FES, and that there is not enough evidence to recommend the use of steroids for the prophylaxis of this syndrome. PMID:24573593

  14. SERPINE1-675 4G/5G polymorphism is associated with asthma severity and inhaled corticosteroid response

    NARCIS (Netherlands)

    Dijkstra, A.; Postma, D. S.; Bruinenberg, M.; van Diemen, C. C.; Boezen, H. M.; Koppelman, G. H.; Timens, W.; Vonk, J. M.

    2011-01-01

    Asthma is characterised by chronic airway inflammation and remodelling, which can be (partially) suppressed by inhaled corticosteroids (ICSs). Plasminogen activator inhibitor-1, encoded by the SERPINE1 gene, is the key inhibitor of the plasminogen activator system, which affects tissue repair and re

  15. Tc-99m technegas scintigraphy to evaluate the lung ventilation in patients with oral corticosteroid-dependent bronchial asthma

    International Nuclear Information System (INIS)

    Bronchial asthma is a clinical syndrome characterized by the reversibility of airway obstruction. Recently it has been suggested that remodeling of the airway causes irreversible airway obstruction which may be responsible for the patient's symptoms. With this background, the purpose of the present study was to assess patients with corticosteroid-dependent asthma by Tc-99m Technegas scintigraphy (Technegas) in both planar and SPECT images. Twelve patients (7 females and 5 males aged 36-72 years with a median age of 60 years: 4 smokers and 8 non-smokers) with oral corticosteroid-dependent asthma were enrolled in this study. Lung ventilation scanning with Technegas in both planar and SPECT images, high-resolution computed tomography, and pulmonary function tests were performed in all patients. The results of Technegas scanning were graded and correlations with other clinical parameters were evaluated. Significant abnormalities were detected by ventilation scintigraphy with Technegas in patients with corticosteroid-dependent bronchial asthma even during remission. Our data demonstrate that airflow obstruction took place in patients with corticosteroid-dependent asthma even during remission. Technegas scanning appears to be a useful radiopharmaceutical for demonstrating airflow obstruction in patients with bronchial asthma. (author)

  16. Comparison of the narrow band UVB versus systemic corticosteroids in the treatment of lichen planus: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Fariba Iraji

    2011-01-01

    Conclusions: Overall, the results of our study and other previous studies showed that NBUVB may be regarded as an effective treatment for generalized cutaneous lichen planus. This treatment may be especially utilized when there is contraindication for systemic corticosteroids or other immunosuppressive drugs.

  17. Sputum mast cell subtypes relate to eosinophilia and corticosteroid response in asthma.

    Science.gov (United States)

    Wang, Gang; Baines, Katherine J; Fu, Juan Juan; Wood, Lisa G; Simpson, Jodie L; McDonald, Vanessa M; Cowan, Douglas C; Taylor, D Robin; Cowan, Jan O; Gibson, Peter G

    2016-04-01

    Mast cells are a resident inflammatory cell of the airways, involved in both the innate and adaptive immune response. The relationship between mast cells and inflammatory phenotypes and treatment response of asthma is not clear.Clinical characteristics of subjects with stable asthma (n=55), inflammatory cell counts and gene expression microarrays in induced sputum were analysed. Sputum mast cell subtypes were determined by molecular phenotyping based on expression of mast cell biomarkers (tryptase (TPSAB1), chymase (CMA1) and carboxypeptidase A3 (CPA3)). Effects of mast cell subtypes on steroid response were observed in a prospective cohort study (n=50).MCT(n=18) and MCT/CPA3(mRNA expression ofTPSAB1andCPA3; n=29) subtypes were identified, as well as a group without mast cell gene expression (n=8). The MCT/CPA3subtype had elevated exhaled nitric oxide fraction, sputum eosinophils, bronchial sensitivity and reactivity, and poorer asthma control. This was accompanied by upregulation of 13 genes. Multivariable logistic regression identifiedCPA3(OR 1.21, p=0.004) rather thanTPSAB1(OR 0.92, p=0.502) as a determinant of eosinophilic asthma. The MCT/CPA3subtype had a better clinical response and reduced signature gene expression with corticosteroid treatment.Sputum mast cell subtypes of asthma can be defined by a molecular phenotyping approach. The MCT/CPA3subtype demonstrated increased bronchial sensitivity and reactivity, and signature gene expression, which was associated with airway eosinophilia and greater corticosteroid responsiveness. PMID:26699720

  18. Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Brito PN

    2012-10-01

    Full Text Available Pedro Nuno Brito,1 Sérgio Estrela Silva,1 José Silva Cotta,1 Fernando Falcão-Reis1,21Ophthalmology Department, Hospital S João, Porto, Portugal; 2Faculty of Medicine of Porto, University of Porto, Porto, PortugalPurpose: To report a case of severe, acute ocular hypertension in a 6-year-old child, 7 days after initiating treatment with oral prednisolone, due to nephrotic syndrome.Methods: A 6-year-old female Caucasian child was diagnosed with nephrotic syndrome and treated with oral prednisolone (60 mg/day. Seven days later the child initiated complaints of headache, vomiting, ocular pain, and photophobia. Ophthalmologic examination revealed a severely increased intraocular pressure (IOP of 52 mmHg in the right eye and 56 mmHg in the left eye. Anterior segment morphology was evaluated with ultrasound biomicroscopy. Optic disc status was evaluated by disc photography, kinetic perimetry, and optical coherence tomography.Results: Treatment was initiated with latanoprost, brimonidine, and the fixed association of timolol and dorzolamide. At each follow-up examination, progressively better control of IOP was obtained. Simultaneous with corticosteroid dosage decrease we were able to reduce antiglaucomatous medication while maintaining IOP under control. Ultrasound biomicroscopy revealed an open angle with normal anterior segment echographic findings. Perimetric evaluation revealed normal visual fields in both eyes. Four months after presentation, steroid treatment had been completed and IOP was 10 mmHg in both eyes without any antiglaucomatous medication. Optical coherence tomography revealed normal retinal nerve fiber layer thickness in all peripapillary sectors.Conclusions: Systemic steroid treatment can cause a severe, acute increase in IOP in children. Children undergoing steroid treatment should have routine ophthalmologic examinations during treatment duration. Prompt antiglaucomatous treatment prevents retinal nerve fiber layer damage and

  19. Effective use of corticosteroids in treatment of plastic bronchitis with hemoptysis in Chinese adults

    Institute of Scientific and Technical Information of China (English)

    Gang WANG; You-juan WANG; Feng-ming LUO; Lei WANG; Li-li JIANG; Lin WANG; Bing MAO

    2006-01-01

    Aim: To investigate whether corticosteroids are effective in the treatment of plastic bronchitis with hemoptysis. Methods: A retrospective, clinical study was undertaken. Thirty two patients with only first episodes of plastic bronchitis with hemoptysis were divided into a steroid group (n=18) treated with glucocorticoids, and a non-steroid group (n=14). The supportive therapy was uniformly applied to both groups, except for glucocorticoids. Variables such as temperature and white blood cell counts were determined. Furthermore, the volume of hemoptysis and bronchial casts were evaluated in detail daily. Results: There was no difference in the demographic data and variables at baseline between both groups (all P>0.05).On days 5,6,7 and 8, the volume of hemoptysis was significantly decreased in the steroid group compared with the non-steroid group (43±15 mL vs 117±33 mL on d 5,29±12mL vs 97±23mL on d 6,18±10mL vs 80±20mL on d 7,and 13±8mL vs 66±14 mL on d 8; all P<0.05), and on d 10 after fibreoptic bronchoscopy, the cases with bronchial casts was reduced evidently in the steroid group in comparison with the non-steroid group (OR=5.69,95% CI=1.76-43.6; P=0.005). There was no significance in mechanical ventilation and mortality between both groups. Conclusion: Despite some limitations of this study, it has been demonstrated that, on the basis of common supportive therapy, corticosteroids would be effective and safe for the treatment of plastic bronchitis with hemoptysis.

  20. Timing of Emergency Department Visits for Childhood Asthma after Initial Inhaled Corticosteroid Use

    Science.gov (United States)

    Zhang, Shun; Holloway, Kelvin; Tyler-Hill, Yasmin

    2015-01-01

    Abstract Inhaled corticosteroids can prevent acute exacerbations and emergency visits when used as part of a chronic care plan for long-term control of asthma, but low patient adherence and inadequate provider prescribing (clinical inertia) can limit these benefits. State Medicaid programs are a major source of insurance coverage for low-income children, paying for medications and preventive care, as well as bearing the cost of adverse outcomes for common chronic conditions in childhood, such as asthma. This study measured the incidence and timing of emergency department (ED) visits in the first 90 days after an initial inhaled corticosteroid prescription (ICS-Rx) among 43,156 Medicaid-enrolled children with a diagnosis of asthma in 14 southern states in 2007. One in 5 children (19.6%) with asthma had at least 1 ED visit in the first 90 days after initial ICS-Rx; 10% of these visits occurred within the first 48 hours, and 25% occurred within the first week. Continued ICS-Rx use was associated with lower risk of an ED visit. There were no racial differences in the ED visit rates. Initial ICS-Rx for Medicaid-enrolled children is a warning flag for short-term risk of asthma-related ED visits, whereas continued ICS-Rx use is protective for at least 90 days. Primary care follow-up may be needed within the first 2 days after initial ICS-Rx to prevent adverse outcomes. Medicaid programs could use claims data for surveillance of adherence to guideline-concordant therapy and for sentinel events marking windows of a higher risk for ED visits. Population Health Management 2015;18:54–60. PMID:25046059

  1. Amphiphilic polymeric micelle as pseudostationary phase in electrokinetic chromatography for analysis of eight corticosteroids in cosmetics.

    Science.gov (United States)

    Xu, Xiaojin; Ni, Xinjiong; Cao, Yuhua; Zhuo, Xiaolu; Yang, Xiaoxiao; Cao, Guangqun

    2014-03-01

    Amphiphilic polymeric micelle, as a novel pseudostationary phase in EKC was used to determine eight kinds of corticosteroids namely hydrocortisone, prednisolone, hydrocortisone acetate, prednisone, cortisone acetate, prednisolone acetate, dexamethasone, and triamcinolone acetonide in cosmetics. Amphiphilic random copolymer poly(methyl methacrylate-co-methacrylic acid) (P(MMA-co-MAA)) was micellizated via neutralization in alkaline aqueous solution. The influences of the molar ratio of monomer MMA to MAA, the concentration of polymer and pH on the polymeric micelle microstructure and EKC performances were investigated. As molar ratio of MMA to MAA in P(MMA-co-MAA) increased, both CMC and environmental polarity of the inner core in polymeric micelle decreased dramatically. With increasing monomer ratio, the size of polymeric micelles increased firstly, and then decreased, finally increased again. ζ potential of the micelle had a slight decline trend. As increment of polymer concentration, the size of the polymeric micelle increased steadily. By optimizing the monomer ratio, the polymer concentration, and pH of the running buffer, as well as operation conditions such as separation voltage and temperature, the eight analytes could be separated within 16.5 min using 7.5 mg/mL polymer with the monomer ratio of 7:3 dissolved in pH 9.2 borax buffer as the running buffer. The method has been used for analysis of corticosteroids in cosmetic samples with simple extraction; the recoveries for eight analytes were between 85.9 and 106%. This method was of accuracy, repeatability, pretreatment simplicity, and could be applied to the quality control of cosmetics. PMID:24338855

  2. Differential effect of corticosteroids on serum cystatin C in thrombocytopenic purpura and leukemia.

    Science.gov (United States)

    Bardi, Edit; Dobos, Eva; Kappelmayer, János; Kiss, Csongor

    2010-09-01

    The aim of our study was to evaluate the influence of steroid therapy on serum cystatin C (cysC) concentrations in patients with acute lymphoblastic leukemia (ALL) and idiopthiás thrombocytopenias purpura (ITP). We studied 17 patients with ITP (girls: boys =5:12, mean age: 7.6 yrs, range between 1 to 17 years) and 18 patients with ALL (girls: boys =6:12, mean age: 6.3 yrs, range between 2 to 17 years). CysC and white blood cell count (WBC) in both group of patients were determined before and after 300 mg/m(2) cumulative dose of steroid therapy. Corticosteroids increased the level of cysC in both groups of patients, however significant increase was found only in ITP patients between pre- and posttreatment values (0.96 +/-0.27 mg/L vs. 1.16 +/- 0.3 mg/L, p =0,02). Pretreatment cysC concentrations were within the reference range in patients with ITP but not with ALL and were significantly higher in ALL patients, than in ITP patients (1.23 +/- 1,12 mg/L vs. 0.96 +/- 0.27 mg/L, p =0,02). Pretreatment WBC of ALL patients were significantly higher than of ITP patients (22.58 G/L, min. 3.5 G/L, max. 102.1 G/L vs. 7.46 G/L, min. 4.8 G/L, max. 12.3 G/L, p =0.03). We have found significant correlation between pretreatment cysC and WBC values in ALL patients (p = 0.04). Although the concentration of cysC may be slightly and reversibly influenced by corticosteroid treatment, cysC is sensitive to detect early and moderate deterioration of GFR in children with cancer. PMID:20084479

  3. Long acting β2-agonist and corticosteroid restore airway glandular cell function altered by bacterial supernatant

    Directory of Open Access Journals (Sweden)

    Nawrocki-Raby Béatrice

    2010-01-01

    Full Text Available Abstract Background Staphylococcus aureus releases virulence factors (VF that may impair the innate protective functions of airway cells. The aim of this study was to determine whether a long-acting β2 adrenergic receptor agonist (salmeterol hydroxynaphthoate, Sal combined with a corticosteroid (fluticasone propionate, FP was able to regulate ion content and cytokine expression by airway glandular cells after exposure to S. aureus supernatant. Methods A human airway glandular cell line was incubated with S. aureus supernatant for 1 h and then treated with the combination Sal/FP for 4 h. The expression of actin and CFTR proteins was analyzed by immunofluorescence. Videomicroscopy was used to evaluate chloride secretion and X-ray microanalysis to measure the intracellular ion and water content. The pro-inflammatory cytokine expression was assessed by RT-PCR and ELISA. Results When the cells were incubated with S. aureus supernatant and then with Sal/FP, the cellular localisation of CFTR was apical compared to the cytoplasmic localisation in cells incubated with S. aureus supernatant alone. The incubation of airway epithelial cells with S. aureus supernatant reduced by 66% the chloride efflux that was fully restored by Sal/FP treatment. We also observed that Sal/FP treatment induced the restoration of ion (Cl and S and water content within the intracellular secretory granules of airway glandular cells and reduced the bacterial supernatant-dependent increase of pro-inflammatory cytokines IL8 and TNFα. Conclusions Our results demonstrate that treatment with the combination of a corticosteroid and a long-acting β2 adrenergic receptor agonist after bacterial infection restores the airway glandular cell function. Abnormal mucus induced by defective ion transport during pulmonary infection could benefit from treatment with a combination of β2 adrenergic receptor agonist and glucocorticoid.

  4. 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.

  5. From inhaler to lung: clinical implications of the formulations of ciclesonide and other inhaled corticosteroids

    Directory of Open Access Journals (Sweden)

    Nave R

    2013-03-01

    Full Text Available Ruediger Nave, Helgert Mueller Nycomed: a Takeda Company, Nycomed GmbH, Konstanz, Germany Abstract: Asthma continues to be a global health problem and currently available treatments such as corticosteroids can cause unwanted side effects. Inhaled corticosteroids (ICS are recommended as first-line therapy for reducing airway inflammation and have a distinct advantage over oral preparations as they provide a direct route of delivery to the lungs. However, local deposition of ICS in the oropharynx can lead to oral candidiasis, dysphonia, and pharyngitis. The pharmaceutical quality is a primary concern of any ICS asthma treatment, with a higher quality product resulting in improved efficacy and safety profiles. The particle size distribution and the spray force velocity of an ICS may directly influence lung deposition, and the spray duration of a device is another important factor when coordinating inhalation. Recent advances in ICS device and formulation technology have resulted in significant improvements in the efficacy of available asthma treatments. In particular, hydrofluoroalkane (HFA solution technology and the development of smaller particle sizes have resulted in the production of new ICS formulations that have the ability to directly target drug delivery to the site of airway inflammation. Both the ICS formulation and the pressurized metered-dose inhaler device used to administer ciclesonide (CIC HFA have been developed to treat the underlying chronic inflammation associated with asthma. CIC is administered as a prodrug which is activated in the lungs, leading to minimal oropharyngeal deposition. The small particle size of CIC results in the delivery of a high fraction of respirable particles to the small airways of the lungs, resulting in high lung deposition and continual dose consistency. This review summarizes how CIC administered as an HFA formulation is an effective treatment for asthma. Keywords: ciclesonide, asthma, small airways

  6. Identifying a biomarker network for corticosteroid resistance in asthma from bronchoalveolar lavage samples.

    Science.gov (United States)

    Vargas, José Eduardo; Porto, Bárbara Nery; Puga, Renato; Stein, Renato Tetelbom; Pitrez, Paulo Márcio

    2016-07-01

    Corticosteroid resistance (CR) is a major barrier to the effective treatment of severe asthma. Hence, a better understanding of the molecular mechanisms involved in this condition is a priority. Network analysis is an emerging strategy to explore this complex heterogeneous disorder at system level to identify a small own network for CR in asthma. Gene expression profile of GSE7368 from bronchoalveolar lavage (BAL) of CR in subjects with asthma was downloaded from the gene expression omnibus (GEO) database and compared to BAL of corticosteroid-sensitive (CS) patients. DEGs were identified by the Limma package in R language. In addition, DEGs were mapped to STRING to acquire protein-protein interaction (PPI) pairs. Topological properties of PPI network were calculated by Centiscape, ClusterOne and BINGO. Subsequently, text-mining tools were applied to design one own cell signalling for CR in asthma. Thirty-five PPI networks were obtained; including a major network consisted of 370 nodes, connected by 777 edges. After topological analysis, a minor PPI network composed by 48 nodes was indentified, which is composed by most relevant nodes of major PPI network. In this subnetwork, several receptors (EGFR, EGR1, ESR2, PGR), transcription factors (MYC, JAK), cytokines (IL8, IL6, IL1B), one chemokine (CXCL1), one kinase (SRC) and one cyclooxygenase (PTGS2) were described to be associated with inflammatory environment and steroid resistance in asthma. We suggest a biomarker network composed by 48 nodes that could be potentially explored with diagnostic or therapeutic use. PMID:27188427

  7. Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice

    Directory of Open Access Journals (Sweden)

    Verhaar Jan AN

    2007-09-01

    Full Text Available Abstract Background Regional pain in the hip in adults is a common cause of a general practitioner visit. A considerable part of patients suffer from (greater trochanteric pain syndrome or trochanteric bursitis. Local corticosteroid injections is one of the treatment options. Although clear evidence is lacking, small observational studies suggest that this treatment is effective in the short-term follow-up. So far, there are no randomised controlled trials available evaluating the efficacy of injection therapy. This study will investigate the efficacy of local corticosteroid injections in the trochanter syndrome in the general practice, using a randomised controlled trial design. The cost effectiveness of the corticosteroid injection therapy will also be assessed. Secondly, the role of co-morbidity in relation to the efficacy of local corticosteroid injections will be investigated. Methods/Design This study is a pragmatic, open label randomised trial. A total of 150 patients (age 18–80 years visiting the general practitioner with complaints suggestive of trochanteric pain syndrome will be allocated to receive local corticosteroid injections or to receive usual care. Usual care consists of analgesics as needed. The randomisation is stratified for yes or no co-morbidity of low back pain, osteoarthritis of the hip, or both. The treatment will be evaluated by means of questionnaires at several time points within one year, with the 3 month and 1 year evaluation of pain and recovery as primary outcome. Analyses of primary and secondary outcomes will be made according to the intention-to-treat principle. Direct and indirect costs will be assessed by questionnaires. The cost effectiveness will be estimated using the following ratio: CE ratio = (cost of injection therapy minus cost of usual care/(effect of injection therapy minus effect of usual care. Discussion This study design is appropriate to estimate effectiveness and cost-effectiveness of the

  8. Profiling of Concanavalin A-Binding Glycoproteins in Human Hepatic Stellate Cells Activated with Transforming Growth Factor-β1

    Directory of Open Access Journals (Sweden)

    Yannan Qin

    2014-11-01

    Full Text Available Glycoproteins play important roles in maintaining normal cell functions depending on their glycosylations. Our previous study indicated that the abundance of glycoproteins recognized by concanavalin A (ConA was increased in human hepatic stellate cells (HSCs following activation by transforming growth factor-β1 (TGF-β1; however, little is known about the ConA-binding glycoproteins (CBGs of HSCs. In this study, we employed a targeted glycoproteomics approach using lectin-magnetic particle conjugate-based liquid chromatography-tandem mass spectrometry to compare CBG profiles between LX-2 HSCs with and without activation by TGF-β1, with the aim of discovering novel CBGs and determining their possible roles in activated HSCs. A total of 54 and 77 proteins were identified in the quiescent and activated LX-2 cells, respectively. Of the proteins identified, 14.3% were glycoproteins and 73.3% were novel potential glycoproteins. Molecules involved in protein processing in the endoplasmic reticulum (e.g., calreticulin and calcium signaling (e.g., 1-phosphatidylinositol-4,5-bisphosphate phosphodiesterase β-2 [PLCB2] were specifically identified in activated LX-2 cells. Additionally, PLCB2 expression was upregulated in the cytoplasm of the activated LX-2 cells, as well as in the hepatocytes and sinusoidal cells of liver cirrhosis tissues. In conclusion, the results of this study may aid future investigations to find new molecular mechanisms involved in HSC activation and antifibrotic therapeutic targets.

  9. Corticosteroid hormone receptors and prereceptors as new biomarkers of the illegal use of glucocorticoids in meat production.

    Science.gov (United States)

    Divari, Sara; Cannizzo, Francesca T; Uslenghi, Federica; Pregel, Paola; Mulasso, Chiara; Spada, Francesca; De Maria, Raffaella; Biolatti, Bartolomeo

    2011-03-01

    Despite the European ban on the use of growth promoters in cattle, veterinary surveillance reports indicate that the illicit use of corticosteroids persists both alone and in combination with anabolic hormones and β-agonists. Current control strategies should be informed by research into the effects of corticosteroids on bovine metabolism and improved through the development of specific, sensitive diagnostic methods that utilize potential molecular biomarkers of corticosteroid treatment. The actions of corticosteroids on target tissues are principally regulated by two receptors: the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR). The effects of these steroids are modulated by prereceptor enzyme-mediated metabolism: the two isoforms of the 11β-hydroxysteroid dehydrogenase (11β-HSDs) enzyme catalyze the interconversion between active glucocorticoids, such as cortisol, into inactive compounds, such as cortisone. This study aimed to determine whether the expression of the prereceptor system and of the corticosteroid receptors could be regulated in different target tissues by the administration of dexamethasone and prednisolone in cattle. It was observed that greater up-regulation of the GR and MR genes followed dexamethasone treatment in the muscle tissues than in the kidney, liver, and salivary glands; up-regulation of GR and MR expression following prednisolone treatment was higher in adipose tissue than in the other tissues. The thymus seemed to respond to dexamethasone treatment but not to prednisolone treatment. Both treatments significantly down-regulated 11β-HSD2 gene expression in the adrenal tissues, but only dexamethasone treatment down-regulated 11β-HSD2 expression in the bulbourethral and prostate glands. Together, these data indicate that the combination of GR, MR, and 11β-HSD2 could provide a useful biomarker system to detect the use of illicit glucocorticoid treatment in cattle. PMID:21306119

  10. Effect of local corticosteroid injection of the hand and wrist on blood glucose in patients with diabetes mellitus.

    Science.gov (United States)

    Catalano, Louis W; Glickel, Steven Z; Barron, O Alton; Harrison, Richard; Marshall, Astrid; Purcelli-Lafer, Marissa

    2012-12-01

    Locally administered corticosteroids are a common therapy in many hand and wrist disorders. Corticosteroids pose a theoretical risk to patients with diabetes mellitus by potentially raising blood glucose to hyperglycemic levels. Although oral corticosteroids are known to have an effect on blood glucose control, limited data exist on extra-articular administration. The purpose of this study was to examine the systemic impact of extra-articularly administered corticosteroids in the hand and wrist on serum glucose concentration in patients with diabetes mellitus.Twenty-three patients with diabetes mellitus received a 1-mL triamcinolone acetonide injection for de Quervain's tenosynovitis, trigger finger, flexor carpi ulnaris tendonitis, or carpal tunnel syndrome. Patients recorded their daily morning blood glucose levels for 1 week before injection and for 4 weeks after injection. Average blood glucose levels increased slightly from baseline after injection, reaching statistical significance 1, 5, and 6 days after injection, but were not clinically significant (average increase, 14.2, 9.7, and 32.7 mg/dL, respectively). Isolated increases more than 2 times the standard deviation of preinjection values occurred at least once in the majority of patients. The frequency of hyperglycemic episodes increased after injection, but the proportions of patients with at least 1 hyperglycemic episode before and after injection were not significantly different.These results suggest that local corticosteroid injections are a clinically safe treatment option for inflammatory processes of the hand and wrist in patients with diabetes mellitus. On average, patients experienced slight increases in blood glucose after receiving an injection. Most experienced isolated increases substantially beyond baseline and isolated hyperglycemic effects, but these did not pose an apparent clinical risk. PMID:23218632

  11. Corticosteroides no tratamento da miastenia grave. Estudo de 12 casos com revisão da literatura Corticosteroids in the management of myasthenia gravis

    Directory of Open Access Journals (Sweden)

    José Lamartine de Assis

    1975-03-01

    to suppress the symptoms, as well as to allow remission or an improvement for remaining even when prednisone had been slowly decreased, after a scheduled of one to two years of treatment. In conclusion, 75% of 12 patients with generalized myasthenia gravis showed improvement or complete remission of symptoms during the corticosteroid therapy. There was only a case with thymoma that showed no response to all treatments. Other patient had a polymyositis associated with myasthenia gravis and showed an excellent therapeutic result. Two patients without thymoma showed an initial worsening. To date no important side effect was noted including in the patients treated for a long period.

  12. Fluticasone propionate-salmeterol versus inhaled corticosteroids plus montelukast: outcomes study in pediatric patients with asthma

    Directory of Open Access Journals (Sweden)

    Stanford RH

    2012-12-01

    Full Text Available Richard H Stanford,1 Manan Shah,2 Anna O D'Souza21GlaxoSmithKline, Research Triangle Park, Durham, NC, 2Xcenda, Palm Harbor, FL, USABackground: The purpose of this study (GSK ADA111194 was to compare asthma-related health care utilization and costs associated with fluticasone propionate (an inhaled corticosteroid [ICS] and salmeterol (a long-acting beta-agonist in a single inhalation device (fluticasone propionate-salmeterol versus the combination of ICS + montelukast in the treatment of pediatric patients with asthma.Methods: This was a retrospective, observational cohort study using a large health insurance claims database spanning January 1, 2000 to January 31, 2008. The target population was patients aged 4–11 years with at least one pharmacy claim for fluticasone propionate-salmeterol, any ICS, or montelukast during the study period. The date of first claim for the medication of interest was deemed the index date. Patients were required to be continuously eligible to receive health care services one year prior to and 30 days after the index date, and have at least one claim with an ICD-9-CM code for asthma (493.xx in the one-year pre-index period. Patients with prescriptions for fluticasone propionate-salmeterol, ICS + montelukast, or long-acting beta-agonists during the pre-index period were excluded. Patients were matched on a 1:1 basis according to three variables, ie, pre-index use of oral corticosteroids, ICS, and presence of pre-index respiratory-related hospitalizations/emergency department visits. The risk of asthma-related hospitalization, combined hospitalization/emergency department visit, and monthly asthma-related costs were assessed using multivariate methods.Results: Of the 3001 patients identified, 2231 patients were on fluticasone propionate-salmeterol and 770 were on ICS + montelukast. After matching, there were 747 pairs of fluticasone propionate-salmeterol and ICS + montelukast patients, which were well matched for

  13. Patient perspectives on fluticasone–vilanterol versus other corticosteroid combination products for the treatment of asthma

    Directory of Open Access Journals (Sweden)

    Bollmeier SG

    2016-05-01

    Full Text Available Suzanne G Bollmeier, Theresa R Prosser St Louis College of Pharmacy, St Louis, MO, USA Objective: Fluticasone furoate (FF, an inhaled corticosteroid (ICS, and vilanterol (VI, a long-acting beta2 receptor agonist (LABA, is a new combination used in an Ellipta® device. This article compares FF–VI to other ICS–LABA combinations available, particularly emphasizing product selection from the patient perspective. Data sources: A PubMED and EMBASE search completed in October 2015 identified trials using the MeSH terms “fluticasone”, “vilanterol”, and “asthma”. Additional information was gathered from references cited in the identified publications, the manufacturer, package insert, and ClinicalTrials.gov registry. Study selection/data extraction: Preference was given to randomized controlled clinical trials. Animal trials, trials for COPD, and non-English sources were excluded. Data synthesis: Seven efficacy trials of FF–VI in asthma were identified. Only one (24 weeks trial compared FF–VI to another ICS–LABA combination (fluticasone propionate–salmeterol. Primary outcomes (usually lung function and secondary outcomes (eg, quality of life and symptom scores were comparable. In three FF–VI safety trials, the type and frequency of common adverse reactions (ie, thrush and dysphonia were similar to those in clinical trials. Over 90% of subjects rated the Ellipta® device as “easy to use” and demonstrated correct device technique initially and at 4 weeks. Conclusion: Individuals may have drug- and device-specific preferences that should be incorporated into therapeutic decision making. Limited data indicate that clinical and patient-oriented efficacy/safety outcomes of FF–VI are likely comparable to other available combinations for adults with asthma. Patient-friendly features include once-daily dosing, flexibility of dose timing, and design/ease of the use of the device. Additional larger and long-term comparative

  14. CMTR1 is associated with increased asthma exacerbations in patients taking inhaled corticosteroids.

    Science.gov (United States)

    Dahlin, Amber; Denny, Joshua; Roden, Dan M; Brilliant, Murray H; Ingram, Christie; Kitchner, Terrie E; Linneman, James G; Shaffer, Christian M; Weeke, Peter; Xu, Hua; Kubo, Michiaki; Tamari, Mayumi; Clemmer, George L; Ziniti, John; McGeachie, Michael J; Tantisira, Kelan G; Weiss, Scott T; Wu, Ann Chen

    2015-12-01

    Inhaled corticosteroids (ICS) are the most effective controller medications for asthma, and variability in ICS response is associated with genetic variation. Despite ICS treatment, some patients with poor asthma control experience severe asthma exacerbations, defined as a hospitalization or emergency room visit. We hypothesized that some individuals may be at increased risk of asthma exacerbations, despite ICS use, due to genetic factors. A GWAS of 237,726 common, independent markers was conducted in 806 Caucasian asthmatic patients from two population-based biobanks: BioVU, at Vanderbilt University Medical Center (VUMC) in Tennessee (369 patients), and Personalized Medicine Research Project (PMRP) at the Marshfield Clinic in Wisconsin (437 patients). Using a case-control study design, the association of each SNP locus with the outcome of asthma exacerbations (defined as asthma-related emergency department visits or hospitalizations concurrent with oral corticosteroid use), was evaluated for each population by logistic regression analysis, adjusting for age, gender and the first four principal components. A meta-analysis of the results was conducted. Validation of expression of selected candidate genes was determined by evaluating an independent microarray expression data set. Our study identified six novel SNPs associated with differential risk of asthma exacerbations (P < 10(-05)). The top GWAS result, rs2395672 in CMTR1, was associated with an increased risk of exacerbations in both populations (OR = 1.07, 95% CI 1.03-1.11; joint P = 2.3 × 10(-06)). Two SNPs (rs2395672 and rs279728) were associated with increased risk of exacerbations, while the remaining four SNPs (rs4271056, rs6467778, rs2691529, and rs9303988) were associated with decreased risk. Three SNPs (rs2395672, rs6467778, and rs2691529) were present in three genes: CMTR1, TRIM24 and MAGI2. The CMTR1 mRNA transcript was significantly differentially expressed in nasal lavage samples

  15. Sacroiliitis in children with spondyloarthropathy: therapeutic effect of CT-guided intra-articular corticosteroid injection

    International Nuclear Information System (INIS)

    Purpose: The prospective investigation of the therapeutic effect of CT-guided intra-articular corticosteroid injection into inflammatory sacroiliac (SI) joints compared to conventional treatment with nonsteroidal anti-inflammatory drugs (NSAIDS) in children with juvenile spondyloarthropathy (jSpA) and the determination of the role of dynamic magnetic resonance imaging (MRI) in establishing the indication and monitoring the therapy. Materials and Methods: The study comprises 89 children with known jSpA who were diagnosed by MRI to have a unilateral or bilateral sacroiliitis. Therapy with NSAIDS was initiated or continued in all 89 patients. Four weeks after the diagnostic MRI, two groups were distinguished according to the clinical response of NSAIDS, with group 1 consisting of 22 responders and group 2 of 56 non-responders. The patients of group 2 were treated with CT-guided intra-articular corticosteroid injection (low-dose injection) while the therapy with NSAIDS was continued. A total of 83 SI joints were punctured without complications, 27 bilaterally and 29 unilaterally. The indication for the intervention was based on inflammatory activity as determined by MRI. The therapy was monitored by clinical follow-up every 8 to 12 weeks over a period of 20 months. Follow-up by dynamic MRI was performed in all 56 children of group 2 and 15 of the 33 children of group 1 within 8±4 months of the initial examination. Results: A total of 87.5% of the children in group 2 showed a statistically signficant decrease in their subjective complaints from 6.9±3.4 to 1.8±1.7 (p<0.05) as measured on a visual analog scale (VAS from 0 to 10). Improvement was seen as early as 1.5±1.0 weeks after the intervention and lasted for a mean of 12±6 months. The children in group 1 already showed similar improvement of the VAS from 6.8±3.2 to 1.5±1.4 (p<0.05) during the initial four weeks of NSAIDS therapy, with the improvement lasting for the 20-month observation period. The follow

  16. [Electron paramagnetic resonance study of the interactions between steroid hormones and binding proteins].

    Science.gov (United States)

    Basset, M; Chambaz, E M; Defaye, G; Metz, B

    1978-01-01

    Interaction of a spin labeled corticosteroid (desoxycorticosterone nitroxyde: DOC -NO) with three purified proteins (albumin, transcortin, progesterone binding protein: PBG) was studied by electron spin resonance (ESR) spectroscopy. DOC-NO was competitive with natural corticosteroids and therefore bound at the same site to specific binding proteins. ESR spectra in the presence of each of the proteins showed an immobilized (bound) form of the spin labeled steroid and allowed the calculation of the corresponding association constant (Ka) at equilibrium. The three binding proteins could be characterized by the ESR parameters of the DOC-NO bound form. The thermodynamic parameters (deltaH, deltaS) of the steroid-protein interactions were calculated from the ESR data obtained within a wide temperature range (3--40 degrees C). The ESR spectra width (2T) was used to evaluate the polarity of the spin label environment within the steroid binding site: a hydrophobic character was observed for transcortin whereas PBG exhibited a more hydrophilic steroid binding sits. The rotational correlation time of the three protein DOC-NO complexes at equilibrium were calculated from ESR data; the results were correlated with the protein molecular size and suggested a non spherical shape for the binding macromolecule in solution. Spin labelling of biologically active steroids thus provides a novel approach for the study of the interaction of these hormones with their binding protein. Providing a suitable spin label, the ESR parameters may allow the characterization of several types of binding sites of different biological significance for the same hormone, in biological fluids as well as in target tissues. PMID:83166

  17. Comparison of efficacy of high dose inhaled corticosteroids with a combination of low dose inhaled corticosteroids and long acting AND#946;2 agonists in patients of moderate persistent asthma : a randomised prospective comparative study

    OpenAIRE

    Vivek Sood; Parveen Sharma; Rekha Bansal; Dinesh Kansal

    2016-01-01

    Background: Asthma has global prevalence varying from 2-25%. Among various subtypes, moderate persistent asthma is a subtype currently managed by a combination therapy of low dose inhaled corticosteroids and LABA (long acting beta2 agonists). Search is on for LABA free regime because of safety concerns and increased risk of exacerbations as reported in meta-analysis conducted by FDA in 2008. Methods: Patients (new and old) of either sex and age having moderate persistent asthma as per GINA...

  18. [Directions for use of corticosteroids and calcineurin inhibitors against generalized myasthenia gravis: therapeutic strategies that can lead to early improvements and veer away from high-dose oral corticosteroids].

    Science.gov (United States)

    Utsugisawa, Kimiaki; Nagane, Yuriko; Suzuki, Shigeaki; Suzuki, Norihiro

    2012-01-01

    The advent of effective immune treatment has meant that myasthenia gravis (MG) is most often not lethal. However, many MG patients still find it difficult to maintain daily activities due to chronic residual fatigability and long-term side effects of medication, since full remission without immune treatment is not common. Our analysis demonstrated that disease severity, dose of oral corticosteroids, and depressive state are the major independent factors negatively associated with self-reported QOL (MG-QOL15-J score). It is noteworthy that oral corticosteroid, the first-line agent for MG, is negatively associated with patients' QOL. When the analysis took into account MGFA postintervention status and dose of oral prednisolne (PSL), the MG-QOL15-J score of MM status patients taking ≤ 5 mg PSL per day is identically low (i.e., just as good QOL) as that seen in CSR and is a target of treatment. In order to veer away from high-dose oral corticosteroids and to achieve early MM or better status with PSL ≤ 5 mg/day, we advocate the early aggressive treatment strategy that can achieve early improvement by performing an aggressive therapy using combined treatment with plasmapheresis and high-dose intravenous methylprednisolone and then maintain an improved clinical status using low-dose oral corticosteroids and calcineurin inhibitors (cyclosporine microemulsion and tacrolimus). The early stages of MG are susceptible to treatment with calcineurin inhibitors. When using cyclosporine microemulsion for MG, blood concentrations 2 h after administration (C2) correlate with clinical improvement and immediately before administration (C0) with side effects (increased serum creatinine and/or hypertension). Monitoring of C2 and C0 levels is useful to estimate efficacy and safety of the drug. PMID:23196511

  19. Evaluation of the benefit of corticosteroid injection before exercise therapy in patients with osteoarthritis of the knee

    DEFF Research Database (Denmark)

    Henriksen, Marius; Christensen, Robin; Klokker, Louise;

    2015-01-01

    clinical benefits of an intra-articular corticosteroid injection given before exercise therapy in patients with OA of the knee. DESIGN, SETTING, AND PARTICIPANTS: We performed a randomized, blinded, placebo-controlled clinical trial evaluating the benefit of intra-articular corticosteroid injection vs...... placebo injection given before exercise therapy at an OA outpatient clinic from October 1, 2012, through April 2, 2014. The participants had radiographic confirmation of clinical OA of the knee, clinical signs of localized inflammation in the knee, and knee pain during walking (score >4 on a scale of 0 to......) questionnaire (range, 0-100; higher scores indicate greater improvement) at week 14. Secondary outcomes included the remaining KOOS subscales and objective measures of physical function and inflammation. Outcomes were measured at baseline, week 2 (exercise start), week 14 (exercise stop), and week 26 (follow...

  20. Effect of corticosteroids on articular cartilage: have animal studies said everything?

    Science.gov (United States)

    Vandeweerd, Jean-Michel; Zhao, Yang; Nisolle, Jean-François; Zhang, Wenhui; Zhihong, Liu; Clegg, Peter; Gustin, Pascal

    2015-10-01

    Intra-articular (IA) corticosteroids (CS) have been used in the treatment of osteoarthritis for many years, although their effects on articular cartilage are not fully understood. To identify whether previous animal studies have provided enough evidence about the effects of CS, we undertook a systematic review that identified 35 relevant in vivo animal experimental studies between 1965 and 2014 assessing the effects of CS on either normal cartilage, or in either induced osteoarthritis (OA) or synovitis. The quality of the methodology was assessed. Deleterious effects, both structural and biochemical, have mainly been reported in rabbits and are associated with frequent administration of CS, sometimes at high dose and with systemic side effects. In dogs, four identified studies concluded that there were beneficial effects with methylprednisolone acetate (MPA) and triamcinolone hexacetonide therapy. In horses, MPA was mostly deleterious, while triamcinolone acetonide had positive effects in one study highly rated at quality assessment. However, many methodological weaknesses have been identified, such as the lack of pharmacokinetic and pharmocodynamics data and the large variation in doses between studies, the limited selection criteria at baseline, the absence of blinding, and the lack of statistics or appropriate controls for testing the effects of the vehicle of the drug. Those methodological weaknesses weaken the conclusions of numerous studies that assess beneficial or deleterious effects of CS on articular cartilage. Animal studies have not yet provided definitive data, and further research is required into the role of CS in articular pathobiology. PMID:26211421

  1. Listeria monocytogenes meningitis in an atomic bomb survivor receiving corticosteroid therapy for aplastic anemia

    International Nuclear Information System (INIS)

    We report a case of successfully treated Listeria monocytogenes (Lm) meningitis in a atomic bomb survivor receiving steroid therapy for aplastic anemia. The patient was a 62-year-old woman and the past medical history included hypothyroidism due to radioiodide therapy for Basedow disease, breast cancer, aplastic anemia, steroid-induced diabetes mellitus, and pulmonary tuberculosis. At the time of onset, she was receiving corticosteroid, anabolic steroid, an H2-blocker (famotidine), and other medication. Since she developed symptoms of meningitis when she visited our hospital for regular medical check-up for aplastic anemia, she was hospitalized and given antibiotic therapy, including ABPC, without delay. With this effective antibiotic therapy and successful management of the co-existing medical conditions, she was cured except for being a little euphoric. Lm meningitis is known to occur in aged and immunocompromised patients. Since most of the atomic bomb survivors are now aged and the prevalence of malignancy, diabetes mellitus, and other diseases which cause immunodeficiency have been rising year by year, Lm meningitis is one of the emergency neurologic conditions whose diagnosis should not be delayed in this population. (author)

  2. Evaluation of the conservative treatment of Trigger finger by local instillation of corticosteroids

    Directory of Open Access Journals (Sweden)

    Muris Pecar

    2011-12-01

    Full Text Available Introduction: Trigger Finger (tenosynovitis stenosans is a specific, named disease from a group of repetitive strain injury (RSI diseases, caused by inflammation which results in difficulties during muscle contraction and weakened and painful tendon movement. It is common in the outpatient physical medicine and rehabilitation practice. The aim of our study was to evaluate the success of conservative treatment of Trigger Finger by local instillation of corticosteroids.Methods: The study was designed as an observational and open analysis of the results of conservative treatment of 45 patients. We used precise instillation of steroid anti-inflammatory antirheumatic drugs in the area of patho-anatomic, microtraumatic injuries of tendon and its sheath. Patients were evaluated before and after the treatment with 0 to 5 evaluation score scale. The data were analyzed using X2 test.Results: Most of the patients had evaluation score of 2, 3 and 4, before the treatment. After the treatment 10 (29% patients had achieved score 4 and 35 (71% patients had achieved score 5. All of the patients with score 5 had excellent working ability with full working capacity. Other patients had well-preserved working ability, which improved to excellent in maximum of 7 days.Conclusions: Conservative treatment of Trigger finger shows good therapeutic effects and taking into account the benefits, convenience and generally lower cost of conservative treatment for the patient, should be considered as an effective alternative to surgical treatment.

  3. Listeria monocytogenes meningitis in an atomic bomb survivor receiving corticosteroid therapy for aplastic anemia

    Energy Technology Data Exchange (ETDEWEB)

    Fujihara, Kazuo; Shida, Norihiko; Ohta, Michiya [Hiroshima Atomic Bomb Hospital (Japan)

    1995-12-01

    We report a case of successfully treated Listeria monocytogenes (Lm) meningitis in a atomic bomb survivor receiving steroid therapy for aplastic anemia. The patient was a 62-year-old woman and the past medical history included hypothyroidism due to radioiodide therapy for Basedow disease, breast cancer, aplastic anemia, steroid-induced diabetes mellitus, and pulmonary tuberculosis. At the time of onset, she was receiving corticosteroid, anabolic steroid, an H{sub 2}-blocker (famotidine), and other medication. Since she developed symptoms of meningitis when she visited our hospital for regular medical check-up for aplastic anemia, she was hospitalized and given antibiotic therapy, including ABPC, without delay. With this effective antibiotic therapy and successful management of the co-existing medical conditions, she was cured except for being a little euphoric. Lm meningitis is known to occur in aged and immunocompromised patients. Since most of the atomic bomb survivors are now aged and the prevalence of malignancy, diabetes mellitus, and other diseases which cause immunodeficiency have been rising year by year, Lm meningitis is one of the emergency neurologic conditions whose diagnosis should not be delayed in this population. (author).

  4. Psychiatric side effects of acute high-dose corticosteroid therapy in neurological conditions.

    Science.gov (United States)

    Lotan, Itay; Fireman, Liora; Benninger, Felix; Weizman, Abraham; Steiner, Israel

    2016-07-01

    It has been implied that high-dose corticosteroids (CSs) commonly cause psychiatric side effects. Here, we examined the rate and risk factors of psychiatric side effects during high-dose CS treatment in patients with neurological disorders. Patients treated with high-dose intravenous CSs for neurological disorders were evaluated for depression, mania, and psychosis using the Beck Depression Inventory, the Geriatric Depression Scale, the Young Mania Rating Scale, and the Brief Psychiatric Rating Scale before CS treatment, immediately after, and 1 month following treatment. Forty-nine consecutive patients were monitored. There was a reduction in the Beck Depression Inventory and Geriatric Depression Scale scores as well as in the Brief Psychiatric Rating Scale scores throughout the study period and a transitory increase in the Young Mania Rating Scale score immediately after CS administration. Thus, a tendency to develop transient mild euphoria during high-dose CS treatment exists, but is reversible at 1 month, whereas a reduction in depressive symptoms tended to persist. Overall, our data indicate that high-dose CS treatment for neurological diseases is relatively safe with respect to psychiatric complications. PMID:26938038

  5. Identification of a Benzamide Derivative that Inhibits Stress-Induced Adrenal Corticosteroid Synthesis

    Directory of Open Access Journals (Sweden)

    Jing Xu

    2009-09-01

    Full Text Available Elevated serum glucocorticoid levels contribute to the progression of many diseases, including depression, Alzheimer’s disease, hypertension, and acquired immunodeficiency syndrome. Here we show that the benzamide derivative N-[2-(4-cyclopropanecarbonyl-3-methyl-piperazin-1-yl-1-(tert-butyl-1H-indol-3-yl-methyl-2-oxo-ethyl]-4-nitrobenzamide (SP-10 inhibits dibutyryl cyclic AMP (dbcAMP-induced corticosteroid synthesis in a dose-dependent manner in Y-1 adrenal cortical mouse tumor cells, without affecting basal steroid synthesis and reduced stress-induced corticosterone increases in rats without affecting the physiological levels of the steroid in blood. SP-10 did not affect cholesterol transport and metabolism by the mitochondria but was unexpectedly found to increase 3-hydroxy-3-methylglutaryl-coenzyme A, low density lipoprotein receptor, and scavenger receptor class B type I (SR-BI expression. However, it also markedly reduced dbcAMP-induced NBD-cholesterol uptake, suggesting that this is a compensatory mechanism aimed at maintaining cholesterol levels. SP-10 also induced a redistribution of filamentous (F- and monomeric (G- actin, leading to decreased actin levels in the submembrane cytoskeleton suggesting that SP-10-induced changes in actin distribution might prevent the formation of microvilli–cellular structures required for SRBI-mediated cholesterol uptake in adrenal cells.

  6. Influence of prenatal corticosteroids on bacterial colonization in the newborn rat.

    Science.gov (United States)

    Schiffrin, E J; Carter, E A; Walker, W A; Frieberg, E; Benjamin, J; Israel, E J

    1993-10-01

    The interactions between bacteria and the host's intestinal barrier appear to be important regulators of bacterial colonization. In this study we investigated the effect of prenatal corticosteroids, known to accelerate the intestinal maturation of newborn rats, on bacterial colonization in the rat pup. Pregnant rats were treated with either cortisone acetate or normal saline on days 18-21 of gestation and were allowed to deliver spontaneously. The pups, after normal delivery, were sacrificed at different times during the first 10 days of life. The entire small intestine was removed, and each lumen was flushed to exclude nonadherent, transient organisms and homogenized. Tenfold dilutions were plated on horse-blood agar (total bacteria) and MacConkey's medium (gram-negatives). Quantitation and bacterial typification was determined after 24 h of incubation at 37 degrees C. Total bacteria and gram-negatives found in association with the mucosa were significantly lower in pups prenatally treated with steroids. These changes were not related to any changes in motility or intraluminal digestion. This suggests that the developmental condition of the host's intestinal barrier may be an important regulator of the bacterial microenvironment of the newborn small intestinal mucosa. PMID:8271126

  7. Cryptogenic organizing pneumonia due to amiodarone: long-term follow-up after corticosteroid treatment.

    Science.gov (United States)

    Schindler, Katja; Schima, Wolfgang; Kaliman, Josef F

    2010-08-01

    Cryptogenic organizing pneumonia (formerly known as bronchiolitis obliterans organizing pneumonia) is a clinicopathological entity with characteristical radiographic findings such as bilateral, asymmetrical, sometimes migrating, patchy infiltrates in chest radiograph and ground-glass opacities in computed tomography. The disease has been observed in the context of gastrointestinal disorders, certain lung infections, autoimmune-mediated diseases (such as Wegener granulomatosis), inhalation of toxic fumes, bone marrow transplantation and administration of drugs. The benzofuran amiodarone, a commonly used antiarrythmic drug for atrial fibrillation, can exhibit several pulmonary adverse effects, amongst them cryptogenic organizing pneumonia as a rarely diagnosed and published one. We report a case of cryptogenic organizing pneumonia secondary to amiodarone treatment, its clinical course with significant improvement of clinical symptoms within a few days after discontinuation of amiodarone treatment and administration of corticosteroids. Also the infiltrations found in chest X-ray and computed tomography responded well and showed remarkable resolution tendency quickly. During 5 months of corticoid therapy pulmonary abnormalities gradually resolved almost completely and remained equal during the 8 months follow-up after corticoid termination. PMID:20668958

  8. Increased use of inhaled corticosteroids among young Danish adult asthmatics: An observational study

    DEFF Research Database (Denmark)

    Davidsen, Jesper Rømhild; Søndergaard, Jens; Hallas, Jesper; Siersted, Hans Christian; Lykkegaard, Jesper; Andersen, Morten

    2010-01-01

    OBJECTIVE: This population-based longitudinal study aimed to investigate trends in use of inhaled corticosteroids (ICS) and determinants of ICS use in young Danish adults with asthma. METHODS: 106 757 users, aged 18-44 years, of anti-asthmatic drugs were identified in the Danish Register of Medical.......96-1.01) compared to 1.12 (95% CI 1.09-1.15) in 2001, and 1.81 (95% CI 1.75-1.87) in 2006. Other determinants of high ICS use were female gender, young age, and high annual IBA consumption. Among those using at least 400 DDD of IBA per year (corresponding to 4.4 powder inhalations daily), nearly 20% had no ICS...... Product Statistics during 1997-2006. One year prevalences of ICS use were calculated in categories of gender, age, and annual consumption of inhaled beta-2-agonists (IBA) in defined daily doses (DDD) per year. Determinants of ICS use were estimated by logistic regression models. RESULTS: The one year...

  9. 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.

  10. Impact of socioeconomic status on the use of inhaled corticosteroids in young adult asthmatics

    DEFF Research Database (Denmark)

    Davidsen, Jesper Rømhild; Søndergaard, Jens; Hallas, Jesper; Siersted, Hans Christian; Knudsen, Thomas Bøllingtoft; Lykkegaard, Jesper; Andersen, Morten

    2011-01-01

    OBJECTIVE: The aim of this population-based longitudinal study was to examine the associations between socioeconomic status (SES) and anti-asthmatic treatment with inhaled corticosteroids (ICS) among young Danish adult asthmatics, and to investigate whether these associations were consistent over...... ICS use in young adult asthmatics. To encourage ICS use, special attention should be paid to asthmatics with low educational level and low income. Further studies are needed to elucidate underlying mechanisms for this socioeconomic inequality....... time. METHODS: We extracted data on prescription drug use, education, and income in 97 665 users of anti-asthmatic drugs, aged 18-44 years, identified in Statistics Denmark during 1997-2005. Individual information on education and income was used as measures of SES. Education was categorised into basic...... school/high school, vocational training, and higher education, and income was categorised into low, middle, and high income. Associations between ICS use and SES were estimated by logistic regression models. RESULTS: High levels of education and income were independently associated with ICS use...

  11. Biomarkers of alopecia areata disease activity and response to corticosteroid treatment.

    Science.gov (United States)

    Fuentes-Duculan, Judilyn; Gulati, Nicholas; Bonifacio, Kathleen M; Kunjravia, Norma; Zheng, Xiuzhong; Suárez-Fariñas, Mayte; Shemer, Avner; Guttman-Yassky, Emma; Krueger, James G

    2016-04-01

    Alopecia areata (AA) is a common inflammatory disease targeting the anagen-stage hair follicle. Different cytokines have been implicated in the disease profile, but their pathogenic role is not yet fully determined. We studied biopsies of pretreatment lesional and non-lesional (NL) scalp and post-treatment (intra-lesional steroid injection) lesional scalp of 6 patchy patients with AA using immunohistochemistry and gene expression analysis. Immunohistochemistry showed increases in CD3(+) , CD8(+) T cells, CD11c(+) dendritic cells and CD1a(+) Langerhans cells within and around hair follicles of pretreatment lesional scalp, which decreased upon treatment. qRT-PCR showed in pretreatment lesional scalp (compared to NL) significant increases (P hair keratins in lesional scalp, with significant upregulation of KRT35, KRT75 and KRT86 in post-treatment lesional scalp. This study shows concurrent activation of Th1 and Th2 immune axes as well as IL-23 and IL-32 cytokine pathways in lesional AA scalp and defined a series of response biomarkers to corticosteroid injection. Clinical trials with selective antagonists coupled with cytokine-pathway biomarkers will be necessary to further dissect pathogenic immunity. PMID:26661294

  12. Add-on therapy options in asthma not adequately controlled by inhaled corticosteroids: a comprehensive review

    Directory of Open Access Journals (Sweden)

    Moilanen Eeva

    2004-10-01

    Full Text Available Abstract Many patients with persistent asthma can be controlled with inhaled corticosteroids (ICS. However, a considerable proportion of patients remain symptomatic, despite the use of ICS. We present systematically evidence that supports the different treatment options. A literature search was made of Medline/PubMed to identify randomised and blinded trials. To demonstrate the benefit that can be obtained by increasing the dose of ICS, dose-response studies with at least three different ICS doses were identified. To demonstrate whether more benefit can be obtained by adding long-acting β2-agonist (LABA, leukotriene antagonist (LTRA or theophylline than by increasing the dose of ICS, studies comparing these options were identified. Thirdly, studies comparing the different "add-on" options were identified. The addition of a LABA is more effective than increasing the dose of ICS in improving asthma control. By increasing the dose of ICS, clinical improvement is likely to be of small magnitude. Addition of a LTRA or theophylline to the treatment regimen appears to be equivalent to doubling the dose of ICS. Addition of a LABA seems to be superior to an LTRA in improving lung function. However, addition of LABA and LTRA may be equal with respect to asthma exacerbations. However, more and longer studies are needed to better clarify the role of LTRAs and theophylline as add-on therapies.

  13. Saturation analysis studies of corticosteroid levels in normal Greek subjects and in subjects with haemolytic diseases

    International Nuclear Information System (INIS)

    Between 1970 and 1974 a saturation analysis for cortisol in plasma and free cortisol in urine, and a radioimmunoassay method for aldosterone in plasma and urine were developed. In order to permit a comparative evaluation it was necessary to study corticosteroids, diurnal rhythm and the probable effect of a siesta on this rhythm both in normal subjects and in patients suffering from hemic diseases, in particular from sickle-cell anemia. Saturation assay for cortisol, using serum from pregnant women as source of transcortin, and radioimmunoassay for aldosterone were the basic methods used. Serum cortisol was estimated twice a day (8-9 a.m. and 5-6 p.m.). Cortisol and aldosterone were also estimated in serum and in urine before and after adrenalin stimulation with ACTH. No significant influence of a siesta on the diurnal rhythm of cortisol was observed, nor did the levels of serum cortisol or the diurnal rhythm appear affected in congenital hemolytic anemias, following adrenalin stimulation. The report lists experimental results briefly and refers to a paper in which these are published in more detail

  14. Rational and ethical use of topical corticosteroids based on safety and efficacy

    Directory of Open Access Journals (Sweden)

    Sanjay K Rathi

    2012-01-01

    Full Text Available Topical corticosteroids (TC have greatly contributed to the dermatologist′s ability to effectively treat several difficult dermatoses. The available range of formulations and potency gives flexibility to treat all groups of patients, different phases of disease, and different anatomic sites. However, the rapid rise in incidence of improper use of these drugs by dermatologists, general physicians, and patients threatens to bring disrepute to the entire group of these amazing drugs. Responsibility to disseminate proper knowledge regarding when, where, and how to use TC both to internists and patients rests primarily with the dermatologist. Benefits of rational and ethical use and the harm of overuse and misuse for nonmedical, specially for cosmetic purposes, should be clearly conveyed before penning a prescription involving TC. Simultaneous efforts to use political, legal, and other institutions to prevent misuse of these drugs by rationing their availability only through proper prescriptions will greatly help the cause. This will hopefully bring down both the extremes of ever increasing cases of steroid-induced dermatoses on one hand and the irrational fears of using TC in well justified indications on the other.

  15. Coronary slow flow accompanying exertional blurred vision and effects of corticosteroids.

    Science.gov (United States)

    Koç, Şahbender; Vural, Aslı; Aksoy, Hakan; Dindar, Barış; Karagöz, Ahmet; Günaydın, Zeki Yüksel; Bektaş, Osman

    2015-01-01

    Background Various pathophysiological mechanisms such as microvascular and endothelial dysfunction, small vessel disease, diffuse atherosclerosis, and inflammation have been held responsible in the etiology of coronary slow flow. It is also thought to be a reflection of a systemic slow-flow phenomenon in the coronary arterial tree. Case Report A 44-year-old man presented with chest pain causing fatigue, together with blurred vision for the last 2 years, which disappeared after resting. He had used corticosteroid therapy for facial paralysis 1 month ago. Coronary slow flow was detected in all 3 major coronary arteries on coronary angiography. TIMI measurements for the left anterior descending artery, circumflex, and right coronary artery were 64, 72, and 55, respectively. In fundus fluorescein angiography, retinal vascularity was normal, the arm-to-retina circulation time was 21.8 s, and the arteriovenous transit time was 4.3 s. In the early arteriovenous phase, choroidal filling was long, with physiological patchy type. Diltiazem 90 mg/day and acetylsalicylic acid 100 mg/day were given. His chest pain and visual symptoms disappeared after medical treatment. Conclusions Physicians should be aware that glucocorticoids might cause an increase in the symptoms of coronary slow flow and some circulation problems, which might lead to systematic symptoms. PMID:26008865

  16. Antenatal Corticosteroids: A Risk Factor for the Development of Chronic Disease

    Directory of Open Access Journals (Sweden)

    Elizabeth Asztalos

    2012-01-01

    Full Text Available Preterm birth remains a major health issue worldwide. Since the 1990s, women at risk for preterm birth received a single course of exogenous antenatal corticosteroids (ACSs to facilitate fetal lung maturity. More recently, repeated or multiple courses of ACS have been supported to provide continued fetal maturity support for women with continued risk of preterm birth. However, exogenous ACS reduces birth weight which, in turn, is associated with adverse adult outcomes such as coronary heart disease, stroke, hypertension, and type 2 diabetes. The long-term effects of ACS exposure on HPA axis activity and neurological function are well documented in animal studies, and it appears that ACS, regardless of dose exposure, is capable of affecting fetal HPA axis development causing permanent changes in the HPA axis that persists through life and is manifested by chronic illness and behavioral changes. The challenge in human studies is to demonstrate whether an intervention such as ACS administration in pregnancy contributes to developmental programming and how this is manifested in later life.

  17. Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up

    Directory of Open Access Journals (Sweden)

    Ricardo Yuji Abe

    2013-02-01

    Full Text Available OBJECTIVE: To analyze the recovery of visual acuity (VA and graft survival after first episode of endothelial rejection in penetrating keratoplasty (PKP treated with intravenous (IV and topic corticosteroid. METHODS: Interventional, prospective, non-comparative case series study evolving 32 PKP patients in one year follow up, who presented first episode of corneal endothelial rejection. The patients were submitted to 500 mg IV injection of methylprednisolone in association with topical prednisolone. Main outcome measures included VA recovery and corneal edema regression. Second outcome included new rejections and graft failure. Multivariate analysis techniques were used to estimate rates of graft outcome events and the impact of risk factors. RESULTS: A total of 32 eyes from 32 patients (13 male and 19 female were included in the study. The mean VA (in number of letters before rejection was 48 (22 to 88 letters. Patients treated within 7 days or less of initial symptoms had better VA recovery, corneal edema regression and less graft failure (p<0.001. Patients with previous ocular surgery had worse VA recovery and more graft failure (p<0.047. CONCLUSION: The association between the other risk factors and the outcomes did not reach statistical significance in the multivariate model because of the small numbers of patients. Methylprednisolone in association with topical prednisolone is an alternative treatment for graft rejection. Our study showed that patients treated within 7 days of symptoms and no previous anterior segment surgery had better visual outcome and graft survival after treatment.

  18. Hippocampal synthesis of sex steroids and corticosteroids: essential for modulation of synaptic plasticity

    Directory of Open Access Journals (Sweden)

    SuguruKawato

    2011-10-01

    Full Text Available Sex steroids play essential roles in the modulation of synaptic plasticity and neuroprotection in the hippocampus. Accumulating evidence shows that hippocampal neurons synthesize both estrogen and androgen. Recently, we also revealed the hippocampal synthesis of corticosteroids. The accurate concentrations of these hippocampus-synthesized steroids are determined by liquid chromatography-tandem mass spectrometry in combination with novel derivatization. The hippocampal levels of 17β-estradiol (E2, testosterone (T, dihydrotestosterone (DHT and corticosterone (CORT, are 5-15 nM, and these levels are sufficient to modulate synaptic plasticity. Hippocampal E2 modulates memory-related synaptic plasticity not only slowly/genomicaly but also rapidly/nongenomically. Slow actions of E2 occur via classical nuclear receptors (ERα or ERβ, while rapid E2 actions occur via synapse-localized or extranuclear ERα or ERβ. Nanomolar concentrations of E2 changes rapidly the density and morphology of spines in hippocampal neurons. ERα, but not ERβ, drives this enhancement/suppression of spinogenesis in adult animals. Nanomolar concentrations of androgens (T and DHT and CORT also increase in the spine density. Kinase networks are involved downstream of ERα and androgen receptor (AR. Newly developed Spiso-3D mathematical analysis is useful to distinguish these complex effects by sex steroids and kinases. Significant advance has been achieved in investigations of rapid modulation by E2 of the long-term depression or the long-term potentiation.

  19. Separation of corticosteroids by microemulsion EKC with diethyl L-tartrate as the oil phase.

    Science.gov (United States)

    Wu, Chi-Hung; Chen, Tse-Hsien; Huang, Kuan-Pin; Wang, Guan-Ren; Liu, Chuen-Ying

    2007-10-01

    A novel microemulsion based on a mixture of diethyl L-tartrate (DET) and SDS was developed for the microemulsion EKC (MEEKC) determination of structurally related steroids. The system consisted of 0.5% w/w DET, 1.7% w/w SDS, 1.2% w/w 1-butanol, 89.6% w/w phosphate buffer (40 mM, pH 7.0), and 7% w/w ACN. With an applied voltage of +10 kV, a baseline separation of aldosterone (A), cortisone acetate (CA), dexamethasone (D), hydrocortisone (H), hydrocortisone acetate (HA), prednisolone (P), prednisolone acetate (PA), prednisone (Ps), triamcinolone (T), and triamcinolone acetonide (TA) could be achieved. Under the optimized conditions, the reproducibility of the retention time (n = 4) for most of the compounds was less than +/-0.8% with the exception of A, Ps, and T. The average number of theoretical plates was 18 800 plates/m. The results were compared with those achieved by the modified micellar EKC (MEKC). MEEKC showed obvious advantages over MEKC for the separation of highly hydrophobic substances. To further evaluate the system, we tested the MEEKC method by analyzing corticosteroids in a spiked urine sample. PMID:17893939

  20. Influence of medication on the rate of orthodontic tooth movement (Part 1: hormons and corticosteroids

    Directory of Open Access Journals (Sweden)

    Mirhashemi Amirhossein

    2015-05-01

    Full Text Available The aim of this review article was to define the mechanism of action and effects of commonly used medications on the tissue remodeling and Orthodontic Tooth Movement (OTM. A review on the effects of medications and dietary supplements on the rate of experimental tooth movement was performed using Cochrane library, Embase and medline (1980-2013. 63 articles were included in this review. 34 of them were related to the effects of hormones and analgesics, were evaluated in this article but their interpretation was hindered by the variability in experimental design, magnitude of force applied during tooth movement and medication regimens. Non Steroidal Anti-Inflammatory Drugs (NSAIDs reduced the rate of tooth movement while non-NSAIDs such as acetaminophen had no effect on the rate of OTM. Corticosteroids, parathyroid hormone and thyroxin increased the rate of tooth movement. Sturgeons might slow OTM, but experimental studies are lacking. Medications might have an important influence on the rate of tooth movement and information on their consumption is necessary to adequately discuss treatment planning with patients.

  1. CT-guided corticosteroid injection for solitary eosinophilic granuloma of the spine

    Energy Technology Data Exchange (ETDEWEB)

    Rimondi, Eugenio; Rossi, Giuseppe [Istituto Ortopedico Rizzoli, University of Bologna, Department of Radiology and Interventional Angiographic Radiology, Bologna (Italy); Mavrogenis, Andreas F. [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopaedics, Orthopaedic Oncology Service, Bologna (Italy); Ussia, Giuseppe; Angelini, Andrea [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Ruggieri, Pietro [Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopedics, Bologna (Italy); Istituto Ortopedico Rizzoli, University of Bologna, Department of Orthopaedics, Bologna (Italy)

    2011-06-15

    To evaluate the clinical and imaging outcome of patients with symptomatic eosinophilic granuloma of the spine treated with CT-guided intralesional methylprednisolone injection after biopsy. Patients (n =19) with symptomatic solitary eosinophilic granuloma of the spine treated by CT-guided intralesional methylprednisolone injection were retrospectively studied. There were 12 males and seven females with a mean age of 17 years (range, 3-43 years). The mean follow-up was 6 years (median, 4 years; range, 0.5-19 years). Spinal location included the cervical (two patients), thoracic (seven patients), lumbar spine (eight patients), and the sacrum (two patients). Vertebra plana was observed in two patients. All patients had biopsies before treatment. Complete resolution of pain and healing of the lesion was observed in 17 patients (89.5%); none of these patients had recurrence at the latest examination. Reconstitution of the T1 and L1 vertebra plana was observed in both patients. Two patients initially diagnosed and treated for a solitary eosinophilic granuloma had constant pain after the procedure; in these patients, 6 and 12 months after the procedure, respectively, imaging showed multifocal disease and systemic therapy was administered. Complications related to the procedure were not observed. General anesthesia was administered in two patients because of intolerable pain during the procedure. In view of the benign clinical course of eosinophilic granuloma, in patients with symptomatic lesions, CT-guided intralesional corticosteroid injection is a safe and effective outpatient treatment with a low complication rate. (orig.)

  2. CT-guided corticosteroid injection for solitary eosinophilic granuloma of the spine

    International Nuclear Information System (INIS)

    To evaluate the clinical and imaging outcome of patients with symptomatic eosinophilic granuloma of the spine treated with CT-guided intralesional methylprednisolone injection after biopsy. Patients (n =19) with symptomatic solitary eosinophilic granuloma of the spine treated by CT-guided intralesional methylprednisolone injection were retrospectively studied. There were 12 males and seven females with a mean age of 17 years (range, 3-43 years). The mean follow-up was 6 years (median, 4 years; range, 0.5-19 years). Spinal location included the cervical (two patients), thoracic (seven patients), lumbar spine (eight patients), and the sacrum (two patients). Vertebra plana was observed in two patients. All patients had biopsies before treatment. Complete resolution of pain and healing of the lesion was observed in 17 patients (89.5%); none of these patients had recurrence at the latest examination. Reconstitution of the T1 and L1 vertebra plana was observed in both patients. Two patients initially diagnosed and treated for a solitary eosinophilic granuloma had constant pain after the procedure; in these patients, 6 and 12 months after the procedure, respectively, imaging showed multifocal disease and systemic therapy was administered. Complications related to the procedure were not observed. General anesthesia was administered in two patients because of intolerable pain during the procedure. In view of the benign clinical course of eosinophilic granuloma, in patients with symptomatic lesions, CT-guided intralesional corticosteroid injection is a safe and effective outpatient treatment with a low complication rate. (orig.)

  3. Corticosteroid-Induced MKP-1 Represses Pro-Inflammatory Cytokine Secretion by Enhancing Activity of Tristetraprolin (TTP) in ASM Cells.

    Science.gov (United States)

    Prabhala, Pavan; Bunge, Kristin; Ge, Qi; Ammit, Alaina J

    2016-10-01

    Exaggerated cytokine secretion drives pathogenesis of a number of chronic inflammatory diseases, including asthma. Anti-inflammatory pharmacotherapies, including corticosteroids, are front-line therapies and although they have proven clinical utility, the molecular mechanisms responsible for their actions are not fully understood. The corticosteroid-inducible gene, mitogen-activated protein kinase (MAPK) phosphatase 1 (MKP-1, DUSP1) has emerged as a key molecule responsible for the repressive effects of steroids. MKP-1 is known to deactivate p38 MAPK phosphorylation and can control the expression and activity of the mRNA destabilizing protein-tristetraprolin (TTP). But whether corticosteroid-induced MKP-1 acts via p38 MAPK-mediated modulation of TTP function in a pivotal airway cell type, airway smooth muscle (ASM), was unknown. While pretreatment of ASM cells with the corticosteroid dexamethasone (preventative protocol) is known to reduce ASM synthetic function in vitro, the impact of adding dexamethasone after stimulation (therapeutic protocol) had not been explored. Whether dexamethasone modulates TTP in a p38 MAPK-dependent manner in this cell type was also unknown. We address this herein and utilize an in vitro model of asthmatic inflammation where ASM cells were stimulated with the pro-asthmatic cytokine tumor necrosis factor (TNF) and the impact of adding dexamethasone 1 h after stimulation assessed. IL-6 mRNA expression and protein secretion was significantly repressed by dexamethasone acting in a temporally distinct manner to increase MKP-1, deactivate p38 MAPK, and modulate TTP phosphorylation status. In this way, dexamethasone-induced MKP-1 acts via p38 MAPK to switch on the mRNA destabilizing function of TTP to repress pro-inflammatory cytokine secretion from ASM cells. J. Cell. Physiol. 231: 2153-2158, 2016. © 2016 Wiley Periodicals, Inc. PMID:26825339

  4. Prescribing practices of topical corticosteroids in the outpatient dermatology department of a rural tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Suvarna S Rathod

    2013-01-01

    Full Text Available Background: Inappropriate or excessive use of topical corticosteroids can lead to cutaneous and systemic adverse effects which occur more commonly with the use of very potent steroids. Monitoring and analysis of the prescription practices of topical steroids can help to achieve rational prescription of these drugs. Aim: The present study was carried out to study and analyze the pattern of prescribing topical corticosteroids among outpatients attending the dermatology clinic in a rural tertiary care and teaching hospital, Ambajogai, Maharashtra. Materials and Methods: A cross-sectional descriptive study was conducted for a duration of two months from August 2011 to September 2011, and 500 prescriptions were randomly collected from the dermatology pharmacy and analyzed. Results: About 66% of the prescriptions contained four to five drugs per prescription. Topical steroids were given in 28.4% of all the prescriptions. In almost all the prescriptions, strength, quantity of the steroid to be used, frequency, site, and duration of application was not mentioned. The chief complaints and diagnoses were not mentioned in about 85% of the prescriptions for topical corticosteroids. About 94.36% of the prescriptions contained very potent steroids. Conclusion: Inadequate prescribing information is a clear characteristic of the dermatological prescriptions containing topical corticosteroids. Doctors should be educated about the importance of giving patients sufficient information regarding the use of steroids. There is a need to revise hospital formulary where low-potency steroids can also be included along with potent ones so that the latter can be avoided in conditions where they are unnecessary.

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

    OpenAIRE

    Jungersted, Jakob Mutanu; Høgh, Julie Kaae; Hellgren, Lars; Gregor B.E. Jemec; Agner, Tove

    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 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 pa...

  6. Early initiation of low-dose corticosteroid therapy in the management of septic shock: a retrospective observational study

    OpenAIRE

    Park, Hye Yun; Suh, Gee Young; Song, Jae-Uk; Yoo, Hongseok; Jo, Ik Joon; Shin, Tae Gun; Lim, So Yeon; Woo, Sookyoung; Jeon, Kyeongman

    2012-01-01

    Introduction The use of low-dose steroid therapy in the management of septic shock has been extensively studied. However, the association between the timing of low-dose steroid therapy and the outcome has not been evaluated. Therefore, we evaluated whether early initiation of low-dose steroid therapy is associated with mortality in patients with septic shock. Methods We retrospectively analyzed the clinical data of 178 patients who received low-dose corticosteroid therapy for septic shock bet...

  7. Inflammatory Mediators in Induced Sputum and Airway Hyperresponsiveness in Cough Variant Asthma during Long-Term Inhaled Corticosteroid Treatment

    OpenAIRE

    Meixuan Liu; Kaixiong Liu; Ning Zhu; Jingwen Xia; Xiaodong Chen

    2012-01-01

    Objective. This study aimed to investigate improvements in inflammatory mediator levels in induced sputum and airway hyperresponsiveness (AHR) in cough variant asthma (CVA) during long-term inhaled corticosteroid (ICS) treatment. Patients and Methods. Patients with CVA ( = 3 5 ) and classic asthma ( = 2 6 ) and healthy subjects ( = 2 4 ) were recruited into this study. All patients were treated with budesonide (400 μg/day). Measurement of inflammatory mediators in induced sputum and PD2...

  8. CSACI position statement: systemic effect of inhaled corticosteroids on adrenal suppression in the management of pediatric asthma

    OpenAIRE

    Issa-El-Khoury, Karine; Kim, Harold; Chan, Edmond S; Vander Leek, Tim; Noya, Francisco

    2015-01-01

    Asthma is a chronic inflammatory disease of the airways that affects a growing number of children and adolescents. Inhaled corticosteroids (ICS) are the mainstay of treatment in persistent asthma, with a stepwise approach to increasing doses of ICS depending on asthma severity and control. ICS have known local and systemic side effects, of which adrenal suppression is still under-recognized. The latter is associated with chronic exposure and higher doses, although it has rarely been reported ...

  9. 169 The Efficacy of a Nasal Corticosteroid Ciclesonide for the Treatment of Serous Otitis Media in Atopic Children

    OpenAIRE

    Nsouli, Safa

    2012-01-01

    Background Since chronic inflammation is the histopathologic landmark of otitis media with effusion, clinical observations led us to believe that the use of a Nasal Corticoteroid Ciclesonide may be more effective than an oral antibiotic in the treatment of serous otitis media in atopic children. Methods We studied forty pediatric patients (age 6–11 years) in a randomized open labeled 2-week trial to compare the efficacy of the nasal corticosteroid Ciclesonide 50 mcg/nostril 2 sprays per nostr...

  10. A cross sectional study on the prescribing pattern, self medication and adverse reactions associated with topical corticosteroids

    Directory of Open Access Journals (Sweden)

    Venepalli N. Teja

    2016-04-01

    Conclusions: In this study we observed the rationale and safe prescribing pattern. However, the corticosteroids prescribed by brand names (75.93% were more than generic names (24.07%, information about the strength of the steroid not mentioned and usage of emollients was less. This indicates the need for continuous medical education for the clinicians. [Int J Basic Clin Pharmacol 2016; 5(2.000: 429-433

  11. Perception of bronchial obstruction in asthmatic patients. Relationship with bronchial eosinophilic inflammation and epithelial damage and effect of corticosteroid treatment.

    OpenAIRE

    Roisman, G L; Peiffer, C; Lacronique, J. G.; Le Cae, A; Dusser, D J

    1995-01-01

    We studied the perception of bronchoconstriction in asthmatic subjects who were randomly treated with inhaled beta 2 agonist given either alone (n = 9) or associated with inhaled corticosteroids (n = 9). Methacholine and bradykinin challenges, bronchoalveolar lavage, and bronchial biopsies were performed in all subjects. After each dose of agonist, breathlessness was assessed using a visual analog scale (VAS) and the forced expiratory volume in 1 s (FEV1) was measured. The relationship betwee...

  12. Effect of intranasal corticosteroid on pre-onset activation of eosinophils and mast cells in experimental Japanese cedar pollinosis

    OpenAIRE

    Yasuyuki Noyama; Mitsuhiro Okano; Tazuko Fujiwara; Shin Kariya; Sei-ichiro Makihara; Takenori Haruna; Kengo Kanai; Takaya Higaki; Kazunori Nishizaki

    2016-01-01

    Background: Minimal persistent inflammation (MPI) contributes to hyperreactivity in allergic rhinitis. However, little is known regarding whether pre-onset activation of eosinophils and mast cells is present or not in Japanese cedar pollinosis (JCP). Furthermore, a prophylactic effect of intranasal corticosteroids on such MPI in JCP has not been investigated. Methods: We designed a double-blinded, randomized, placebo-controlled, crossover trial. Twenty patients with JCP were examined outsi...

  13. Impact of different combinations of inhaled corticosteroids and long-acting sympathicomimetics on dental health of asthmatics.

    OpenAIRE

    George Christoff; Emilia Karova

    2012-01-01

    The aim of the investigation is to study the effect of inhaled corticosteroids and long-acting sympathicomimetics on dental health in asthmatics. Thirty patients, from 20 to 55 years old, participate in the study. D-, M-, F- and DMFT indexes are determined in a 6 months period. All participants fill in a questionnaire. Asthmatics complain most frequently from oral dryness, take frequently sugar and soft drinks and visit irregularly dental practitioners. A significant increase in M-index is fo...

  14. Comparing the effects of cryotherapy with nitrous oxide gas versus topical corticosteroids in the treatment of oral lichen planus

    OpenAIRE

    Dariush Amanat; Hooman Ebrahimi; Maryam Zahed Zahedani; Nasim Zeini; Sara Pourshahidi; Zahra Ranjbar

    2014-01-01

    Background: Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa with treatment challenges for clinicians. Aims: The objective of this study is to compare the effects of cryotherapy as a new modality with topical corticosteroids as a conventional therapy in the treatment of OLP. Materials and Methods: Thirty patients with bilateral OLP lesions were selected. From each patient a lesion on one side was chosen randomly for a single session of cryotherapy with nit...

  15. Comparison of the efficacy of physical therapy and corticosteroid injection in the treatment of pes anserine tendino-bursitis.

    Science.gov (United States)

    Sarifakioglu, Banu; Afsar, Sevgi Ikbali; Yalbuzdag, Seniz Akcay; Ustaömer, Kubra; Bayramoğlu, Meral

    2016-07-01

    [Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. [Subjects and Methods] Sixty patient with KOA and PATB (Group 1) and 57 patients with KOA but without PATB (Group 2) were enrolled in the study. The patients' visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three-meter timed-up and go scores were measured. The PATB group was randomly divided into two groups (Group A and B). Physical therapy (PT) modalities were applied to the first group (Group A), and the second group (Group B) received corticosteroid injections to the pes anserine area. Eight weeks later, patients' parameters were measured again. [Results] Initial WOMAC scores and timed up-and-go times were significantly higher in Group 1 than in Group 2. Both treatments resulted in significant improvements in all measured parameters, but no significant difference was detected between Group A and B. [Conclusion] Patients with PATB tend to have more severe pain, more altered functionality, and greater disability than those with KOA but without PATB. Both corticosteroid injection and PT are effective methods of treatment for PATB. Injection therapy can be considered an effective, inexpensive and fast therapeutic method. PMID:27512249

  16. Spirometry Findings Following Treatment with Oral and Inhalant Corticosteroids in Mild to Moderate Asthma Exacerbation in Children

    Directory of Open Access Journals (Sweden)

    Nemat Bilan

    2014-12-01

    Full Text Available Introduction:  Asthma exacerbation is common in children. Treatment with oral corticosteroids (OCS and inhaled corticosteroids are suggested for asthma exacerbation. It is shown that inhaled corticosteroids has similar outcome in reducing asthma symptoms compared to OCS. But few studies have evaluated the pulmonary function changes in these two treatments. In this study, we evaluated the changes in pulmonary function tests in children with mild-to-moderate asthma exacerbation receiving oral prednisolone and inhaled Budesonide. Methods and Materials: Forty-four children with mild-to-moderate asthma exacerbation were randomly assigned to receive oral prednisolone (2 mg/kg or Budesonide spray (2 puffs every 12 hours, each puff contains 200 microgram Budesonide using a spacer for one week. The first dose of the treatment was given in the emergency department. Children were followed for seven days and spirometry findings before and after treatment were evaluated. Results: There was no significant difference between pulmonary function tests before and after treatment between groups. Children receiving oral prednisolone had significantly more improvement in PEF (p=0.01. There was significant improvement in all respiratory parameters after treatment in both groups (p

  17. Cost-utility of Intravenous Immunoglobulin (IVIG) compared with corticosteroids for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) in Canada

    OpenAIRE

    Campbell Kaitryn; Xie Feng; Gaebel Kathryn; Blackhouse Gord; Assasi Nazila; Tarride Jean-Eric; O'Reilly Daria; Chalk Colin; Levine Mitchell; Goeree Ron

    2010-01-01

    Abstract Objectives Intravenous immunoglobulin (IVIG) has demonstrated improvement in chronic inflammatory demyelinating polyneuropathy (CIDP) patients in placebo controlled trials. However, IVIG is also much more expensive than alternative treatments such as corticosteroids. The objective of the paper is to evaluate, from a Canadian perspective, the cost-effectiveness of IVIG compared to corticosteroid treatment of CIDP. Methods A markov model was used to evaluate the costs and QALYs for IVI...

  18. Electronic health record-based assessment of oral corticosteroid use in a population of primary care patients with asthma: an observational study

    OpenAIRE

    Allen-Ramey, Felicia C; Nelsen, Linda M; Leader, Joseph B; Mercer, Dione; Kirchner, Henry Lester; Jones, James B

    2013-01-01

    Background Oral corticosteroid prescriptions are often used in clinical studies as an indicator of asthma exacerbations. However, there is rarely the ability to link a prescription to its associated diagnosis. The objective of this study was to characterize patterns of oral corticosteroid prescription orders for asthma patients using an electronic health record database, which links each prescription order to the diagnosis assigned at the time the order was placed. Methods This was a retrospe...

  19. Cost-utility of Intravenous Immunoglobulin (IVIG compared with corticosteroids for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP in Canada

    Directory of Open Access Journals (Sweden)

    Campbell Kaitryn

    2010-06-01

    Full Text Available Abstract Objectives Intravenous immunoglobulin (IVIG has demonstrated improvement in chronic inflammatory demyelinating polyneuropathy (CIDP patients in placebo controlled trials. However, IVIG is also much more expensive than alternative treatments such as corticosteroids. The objective of the paper is to evaluate, from a Canadian perspective, the cost-effectiveness of IVIG compared to corticosteroid treatment of CIDP. Methods A markov model was used to evaluate the costs and QALYs for IVIG and corticosteroids over 5 years of treatment for CIDP. Patients initially responding to IVIG could remain a responder or relapse every 12 week model cycle. Non-responding IVIG patients were assumed to be switched to corticosteroids. Patients on corticosteroids were at risk of a number of adverse events (fracture, diabetes, glaucoma, cataract, serious infection in each cycle. Results Over the 5 year time horizon, the model estimated the incremental costs and QALYs of IVIG treatment compared to corticosteroid treatment to be $124,065 and 0.177 respectively. The incremental cost per QALY gained of IVIG was estimated to be $687,287. The cost per QALY of IVIG was sensitive to the assumptions regarding frequency and dosing of maintenance IVIG. Conclusions Based on common willingness to pay thresholds, IVIG would not be perceived as a cost effective treatment for CIDP.

  20. Dermoscopic evaluation of therapeutic response to an intralesional corticosteroid in the treatment of alopecia areata

    Directory of Open Access Journals (Sweden)

    Shikhar Ganjoo

    2013-01-01

    Full Text Available Background: Intralesional corticosteroids are the treatment of choice for adults with less than 50% of scalp area involvement with alopecia areata. The sensitivity of picking up clinical response to treatment by clinical examination is very variable and has inter individual variation. Aims: To evaluate the efficacy of intralesional triamcinolone acetonide in the treatment of alopecia areata and to use dermoscopy to identify signs of early clinical response and adverse effects. Methods: Seventy patches in 60 patients were injected with steroid at 4 weeks interval and followed up for 24 weeks. Treatment response was evaluated using regrowth scale (RGS. Heine DELTA 20; dermatoscope was used to assess disease activity, response to treatment and side effects. Results: Twenty eight patients responded early and achieved RGS of 4 within 12 weeks and 29 patients responded late and achieved RGS of 4 within 24 weeks of initiating therapy. There were 3 patients who did not achieve RGS of 4 at 24 weeks. Late and incomplete responders showed statistically significant association with family history of alopecia areata (p < 0.0001, presence of recurrent disease (p = 0.0147 and presence of nail changes (p = 0.0007. Dermoscopically, 60 patches demonstrated regrowth of new vellus hair at 4 weeks. Tapering hair disappeared maximally at 4 weeks. At 12 weeks, complete disappearance was seen in tapering hairs, broken hairs and black dots whereas for yellow dots to disappear completely in all patches it took 16 weeks. The adverse effects were observed at an earlier stage using dermoscopy than clinically. Conclusion: Intralesional triamcinolone acetonide is efficacious for treatment of localized patchy alopecia areata. Dermoscopy is very useful to identify signs of early clinical response, adverse effects and markers of disease activity.

  1. Stress and corticosteroids regulate rat hippocampal mitochondrial DNA gene expression via the glucocorticoid receptor.

    Science.gov (United States)

    Hunter, Richard G; Seligsohn, Ma'ayan; Rubin, Todd G; Griffiths, Brian B; Ozdemir, Yildirim; Pfaff, Donald W; Datson, Nicole A; McEwen, Bruce S

    2016-08-01

    Glucocorticoids (GCs) are involved in stress and circadian regulation, and produce many actions via the GC receptor (GR), which is classically understood to function as a nuclear transcription factor. However, the nuclear genome is not the only genome in eukaryotic cells. The mitochondria also contain a small circular genome, the mitochondrial DNA (mtDNA), that encodes 13 polypeptides. Recent work has established that, in the brain and other systems, the GR is translocated from the cytosol to the mitochondria and that stress and corticosteroids have a direct influence on mtDNA transcription and mitochondrial physiology. To determine if stress affects mitochondrially transcribed mRNA (mtRNA) expression, we exposed adult male rats to both acute and chronic immobilization stress and examined mtRNA expression using quantitative RT-PCR. We found that acute stress had a main effect on mtRNA expression and that expression of NADH dehydrogenase 1, 3, and 6 (ND-1, ND-3, ND-6) and ATP synthase 6 (ATP-6) genes was significantly down-regulated. Chronic stress induced a significant up-regulation of ND-6 expression. Adrenalectomy abolished acute stress-induced mtRNA regulation, demonstrating GC dependence. ChIP sequencing of GR showed that corticosterone treatment induced a dose-dependent association of the GR with the control region of the mitochondrial genome. These findings demonstrate GR and stress-dependent transcriptional regulation of the mitochondrial genome in vivo and are consistent with previous work linking stress and GCs with changes in the function of brain mitochondria. PMID:27457949

  2. Microstructure of microemulsion modified with ionic liquids in microemulsion electrokinetic chromatography and analysis of seven corticosteroids.

    Science.gov (United States)

    Ni, Xinjiong; Yu, Meijuan; Cao, Yuhua; Cao, Guangqun

    2013-09-01

    In this work, the influences of ionic liquid (IL) as a modifier on microemulsion microstructure and separation performance in MEEKC were investigated. Experimental results showed that synergetic effect between IL 1-butyl-3-methylimidazolium tetrafluoro-borate (BmimBF4 ) and surfactant SDS gave a decreased CMC. With increment of IL in microemulsion, negative ζ potential of the microdroplets reduced gradually. The influence of IL on the dimensions of microdroplet was complicated. At BmimBF4 less than 8 mM, IL made microemulsion droplet smaller in size. While at BmimBF4 more than 10 mM, the size increased and reached to a maximum value at 12 mM, where the microdroplets were larger than that without IL. After that, the micreodroplet size decreased again. Relative fluorescence intensity of the first vibration band of pyrene to the third one (I1 /I3 ) enhanced as IL was added to microemulsion, which indicated that this addition increased environmental polarity in the inner core of microdroplets. Prednisone, hydrocortisone, prednisolone, hydrocortisone acetate, cortisone acetate, prednisolone acetate, and triamcinolone acetonide were analyzed with MEEKC modified with IL to evaluate the separation performance. Cortisone acetate and prednisolone acetate could not be separated at all in typical microemulsion. The seven analytes could be separated by the addition of 10 mM BmimBF4 into the microemulsion system. The method has been used for analysis of corticosteroids in cosmetic samples with simple extraction; the recoveries for seven analytes were between 86 and 114%. This method provides accuracy, reproducibility, pretreatment simplicity, and could be applied to the quality control of cosmetics. PMID:23801369

  3. Inhaled corticosteroids and the increased risk of pneumonia: what's new? A 2015 updated review.

    Science.gov (United States)

    Iannella, Hernan; Luna, Carlos; Waterer, Grant

    2016-06-01

    There is a considerable amount of evidence that supports the possibility of an increased risk of pneumonia associated with prolonged use of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD). However, as yet, no statistically significant increase in pneumonia-related 30-day mortality in patients on ICS has been demonstrated. The lack of objective pneumonia definitions and radiological confirmations have been a major source of bias, because of the similarities in clinical presentation between pneumonia and acute exacerbations of COPD. One of the newer fluticasone furoate studies overcomes these limitations and also provides an assessment of a range of doses, suggesting that the therapeutic window is quite narrow and that conventional dosing has probably been too high, although the absolute risk may be different compared to other drugs. Newer studies were not able to rule out budesonide as responsible for pneumonia, as previous evidence suggested, and there is still need for evidence from head-to-head comparisons in order to better assess possible intra-class differences. Although the exact mechanisms by which ICS increase the risk of pneumonia are not fully understood, the immunosuppressive effects of ICS on the respiratory epithelium and the disruption of the lung microbiome are most likely to be implicated. Given that COPD represents such a complex and heterogeneous disease, attempts are being made to identify clinical phenotypes with clear therapeutic implications, in order to optimize the pharmacological treatment of COPD and avoid the indiscriminate use of ICS. If deemed necessary, gradual withdrawal of ICS appears to be well tolerated. Vaccination against pneumococcus and influenza should be emphasized in patients with COPD receiving ICS. Physicians should keep in mind that signs and symptoms of pneumonia in COPD patients may be initially indistinguishable from those of an exacerbation, and that patients with COPD

  4. Impact of Inhaled Corticosteroids on Growth in Children with Asthma: Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Yoon Kong Loke

    Full Text Available Long-term inhaled corticosteroids (ICS may reduce growth velocity and final height of children with asthma. We aimed to evaluate the association between ICS use of >12 months and growth.We initially searched MEDLINE and EMBASE in July 2013, followed by a PubMed search updated to December 2014. We selected RCTs and controlled observational studies of ICS use in patients with asthma. We conducted random effects meta-analysis of mean differences in growth velocity (cm/year or final height (cm between groups. Heterogeneity was assessed using the I2 statistic.We found 23 relevant studies (twenty RCTs and three observational studies after screening 1882 hits. Meta-analysis of 16 RCTs showed that ICS use significantly reduced growth velocity at one year follow-up (mean difference -0.48 cm/year (95% CI -0.66 to -0.29. There was evidence of a dose-response effect in three RCTs. Final adult height showed a mean reduction of -1.20 cm (95% CI -1.90 cm to -0.50 cm with budesonide versus placebo in a high quality RCT. Meta-analysis of two lower quality observational studies revealed uncertainty in the association between ICS use and final adult height, pooled mean difference -0.85 cm (95% CI -3.35 to 1.65.Use of ICS for >12 months in children with asthma has a limited impact on annual growth velocity. In ICS users, there is a slight reduction of about a centimeter in final adult height, which when interpreted in the context of average adult height in England (175 cm for men and 161 cm for women, represents a 0.7% reduction compared to non-ICS users.

  5. Temperature effects in low-frequency Raman spectra of corticosteroid hormones

    Science.gov (United States)

    Minaeva, V. A.; Minaev, B. F.; Baryshnikov, G. V.; Surovtsev, N. V.; Cherkasova, O. P.; Tkachenko, L. I.; Karaush, N. N.; Stromylo, E. V.

    2015-02-01

    Experimental Raman spectra of the corticosteroid hormones corticosterone and desoxycorticosterone are recorded at different temperatures (in the range of 30-310 K) in the region of low-frequency (15-120 cm-1) vibrations using a solid-state laser at 532.1 nm. The intramolecular vibrations of both hormones are interpreted on the basis of Raman spectra calculated by the B3LYP/6-31G(d) density functional theory method. The intermolecular bonds in tetramers of hormones are studied with the help of the topological theory of Bader using data of X-ray structural analysis for crystalline samples of hormones. The total energy of intermolecular interactions in the tetramer of desoxycorticosterone (-49.1 kJ/mol) is higher than in the tetramer of corticosterone (-36.9 kJ/mol). A strong intramolecular hydrogen bond O21-H⋯O=C20 with an energy of -42.4 kJ/mol was revealed in the corticosterone molecule, which is absent in the desoxycorticosterone molecule. This fact makes the Raman spectra of both hormones somewhat different. It is shown that the low-frequency lines in the Raman spectra are associated with skeletal vibrations of molecules and bending vibrations of the substituent at the C17 atom. The calculated Raman spectrum of the desoxycorticosterone dimer allows one to explain the splitting and shift of some lines and to interpret new strong lines observed in the spectra at low temperatures, which are caused by the intermolecular interaction and mixing of normal vibrations in a crystal cell. On the whole the calculated frequencies are in a good agreement with the experimental results.

  6. Severe asthma patients in Korea overestimate their adherence to inhaled corticosteroids.

    Science.gov (United States)

    Bae, Yun-Jeong; Kim, Tae-Bum; Jee, Young-Koo; Park, Heung-Woo; Chang, Yoon-Seok; Cho, Sang-Heon; Cho, You Sook; Moon, Hee-Bom

    2009-08-01

    Good adherence to inhaled corticosteroid (ICS) therapy is essential for effective asthma control. The factors affecting ICS therapy adherence vary among individuals and countries. As few data on adherence have been reported in Korea, the factors influencing such adherence, and the clinical implications thereof, were evaluated in Korean asthma patients. A total of 185 asthma patients who had taken ICS regularly for over 1 year were randomly selected from the recently established domestic adult asthma cohort, COREA (Cohort for Reality and Evolution of Adult Asthma Korea). To obtain adherence to ICS, both prescription refill adherence and self-reported adherence over 1 year (these are objective and subjective measurements respectively) were assessed without any interventions that might affect patients' adherence to ICS. Patients' information such as age, sex, smoking history and number of medication taken, was collected. Assessment of asthma severity, pulmonary function tests, and asthma symptom score were performed to evaluate the possible clinical implication of adherence to ICS. Approximately half of the patients (50.9%) showed less than 80% of prescription refill adherence. There was a considerable discrepancy between prescription refill adherence and self-reported adherence especially in the patients whose refill adherence was under than 50%. Younger asthma patients showed lower adherence to ICS than did older (> or = 60 years old) patients. Higher asthma severity was significantly associated with lower refill adherence to ICS. However, asthma symptom scores and forced expiratory volume in 1 second (FEV(1)) values were not directly related with refill adherence. To improve asthma control in Korea, enhancement of adherence to ICS is critical: our findings emphasize the need to use objective measurements when adherence to asthma medication is to be assessed in clinical practice. PMID:19657900

  7. Detection of brain atrophy due to ACTH or corticosteroid therapy with computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Tamai, I.; Takei, T. (National Sagamihara Hospital, Kanagawa (Japan)); Oota, H.; Maekawa, K.

    1981-07-01

    Adrenocorticotropic hormone (ACTH) or corticosteroids seemed to cause brain atrophy in infants. We studied the atrophy which was caused by these drugs with computed tomography (CT). 1) Nine cases of infantile spasms examined before, during and after ACTH therapy with CT. Brain atrophy on CT was observed immediately after the completion of ACTH therapy. The brain atrophy receded slightly after several months. It was more marked in younger patients, in cases treated by high doses of ACTH and in cases where brain atrophy had already been observed before ACTH therapy. 2) Twenty cases of infantile spasms or Lennox Gastaut syndrome were examined after ACTH therapy with CT. Brain atrophy was observed in twelve cases. Main features of brain atrophy were the enlargement of sylvian fissure and the widening of subarachnoid space at the frontal or temporal region. Mental retardation was observed in eighteen cases. 3) Two cases of nephrotic syndrome were treated with pulse therapy of prednisolone. CT was carried out before and after treatment. Atrophy of cerebrum was observed in these cases. 4) A case of infantile spasms treated with anticonvulsants without ACTH was studied by electroencephalography (EEG) and CT. The abnormal pattern of EEG was markedly corrected, while brain atrophy on CT was not observed after the therapy. Because of these observations the use of ACTH has to be reconsidered. ACTH should be the drug of second choice for the therapy of infantile spasms and should be used in case other anticonvulsants have no effect. ACTH should be used at lower dosages and for shorter periods of time.

  8. The effect of an inhaled corticosteroid on glucose control in type 2 diabetes.

    LENUS (Irish Health Repository)

    Faul, John L

    2009-06-01

    OBJECTIVE: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD). DESIGN: A prospective randomized, double-blind, double-dummy placebo-controlled, crossover investigation of inhaled steroids and oral leukotriene blockers. SETTING: A United States Department of Veterans Affairs Health Care System outpatient setting. PARTICIPANTS: Adults with type 2 diabetes and asthma or COPD. METHODS: Subjects (n=12) were randomized to receive either inhaled fluticasone propionate (440 microg twice daily) and oral placebo, or inhaled placebo and oral montelukast (10 mg\\/day). After 6 weeks, subjects were switched to the opposite therapy for 6 weeks. The primary outcome measure was the change in the percentage of glycosylated hemoglobin (%HbA1c) at 6 weeks relative to the baseline value. RESULTS: Ten patients completed the study. The difference between the mean within-subject changes in %HbA1c associated with 6-week periods of fluticasone and the mean changes associated with montelukast therapy was small but statistically significant (mean difference=0.25; P<0.025). Neither fluticasone nor oral montelukast therapy for 6 weeks led to a significantly different mean % HbA1c compared with the relevant baseline (mean differences=0.11 and -0.14, respectively). CONCLUSION: The absence of a clinically significant within-subject difference in the changes in %HbA1c associated with fluticasone versus oral montelukast therapy, or between either therapy or baseline does not warrant recommending changes in therapy for asthma or diabetes in patients with these co-morbid conditions. However, we suggest that clinicians carefully monitor blood glucose control when diabetic patients initiate ICS, especially with higher dosages.

  9. Effectiveness of intramuscular corticosteroid injection versus placebo injection in patients with hip osteoarthritis: design of a randomized double-blinded controlled trial

    Directory of Open Access Journals (Sweden)

    Dorleijn Desirée MJ

    2011-12-01

    Full Text Available Abstract Background Recent international guidelines recommend intra-articular corticosteroid injections for patients with hip osteoarthritis who have moderate to severe pain and do not respond satisfactorily to oral analgesic/anti-inflammatory agents. Of the five available randomized controlled trials, four showed positive effects with respect to pain reduction. However, intra-articular injection in the hip is complex because the joint is adjacent to important neurovascular structures and cannot be palpated. Therefore fluoroscopic or ultrasound guidance is needed. The systemic effect of corticosteroids has been studied in patients with impingement shoulder pain. Gluteal corticosteroid injection was almost as effective as ultrasound-guided subacromial corticosteroid injection. Such a clinically relevant effect of a systemic corticosteroid injection offers a less complex alternative for treatment of patients with hip osteoarthritis not responsive to oral pain medication. Methods/Design This is a double-blinded, randomized controlled trial. A total of 135 patients (aged > 40 years with hip osteoarthritis and persistent pain despite oral analgesics visiting a general practitioner or orthopaedic surgeon will be included. They will be randomized to a gluteal intramuscular corticosteroid injection or a gluteal intramuscular placebo (saline injection. The randomization will be stratified for setting (general practitioner and outpatient clinics of department of orthopaedics. Treatment effect will be evaluated by questionnaires at 2, 4, 6, and 12 weeks follow-up and a physical examination at 12 weeks. Primary outcome is severity of hip pain reported by the patients at 2-week follow-up. Statistical analyses will be based on the intention-to-treat principle. Discussion This study will evaluate the effectiveness of an intramuscular corticosteroid injection on pain in patients with hip osteoarthritis. Patient recruitment has started. Trial Registration This

  10. Uso de corticosteroide na síndrome do desconforto respiratório agudo em pacientes pediátricos Corticosteroids therapy in pediatric acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Maria Clara de Magalhães Barbosa

    2010-12-01

    Full Text Available A terapia com corticosteroide na lesão pulmonar aguda e na síndrome do desconforto respiratório agudo é um dos temas mais controversos na literatura. Apesar de o corticosteroide ser amplamente utilizado na faixa etária pediátrica, os estudos com corticosteroide na lesão pulmonar aguda/síndrome do desconforto respiratório agudo são restritos a adultos. Esse artigo realiza uma revisão crítica dos estudos experimentais e clínicos sobre a utilização de corticosteroide na síndrome do desconforto respiratório agudo, procurando apontar os prováveis riscos e benefícios da sua utilização em pediatria. Para tal, foi realizada ampla revisão da literatura, de 1980 a 2010, incluindo artigos experimentais e clínicos, bem como metanálises, usando-se o banco de dados do Medline, Registro Central da Cochrane de ensaios clínicos controlados, banco de dados de revisões sistemáticas da Cochrane, SciELO, LILACS e BIREME. As palavras chaves utilizadas foram: lesão pulmonar aguda, síndrome do desconforto respiratório agudo, corticosteroides, criança, ensaios clínicos, metanálises, revisões e relato de casos. A corticoterapia na lesão pulmonar aguda/síndrome do desconforto respiratório agudo foi associada à redução da resposta inflamatória sistêmica, melhora da oxigenação e da disfunção orgânica múltipla, diminuição do tempo de ventilação mecânica e dos dias de internação nas unidades de terapia intensiva. Sugere-se, para pacientes pediátricos, o uso precoce (nas primeiras 72h e prolongado (por 14 dias de metilprednisolona na lesão pulmonar aguda/síndrome do desconforto respiratório agudo, com dose de 1 mg/kg/dia sob infusão contínua para evitar variabilidade glicêmica e recomenda-se controle rígido da existência de infecção. Propõe-se a adequação de alguns aspectos do diagnóstico, da intervenção e da seleção de desfechos para viabilizar os estudos em pediatria. É fundamental a realização de

  11. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  12. Plant Hormone Binding Sites

    OpenAIRE

    Napier, Richard

    2004-01-01

    • Aims Receptors for plant hormones are becoming identified with increasing rapidity, although a frustrating number remain unknown. There have also been many more hormone‐binding proteins described than receptors. This Botanical Briefing summarizes what has been discovered about hormone binding sites, their discovery and descriptions, and will not dwell on receptor functions or activities except where these are relevant to understand binding.

  13. Parasites and steroid hormones: corticosteroid and sex steroid synthesis, their role in the parasite physiology and development.

    Directory of Open Access Journals (Sweden)

    Marta C. Romano

    2015-06-01

    Full Text Available In many cases parasites display highly complex life cycles that include establishment of the larva or adults within host organs, but even in those that have only one host reciprocal intricate interactions occur. A bulk of evidence indicates that steroid hormones influence the development and course of parasitic infections, the host gender susceptibility to the infection and the associate differences in immunological response are good examples of the host-parasite interplay. However, the capacity of these organisms to synthesize their own steroidogenic hormones still has more questions than answers. It is now well known that many parasites synthesize ecdysteroids, but limited information is available on sex steroid and corticosteroid synthesis. This review intends to summarize some of the existing information in the field. In many but not all parasitosis the host hormonal environment determines the susceptibility, the course and severity of parasite infections. In most cases the infection disturbs the host environment, and activate immune responses that finally affect the endocrine system. Furthermore, sex steroids and corticosteroids may also directly modify the parasite reproduction and molting. Available information indicates that parasites synthesize some steroid hormones like ecdysteroids and sex steroids and the presence and activity of related enzymes have been demonstrated. More recently, the synthesis of corticosteroid like compounds has been shown in Taenia solium and tapeworms and in Taenia crassiceps WFU cysticerci. Deeper knowledge of the endocrine properties of parasites will contribute to understand their reproduction and reciprocal interactions with the host, and also may contribute to design tools to combat the infection in some clinical situations.

  14. The incidence of critical-illness-related-corticosteroid-insufficiency is associated with severity of traumatic brain injury in adult rats.

    Science.gov (United States)

    Chen, Xin; Zhao, Zilong; Chai, Yan; Luo, Lanlan; Jiang, Rongcai; Zhang, Jianning

    2014-07-15

    Traumatic brain injury (TBI) causes deleterious critical-illness-related-corticosteroid-insufficiency (CIRCI), leading to high mortality and morbidity. However, the incidence of CIRCI following different TBI severities is not fully defined. This study was designed to investigate mechanistically the effects of injury severity on corticosteroid response and the development of CIRCI in a rat model of experimentally controlled TBI. Adult male Wistar rats were randomly assigned to sham, mild injury, moderate injury or severe injury groups. TBI was induced using a fluid percussion device at magnitudes of 1.2-1.4 atm (mild injury), 2.0-2.2 atm (moderate injury), and 3.2-3.5 atm (severe injury). We first assessed the effects of injury severity on the mortality and CIRCI occurrence using electrical stimulation test to assess corticosteroid response. We also investigated a series of pathological changes in the hypothalamus, especially in the paraventricular nuclei (PVN), among different injury group including: apoptosis detected by a TUNEL assay, blood-brain-barrier (BBB) permeability assessed by brain water content and Evans Blue extravasation into the cerebral parenchyma, and BBB integrity evaluated by CD31 and Claudin-5 expression and transmission electron microscopy. We made the following observations. First, 6.7% of mild-injured, 13.3% of moderate-injured, and 68.8% of severe-injured rats developed CIRCI, with a peak incidence on post-injury day 7. Second, TBI-induced CIRCI is closely correlated with injury severity. As the injury severity rises both the incidence of CIRCI and mortality surge; Third, increased level of injury severity reduces the expression of endothelial tight junction protein, aggravate BBB permeability and exacerbate the ensuing neural apoptosis in the PVN of hypothalamus. These findings indicate that increased severity of TBI aggravate the incidence of CIRCI by causing damage to tight junctions of vascular endothelial cells and increasing neuronal

  15. Adrenal suppression: A practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy

    Directory of Open Access Journals (Sweden)

    Ahmet Alexandra

    2011-08-01

    Full Text Available Abstract Inhaled corticosteroids (ICSs are the most effective anti-inflammatory agents available for the treatment of asthma and represent the mainstay of therapy for most patients with the disease. Although these medications are considered safe at low-to-moderate doses, safety concerns with prolonged use of high ICS doses remain; among these concerns is the risk of adrenal suppression (AS. AS is a condition characterized by the inability to produce adequate amounts of the glucocorticoid, cortisol, which is critical during periods of physiological stress. It is a proven, yet under-recognized, complication of most forms of glucocorticoid therapy that can persist for up to 1 year after cessation of corticosteroid treatment. If left unnoticed, AS can lead to significant morbidity and even mortality. More than 60 recent cases of AS have been described in the literature and almost all cases have involved children being treated with ≥500 μg/day of fluticasone. The risk for AS can be minimized through increased awareness and early recognition of at-risk patients, regular patient follow-up to ensure that the lowest effective ICS doses are being utilized to control asthma symptoms, and by choosing an ICS medication with minimal adrenal effects. Screening for AS should be considered in any child with symptoms of AS, children using high ICS doses, or those with a history of prolonged oral corticosteroid use. Cases of AS should be managed in consultation with a pediatric endocrinologist whenever possible. In patients with proven AS, stress steroid dosing during times of illness or surgery is needed to simulate the protective endogenous elevations in cortisol levels that occur with physiological stress. This article provides an overview of current literature on AS as well as practical recommendations for the prevention, screening and management of this serious complication of ICS therapy.

  16. A comparison of Oral and Inhalant Corticosteroids in Treatment of Mild to Moderate Asthma Exacerbation in Children

    Directory of Open Access Journals (Sweden)

    Nemat Bilan

    2015-04-01

    Full Text Available Introduction: Oral corticosteroids are the main treatment in asthma exacerbation. It has been reported that inhaled corticosteroids can be used instead of oral corticosteroids in asthma exacerbation. We aimed to evaluate the efficacy of inhaled fluticasone and oral prednisolone in children with mild to moderate asthma exacerbation. Materials and Methods: In this randomized clinical trial, 60 children with mild-to-moderate acute asthma exacerbation visiting emergency department were randomly assigned to receive oral prednisolone (2 mg/kg or fluticasone spray (2 puffs every 12 hours, each puff contains 250 microgram fluticasone using an spacer for one week. The first dose of the treatment was given in the emergency department.  Children were followed for seven days and signs and symptoms of exacerbation, as well as spirometry findings were evaluated.Results: On the days 1 and 3, symptoms including cough, sputum and need for salbutamol during day was more improved in oral prednisolone and symptoms at night was more improved in inhaled fluticasone. Patients were almost symptom free on the seventh day. Forced expiratory volume in 1 second, forced vital capacity and forced expiratory flow rate on the seventh day were significantly better with inhaled fluticasone compared to oral prednisolone.Conclusion: Both inhaled fluticasone and oral prednisolone improved symptoms during a week after exacerbation; however, better respiratory function in children treated with inhaled fluticasone is indicative of its further efficacy compared to oral prednisolone. Considering the low systemic effects of inhaled fluticasone, this treatment seems to be more appropriate in treatment of mild to moderate exacerbations. Keywords: Asthma exacerbation; Inhaled fluticasone; Prednisolone

  17. One-year evaluation of combined treatment with an intranasal corticosteroid and montelukast for chronic rhinosinusitis associated with asthma

    International Nuclear Information System (INIS)

    Chronic rhinosinusitis associated with asthma is often difficult to treat effectively with intranasal corticosteroids alone. Thus, the aim of this study was to evaluate the effectiveness of combination treatment with an intranasal corticosteroid and a leukotriene-receptor antagonist (montelukast) in reducing the size of nasal polyps. The subjects of this study were 20 patients with chronic rhinosinusitis associated with adult-onset asthma, which was being treated with inhaled corticosteroids. All patients were treated with intranasal fluticasone propionate, 200 μg/day, and montelukast, 10 mg/day, for 1 year. The size of nasal polyps and the score of sinus shadows were assessed with nasal endoscopy and computed tomography (CT), respectively, before and after treatment. The peripheral blood eosinophil counts were also evaluated before and after treatment. Nasal polyps were significantly smaller after both 6 months (p<0.01) and 12 months of treatment (p<0.01) than before treatment. The decrease in the shadow score was statistically significant after both 6 months (p<0.01) and 12 months of treatment (p<0.01). Significant reductions in peripheral blood eosinophil counts were also seen after both 6 months (p<0.05) and 12 months of treatment (p<0.01). A significant correlation was found between the rate of change in the peripheral blood eosinophil count and that in the CT score after both 6 months (r=0.578, p=0.012) and 12 months (r=0.625, p=0.007). Combined treatment with intranasal fluticasone propionate and montelukast, for at least 1 year, is effective for chronic rhinosinusitis associated with adult-onset asthma. (author)

  18. Corticosteroid and antiviral therapy for Bell's palsy: A network meta-analysis

    Directory of Open Access Journals (Sweden)

    Attia John

    2011-01-01

    Full Text Available Abstract Background Previous meta-analyses of treatments for Bell's palsy are still inconclusive due to different comparators, insufficient data, and lack of power. We therefore conducted a network meta-analysis combining direct and indirect comparisons for assessing efficacy of steroids and antiviral treatment (AVT at 3 and 6 months. Methods We searched Medline and EMBASE until September 2010 using PubMed and Elsviere search engines. A network meta-analysis was performed to assess disease recovery using a mixed effects hierarchical model. Goodness of fit of the model was assessed, and the pooled odds ratio (OR and 95% confidence interval (CI were estimated. Results Six studies (total n = 1805were eligible and contributed to the network meta-analysis. The pooled ORs for resolution at 3 months were 1.24 (95% CI: 0.79 - 1.94 for Acyclovir plus Prednisolone and 1.02 (95% CI: 0.73 - 1.42 for Valacyclovir plus Prednisolone, versus Prednisolone alone. Either Acyclovir or Valacyclovir singly had significantly lower efficacy than Prednisolone alone, i.e., ORs were 0·44 (95% CI: 0·28 - 0·68 and 0·60 (95% CI: 0·42 - 0·87, respectively. Neither of the antiviral agents was significantly different compared with placebo, with a pooled OR of 1·25 (95% CI: 0·78 - 1·98 for Acyclovir and 0·91 (95% CI: 0·63 - 1·31 for Valacyclovir. Overall, Prednisolone-based treatment increased the chance of recovery 2-fold (95% CI: 1·55 - 2·42 compared to non-Prednisolone-based treatment. To gain 1 extra recovery, 6 and 26 patients need to be treated with Acyclovir and prednisolone compared to placebo and prednisolone alone, respectively. Conclusions Our evidence suggests that the current practice of treating Bell's palsy with AVT plus corticosteroid may lead to slightly higher recovery rates compared to treating with prednisone alone but this does not quite reach statistical significance; prednisone remains the best evidence-based treatment.

  19. Patient perspectives on fluticasone–vilanterol versus other corticosteroid combination products for the treatment of asthma

    Science.gov (United States)

    Bollmeier, Suzanne G; Prosser, Theresa R

    2016-01-01

    Objective Fluticasone furoate (FF), an inhaled corticosteroid (ICS), and vilanterol (VI), a long-acting beta2 receptor agonist (LABA), is a new combination used in an Ellipta® device. This article compares FF–VI to other ICS–LABA combinations available, particularly emphasizing product selection from the patient perspective. Data sources A PubMED and EMBASE search completed in October 2015 identified trials using the MeSH terms “fluticasone”, “vilanterol”, and “asthma”. Additional information was gathered from references cited in the identified publications, the manufacturer, package insert, and ClinicalTrials.gov registry. Study selection/data extraction Preference was given to randomized controlled clinical trials. Animal trials, trials for COPD, and non-English sources were excluded. Data synthesis Seven efficacy trials of FF–VI in asthma were identified. Only one (24 weeks) trial compared FF–VI to another ICS–LABA combination (fluticasone propionate–salmeterol). Primary outcomes (usually lung function) and secondary outcomes (eg, quality of life and symptom scores) were comparable. In three FF–VI safety trials, the type and frequency of common adverse reactions (ie, thrush and dysphonia) were similar to those in clinical trials. Over 90% of subjects rated the Ellipta® device as “easy to use” and demonstrated correct device technique initially and at 4 weeks. Conclusion Individuals may have drug- and device-specific preferences that should be incorporated into therapeutic decision making. Limited data indicate that clinical and patient-oriented efficacy/safety outcomes of FF–VI are likely comparable to other available combinations for adults with asthma. Patient-friendly features include once-daily dosing, flexibility of dose timing, and design/ease of the use of the device. Additional larger and long-term comparative studies are needed to determine whether these features translate into greater efficacy, safety, patient

  20. Acute necrotizing eosinophilic myocarditis in a patient taking Garcinia cambogia extract successfully treated with high-dose corticosteroids.

    Science.gov (United States)

    Allen, Scott F; Godley, Robert W; Evron, Joshua M; Heider, Amer; Nicklas, John M; Thomas, Michael P

    2014-12-01

    A previously healthy 48-year-old woman was evaluated for lightheadedness and chest heaviness 2 weeks after starting the herbal supplement Garcinia cambogia. She was found to be hypotensive and had an elevated serum troponin level. The patient had a progressive clinical decline, ultimately experiencing fulminant heart failure and sustained ventricular arrhythmias, which required extracorporeal membrane oxygenation support. Endomyocardial biopsy results were consistent with acute necrotizing eosinophilic myocarditis (ANEM). High-dose corticosteroids were initiated promptly and her condition rapidly improved, with almost complete cardiac recovery 1 week later. In conclusion, we have described a case of ANEM associated with the use of Garcinia cambogia extract. PMID:25475477

  1. Delayed radiation injury to the retrobulbar optic nerves and chiasm. Clinical syndrome and treatment with hyperbaric oxygen and corticosteroids

    Energy Technology Data Exchange (ETDEWEB)

    Roden, D.; Bosley, T.M.; Fowble, B.; Clark, J.; Savino, P.J.; Sergott, R.C.; Schatz, N.J. (Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, PA (USA))

    1990-03-01

    Thirteen patients with delayed radiation injury to the optic nerves and chiasm were treated with hyperbaric oxygen (HBO) and corticosteroids. These patients experienced painless, abrupt loss of vision in one (6 patients) or both (7 patients) eyes between 4 and 35 months after receiving radiation doses of at least 4500 cGy to the region of the chiasm. Diagnostic evaluation including neuro-imaging and lumbar puncture showed no recurrent tumor and no other cause for visual loss. No patient's vision improved during treatment or follow-up lasting between 1 and 4 years. There were no serious complications of treatment.

  2. MRI evaluation of osteonecrosis in knee joints after intravenous administration of corticosteroids in patients with severe acute respiratory syndrome

    International Nuclear Information System (INIS)

    Objective: To evaluate MRI features of osteonecrosis in knee joints after intravenous administration of exogenous corticosteroids in patients with severe acute respiratory syndrome (SARS). Methods: MRI was done in 18 patients (medical staff from 4 hospitals) suffered from SARS and treated with intravenous use of exogenous corticosteroids in hip joints and knee joints to indicate the findings and characteristics of osteonecrosis as well as their relation with hormone amount. Results: Eleven patients showed lesions of osteonecrosis in knee joints with bilateral in 7 and unilateral in 4, and 3 patients were complicated with avascular necrosis in bilateral femoral heads. Among the 38 lesions in knee joints, 34 lesions were located in medial condylu, lateral condylus and shaft of femur, and 4 in medial condylus or lateral condylus of tibia. Large-middle lesions showed geographic focus of typically heterogeneous signal (low or intermediate signal intensity on T1WI and high or intermediate signal intensity T2WI) within the marrow that was surrounded by characteristic low signal intensity, serpentine border on T1, T2WI. This border showed a classic double-line sign on T2WI in 4 lesions. Small lesions showed low signal intensity on T1 and low or high signal intensity on T2WI. Subchondral avascular necrosis in middle-upper femoral heads showed intermediate signal intensity on T1 weighted images and high or complicated signal intensity on T2WI encircled with characteristic low signal intensity, serpentine border on T1 and T2WI. This border showed a classic double-line sign on T2 weighted images in avascular necrosis of bilateral femoral heads in 1 case. Conclusion: In these cases, osteonecrosis in knee joints was more than in femoral heads in patients with SARS after intravenous use of exogenous corticosteroids, mostly located in medial condylus, lateral condylus and shaft of femur as well as in medial condylus or lateral condylus of tibia. So, MRI should be early done in

  3. Successful Use of Plasma Exchange in the Treatment of Corticosteroid-Refractory Eosinophilic Granulomatosis with Polyangiitis Associated with Gastrointestinal Manifestations

    Directory of Open Access Journals (Sweden)

    Kohei Tsujimoto

    2016-01-01

    Full Text Available We describe the case of a 33-year-old woman having corticosteroid-refractory eosinophilic granulomatosis with polyangiitis (EGPA who presented with abdominal pain and responded dramatically to plasma exchange. Eosinophilia, asthma history, neuropathy, pulmonary infiltrates, and paranasal sinus abnormalities confirmed the diagnosis of EGPA. Treatment was initiated with 1 g/day of methylprednisolone pulse therapy for 3 days followed by 60 mg/day of intravenous prednisolone without relieving abdominal pain. Then, plasma exchange was performed thrice. Abdominal pain disappeared after the first plasma exchange. Indication of plasma exchange for EGPA remains controversial; however, it may represent a valid option in cases with gastrointestinal involvement.

  4. Topical antifungal-corticosteroid combination therapy for the treatment of superficial mycoses: conclusions of an expert panel meeting.

    Science.gov (United States)

    Schaller, Martin; Friedrich, Markus; Papini, Manuela; Pujol, Ramon M; Veraldi, Stefano

    2016-06-01

    Superficial fungal infections affect 20-25% of people worldwide and can cause considerable morbidity, particularly if an inflammatory component is present. As superficial fungal infections can be diverse, the treatment should be tailored to the individual needs of the patient and several factors should be taken into account when deciding on the most appropriate treatment option. These include the type, location and surface area of the infection, patient age, degree of inflammation and underlying comorbidities. Although several meta-analyses have shown that there are no significant differences between the numerous available topical antifungal agents with regard to mycological cure, agents differ in their specific intrinsic properties, which can affect their clinical use. The addition of a corticosteroid to an antifungal agent at the initiation of treatment can attenuate the inflammatory symptoms of the infection and is thought to increase patient compliance, reduce the risk of bacterial superinfection and enhance the efficacy of the antifungal agent. However, incorrect use of antifungal-corticosteroid therapy may be associated with treatment failure and adverse effects. This review summarises available treatment options for superficial fungal infections and provides general treatment recommendations based on the consensus outcomes of an Expert Panel meeting on the topical treatment of superficial mycoses. PMID:26916648

  5. Intra-articular injections with corticosteroids and sodium hyaluronate for treating temporomandibular joint disorders: a systematic review

    Directory of Open Access Journals (Sweden)

    Eduardo Machado

    2013-10-01

    Full Text Available INTRODUCTION: In some cases, conservative treatment of internal derangements of the Temporomandibular Joint (TMJ is considered little responsive. Thus, it is necessary to accomplish treatments that aim at reducing pain and improve patients' functions who present arthrogenic temporomandibular disorders. OBJECTIVE: This study, by means of a systematic review of the literature, aimed to analyze the effectiveness of intra-articular injections with corticosteroids and sodium hyaluronate for treating internal derangements of the TMJ. METHODS: Carry out a research in the following databases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs, and BBO, considering publications issued between 1966 and October of 2010, focusing on randomized or quasi-randomized controlled clinical trials, single or double-blind. RESULTS: After applying the inclusion criteria we collected 9 articles, 7 of which were randomized controlled double-blind clinical trials and 2 randomized controlled single-blind clinical trials. CONCLUSION: After analyzing the literature, it was found that intra-articular injection with corticosteroids and sodium hyaluronate seems to be an effective method for treating internal derangements of the TMJ. However, further randomized controlled clinical trials, with representative samples and longer follow-up time must be carried out in order to assess the real effectiveness of this technique.

  6. Is low dose inhaled corticosteroid therapy as effective for inflammation and remodeling in asthma? A randomized, parallel group study

    Directory of Open Access Journals (Sweden)

    Baraket Melissa

    2012-02-01

    Full Text Available Abstract Background While most of the clinical benefits of inhaled corticosteroid (ICS therapy may occur at low doses, results of dose-ranging studies are inconsistent. Although symptom/lung function response to low and high dose ICS medication is comparable, it is uncertain whether low dose ICSs are as effective as high dose in the treatment of inflammation and remodeling. Methods 22 mild or moderate asthmatic adult subjects (corticosteroid free for > 2 months participated in a randomized, parallel group study to compare effects of fluticasone propionate (FP 200 mcg/day and 1000 mcg/day. Alveolar macrophage (AM-derived cytokines and basement membrane thickness (BMT were measured at baseline and after 7 weeks treatment while symptoms, spirometry, exhaled nitric oxide (eNO and airway hyperresponsiveness (AHR to mannitol at baseline and 6 weeks. Results FP improved spirometry, eNO, symptoms and AHR with no difference between low and high dose FP. Both high and low dose FP reduced GM-CSF, TNF-alpha and IL-1ra, with no change in BMT and with no differences between low and high dose FP. Conclusions 200 μg/day of FP was as effective as 1000 μg/day in improving asthma control, airway inflammation, lung function and AHR in adults in the short term. Future studies should examine potential differential effects between low and high dose combination therapy (ICS/long acting beta agonist on inflammation and airway remodeling over longer treatment periods.

  7. A novel method for analysing key corticosteroids in polar bear (Ursus maritimus) hair using liquid chromatography tandem mass spectrometry.

    Science.gov (United States)

    Weisser, Johan J; Hansen, Martin; Björklund, Erland; Sonne, Christian; Dietz, Rune; Styrishave, Bjarne

    2016-04-01

    This paper presents the development and evaluation of a methodology for extraction, clean-up and analysis of three key corticosteroids (aldosterone, cortisol and corticosterone) in polar bear hair. Such a methodology can be used to monitor stress biomarkers in polar bears and may provide as a useful tool for long-term and retrospective information. We developed a combined pressurized liquid extraction (PLE)-solid phase extraction (SPE) procedure for corticosteroid extraction and clean-up followed by high pressure liquid chromatography tandem mass spectrometry (HPLC-MS/MS) analysis. This procedure allows for the simultaneous determination of multiple steroids, which is in contrast to previous polar bear studies based on ELISA techniques. Absolute method recoveries were 81%, 75% and 60% for cortisol, corticosterone and aldosterone, respectively. We applied the developed method on a hair sample pooled from four East Greenland polar bears. Herein cortisol and corticosterone were successfully determined in levels of 0.32±0.02ng/g hair and 0.13±0.02ng/g hair, respectively. Aldosterone was below limit of detection (LODpolar bears was consistent with cortisol levels previously determined in the Southern Hudson Bay and James Bay in Canada using ELISA kits. PMID:26945133

  8. Management of symptomatic erosive-ulcerative lesions of oral lichen planus in an adult Egyptian population using Selenium - ACE combined with topical corticosteroids plus antifungal agent

    Directory of Open Access Journals (Sweden)

    Mahmoud Helmy Belal

    2015-01-01

    Full Text Available Aim: Oral lichen planus (OLP is a chronic mucocutaneous disease with an immunological etiology. This study was conducted to evaluate the effect of selenium combined with Vitamins A, C & E (Selenium-ACE in the treatment of erosive-ulcerative OLP as an adjunctive to topical corticosteroids plus antifungal agent. Subjects and Methods: Thirty patients with a confirmed clinical and histopathologic diagnosis of OLP participated in this clinical trial. Patients were randomly allocated into one of three groups and treated as follows: (I Topical corticosteroids, (II topical corticosteroids plus antifungal, and (III SE-ACE combined with topical corticosteroids plus antifungal. The patients were followed for 6 weeks. The pain and severity of the lesions were recorded at the initial and follow-up visits. All recorded data were analyzed using paired t-test and ANOVA test. A P ≤ 0.05 was considered significant. Results: The experimental groups showed a marked reduction in pain sensation and size of lesions, particularly in the final follow-up period, but there was no significant difference between the first two Groups I and II. However, healing of lesions and improvement of pain sensation was effective in Group III since a significant difference was found favoring Group III over both Groups I and II. Conclusion: No significant difference was found in treating erosive-ulcerative lesions of OLP by topical corticosteroids alone or combined with antifungal. However, when using SE-ACE in combination with topical corticosteroids plus antifungal, this approach may be effective in managing ulcerative lesions of OLP; but more research with a larger sample size and a longer evaluation period may be recommended.

  9. The Circulating Treg/Th17 Cell Ratio Is Correlated with Relapse and Treatment Response in Pulmonary Sarcoidosis Patients after Corticosteroid Withdrawal.

    Directory of Open Access Journals (Sweden)

    Yongzhe Liu

    Full Text Available Pulmonary sarcoidosis is an immune-mediated disease, and some patients can be effectively treated with corticosteroids. However, nearly half of all sarcoidosis patients relapse after corticosteroid withdrawal. Different subsets of CD4+ helper T cells participate in the immunopathogenesis of sarcoidosis. Thus, the aims of our study were to investigate whether the circulating subsets of CD4+ helper T cells were associated with sarcoidosis relapse and with its remission after retreatment. Additionally, we identified a useful biomarker for predicting the relapse and remission of sarcoidosis patients.Forty-two patients were enrolled in the present study who had previously been diagnosed with pulmonary sarcoidosis and treated with corticosteroids. The patients were allocated into either a stable group if they exhibited sustained remission (n = 22 or a relapse group if they experienced clinical or radiological recurrence after treatment withdrawal (n = 20. Peripheral blood cells were collected from these patients and analyzed to determine the frequencies of subsets of circulating CD4+ helper T cells by flow cytometry. The patients in the relapse group were retreated with corticosteroids and immunosuppressive agents and were then reevaluated to determine the frequencies of dynamic subsets of circulating CD4+ helper T cells after remission.The frequencies of circulating Tregs were significantly increased concomitant with a decrease in the circulating Th17 cell frequency in the relapsed patients compared with the stable patients. The Treg/Th17 ratio was negatively correlated with sarcoidosis activity and was sensitive to retreatment. In addition, the percentage of isolated CD45RO+Ki67+ Tregs was higher in the patients who were stable and in those who recovered after retreatment than in those who relapsed.An imbalance between Tregs and Th17 cells is associated with pulmonary sarcoidosis relapse after corticosteroid withdrawal. The circulating Treg/Th17

  10. A Case of Sarcoidosis with Unusual Radiographic Findings that Developed 5 Years after Silicone Augmentation Mammoplasty Complicated by Miliary Tuberculosis during Corticosteroid Treatment

    Directory of Open Access Journals (Sweden)

    Tomoko Miyashita

    2011-01-01

    Full Text Available A 54-year-old woman with a past history of silicone augmentation mammoplasty was admitted with fever and dyspnea with diffuse interstitial shadows on computed tomography (CT. Although radiological findings were atypical, we diagnosed sarcoidosis by laboratory, microbiological, and bronchoalveolar lavage fluid analysis. Corticosteroids ameliorated the condition, but she had recurrent of fever and CT revealed miliary nodules while interstitial shadows disappeared. Liver biopsy showed that noncaseating granuloma and Ziehl-Neelsen stain was positive. We diagnosed miliary tuberculosis which developed during corticosteroid therapy. Antituberculotic therapy resulted in favorable outcome. Possibility exists that onset of sarcoidosis was induced by mammoplasty, namely, human adjuvant disease.

  11. Systemic corticosteroids and early administration of antiviral agents for pneumonia with acute wheezing due to influenza A(H1N1pdm09 in Japan.

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    Koichiro Kudo

    Full Text Available BACKGROUND: Pneumonia patients with wheezing due to influenza A(H1N1pdm09 were frequently treated with systemic corticosteroids in Japan although systemic corticosteroid for critically ill patients with pneumonia caused by influenza A(H1N1pdm09 has been controversial. Applicability of systemic corticosteroid treatment needs to be evaluated. METHODS/PRINCIPAL FINDINGS: We retrospectively reviewed 89 subjects who were diagnosed with influenza A(H1N1pdm09 and admitted to a national hospital, Tokyo during the pandemic period. The median age of subjects (45 males was 8 years (range, 0-71. All subjects were treated with antiviral agents and the median time from symptom onset to initiation of antiviral agents was 2 days (range, 0-7. Subjects were classified into four groups: upper respiratory tract infection, wheezing illness, pneumonia with wheezing, and pneumonia without wheezing. The characteristics of each group was evaluated. A history of asthma was found more frequently in the wheezing illness (55.6% and pneumonia with wheezing (43.3% groups than in the other two groups (p = 0.017. Corticosteroid treatment was assessed among subjects with pneumonia. Oxygen saturation was lower in subjects receiving corticosteroids (steroid group than in subjects not receiving corticosteroids (no-steroid group (p<0.001. The steroid group required greater oxygen supply than the no-steroid group (p<0.001. No significant difference was found by the Kaplan-Meier method between the steroid and the no-steroid groups in hours to fever alleviation from the initiation of antiviral agents and hospitalization days. In logistic regression analysis, wheezing, pneumonia and oxygen saturation were independent factors associated with using systemic corticosteroids. CONCLUSION: Patients with wheezing and a history of asthma were frequently found in the study subjects. Systemic corticosteroids together with early administration of antiviral agents to pneumonia with wheezing and

  12. Variations in corticosteroid/anesthetic injections for painful shoulder conditions: comparisons among orthopaedic surgeons, rheumatologists, and physical medicine and primary-care physicians

    Directory of Open Access Journals (Sweden)

    Skedros John G

    2007-07-01

    Full Text Available Abstract Background Variations in corticosteroid/anesthetic doses for injecting shoulder conditions were examined among orthopaedic surgeons, rheumatologists, and primary-care sports medicine (PCSMs and physical medicine and rehabilitation (PMRs physicians to provide data needed for documenting inter-group differences for establishing uniform injection guidelines. Methods 264 surveys, sent to these physicians in our tri-state area of the western United States, addressed corticosteroid/anesthetic doses and types used for subacromial impingement, degenerative glenohumeral and acromioclavicular arthritis, biceps tendinitis, and peri-scapular trigger points. They were asked about preferences regarding: 1 fluorinated vs. non-fluorinated corticosteroids, 2 acetate vs. phosphate types, 3 patient age, and 4 adjustments for special considerations including young athletes and diabetics. Results 169 (64% response rate, RR surveys were returned: 105/163 orthopaedic surgeons (64%RR, 44/77 PCSMs/PMRs (57%RR, 20/24 rheumatologists (83%RR. Although corticosteroid doses do not differ significantly between specialties (p > 0.3, anesthetic volumes show broad variations, with surgeons using larger volumes. Although 29% of PCSMs/PMRs, 44% rheumatologists, and 41% surgeons exceed "recommended" doses for the acromioclavicular joint, >98% were within recommendations for the subacromial bursa and glenohumeral joint. Depo-Medrol® (methylprednisolone acetate and Kenalog® (triamcinolone acetonide are most commonly used. More rheumatologists (80% were aware that there are acetate and phosphate types of corticosteroids as compared to PCSMs/PMRs (76% and orthopaedists (60%. However, relatively fewer rheumatologists (25% than PCSMs/PMRs (32% or orthopaedists (32% knew that phosphate types are more soluble. Fluorinated corticosteroids, which can be deleterious to soft tissues, were used with these frequencies for the biceps sheath: 17% rheumatologists, 8% PCSMs/PMRs, 37

  13. Python bindings for libcloudph++

    OpenAIRE

    Jarecka, Dorota; Arabas, Sylwester; Del Vento, Davide

    2015-01-01

    This technical note introduces the Python bindings for libcloudph++. The libcloudph++ is a C++ library of algorithms for representing atmospheric cloud microphysics in numerical models. The bindings expose the complete functionality of the library to the Python users. The bindings are implemented using the Boost.Python C++ library and use NumPy arrays. This note includes listings with Python scripts exemplifying the use of selected library components. An example solution for using the Python ...

  14. DNS & Bind Cookbook

    CERN Document Server

    Liu, Cricket

    2011-01-01

    The DNS & BIND Cookbook presents solutions to the many problems faced by network administrators responsible for a name server. Following O'Reilly's popular problem-and-solution cookbook format, this title is an indispensable companion to DNS & BIND, 4th Edition, the definitive guide to the critical task of name server administration. The cookbook contains dozens of code recipes showing solutions to everyday problems, ranging from simple questions, like, "How do I get BIND?" to more advanced topics like providing name service for IPv6 addresses. It's full of BIND configuration files that yo

  15. Python bindings for libcloudph++

    CERN Document Server

    Jarecka, Dorota; Del Vento, Davide

    2015-01-01

    This technical note introduces the Python bindings for libcloudph++. The libcloudph++ is a C++ library of algorithms for representing atmospheric cloud microphysics in numerical models. The bindings expose the complete functionality of the library to the Python users. The bindings are implemented using the Boost.Python C++ library and use NumPy arrays. This note includes listings with Python scripts exemplifying the use of selected library components. An example solution for using the Python bindings to access libcloudph++ from Fortran is presented.

  16. Characterisation and treatment of VOCs in process water from upgrading facilities for compressed biogas (CBG).

    Science.gov (United States)

    Nilsson Påledal, S; Arrhenius, K; Moestedt, J; Engelbrektsson, J; Stensen, K

    2016-02-01

    Compression and upgrading of biogas to vehicle fuel generates process water, which to varying degrees contains volatile organic compounds (VOCs) originating from the biogas. The compostion of this process water has not yet been studied and scientifically published and there is currently an uncertainty regarding content of VOCs and how the process water should be managed to minimise the impact on health and the environment. The aim of the study was to give an overview about general levels of VOCs in the process water. Characterisation of process water from amine and water scrubbers at plants digesting waste, sewage sludge or agricultural residues showed that both the average concentration and composition of particular VOCs varied depending on the substrate used at the biogas plant, but the divergence was high and the differences for total concentrations from the different substrate groups were only significant for samples from plants using waste compared to residues from agriculture. The characterisation also showed that the content of VOCs varied greatly between different sampling points for same main substrate and between sampling occasions at the same sampling point, indicating that site-specific conditions are important for the results which also indicates that a number of analyses at different times are required in order to make an more exact characterisation with low uncertainty. Inhibition of VOCs in the anaerobic digestion (AD) process was studied in biomethane potential tests, but no inhibition was observed during addition of synthetic process water at concentrations of 11.6 mg and 238 mg VOC/L. PMID:26694791

  17. Repeat prenatal corticosteroid prior to preterm birth: a systematic review and individual participant data meta-analysis for the PRECISE study group (prenatal repeat corticosteroid international IPD study group: assessing the effects using the best level of evidence - study protocol

    Directory of Open Access Journals (Sweden)

    Crowther Caroline A

    2012-02-01

    Full Text Available Abstract Background The aim of this individual participant data (IPD meta-analysis is to assess whether the effects of repeat prenatal corticosteroid treatment given to women at risk of preterm birth to benefit their babies are modified in a clinically meaningful way by factors related to the women or the trial protocol. Methods/Design The Prenatal Repeat Corticosteroid International IPD Study Group: assessing the effects using the best level of Evidence (PRECISE Group will conduct an IPD meta-analysis. The PRECISE International Collaborative Group was formed in 2010 and data collection commenced in 2011. Eleven trials with up to 5,000 women and 6,000 infants are eligible for the PRECISE IPD meta-analysis. The primary study outcomes for the infants will be serious neonatal outcome (defined by the PRECISE International IPD Study Group as one of death (foetal, neonatal or infant; severe respiratory disease; severe intraventricular haemorrhage (grade 3 and 4; chronic lung disease; necrotising enterocolitis; serious retinopathy of prematurity; and cystic periventricular leukomalacia; use of respiratory support (defined as mechanical ventilation or continuous positive airways pressure or other respiratory support; and birth weight (Z-scores. For the children, the primary study outcomes will be death or any neurological disability (however defined by trialists at childhood follow up and may include developmental delay or intellectual impairment (developmental quotient or intelligence quotient more than one standard deviation below the mean, cerebral palsy (abnormality of tone with motor dysfunction, blindness (for example, corrected visual acuity worse than 6/60 in the better eye or deafness (for example, hearing loss requiring amplification or worse. For the women, the primary outcome will be maternal sepsis (defined as chorioamnionitis; pyrexia after trial entry requiring the use of antibiotics; puerperal sepsis; intrapartum fever requiring the use

  18. Melanin-binding radiopharmaceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Packer, S; Fairchild, R G; Watts, K P; Greenberg, D; Hannon, S J

    1980-01-01

    The scope of this paper is limited to an analysis of the factors that are important to the relationship of radiopharmaceuticals to melanin. While the authors do not attempt to deal with differences between melanin-binding vs. melanoma-binding, a notable variance is assumed. (PSB)

  19. Melanin-binding radiopharmaceuticals

    International Nuclear Information System (INIS)

    The scope of this paper is limited to an analysis of the factors that are important to the relationship of radiopharmaceuticals to melanin. While the authors do not attempt to deal with differences between melanin-binding vs. melanoma-binding, a notable variance is assumed

  20. DNS BIND Server Configuration

    Directory of Open Access Journals (Sweden)

    Radu MARSANU

    2011-01-01

    Full Text Available After a brief presentation of the DNS and BIND standard for Unix platforms, the paper presents an application which has a principal objective, the configuring of the DNS BIND 9 server. The general objectives of the application are presented, follow by the description of the details of designing the program.

  1. Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy

    Directory of Open Access Journals (Sweden)

    Ratna B Basak

    2011-01-01

    Full Text Available A 2-month-old infant presented to our emergency department with fever, altered consciousness, and focal seizures of acute onset. He had vesicular skin lesions over the right preauricular region. CT brain showed a large hypodense lesion involving the left temporo-parietal region, left basal ganglia and left thalamus. MRI brain revealed bilateral multifocal corticomedullary lesions suggestive of encephalitis. CSF-PCR was positive for herpes simplex virus (HSV type I. He was treated with standard dose intravenous acyclovir for 15 days along with a trial of pulse methylprednisolone, but was readmitted within a week with features of an early relapse. The infant survived but developed significant neurological sequelae. Although treatment of HSV is available, the neurological outcome is guarded even with adequate antiviral therapy. Adjunct corticosteroid therapy did not appear to attenuate the neurological sequelae.

  2. Successful treatment of gefitinib-induced acute interstitial pneumonitis with corticosteroid and non-invasive BIPAP-ventilation.

    Science.gov (United States)

    Zhang, Yalei; Yang, Haihong; Zhao, Meiling; He, Jianxing

    2012-06-01

    This is the case of a 63 year-old male who was diagnosed adenocarcinoma in the left upper lung with ipsilateral malignant pleural effusion. At diagnosis it had already spread to left pulmonary HLN (hilar lymph node) and left supraclavicular lymph node and mediastinal lymph nodes. The patient received combined chemotherapy with bevacizumab and GP (gemcitabine and carboplatin) for 6 courses. Disease progression on chest CT scan was recognized, daily treatment with oral gefitinib (250 mg/day) was commenced. One week later, he was admitted under the impression of gefitinib-related interstitial pneumonitis, gefitinib was discontinued immediately and methylprednisolone with BIPAP assisted ventilation were used. The patient was followed up for 2 months after the start of treatment with corticosteroids and BIPAP assisted ventilation and remained well. PMID:22754672

  3. The effect of short-term corticosteroid treatment on the CT appearance of experimental brain abscesses. [Dogs

    Energy Technology Data Exchange (ETDEWEB)

    Enzmann, D.R.; Britt, R.H.; Placone, R.C. Jr.; Obana, W.; Lyons, B.; Yeager, A.S.

    1982-10-01

    The effect of short-term corticosteroid treatment on contrast enhancement was investigated in an experimental brain abscess model. The degree of enhancement was reduced in the cerebritis stage, unaffected in the capsule stage, and intermediate in the transitional stage. The area and pattern of enhancement were also altered in the cerebritis stage. Although the magnitude of the entire cerebritis time-density curve (extended for 60 minutes) was decreased by the steroids, its configuration was unchanged. Prior to steroid administration, the 10- and 60-minute components of the curve discriminated between cerebritis and capsule stages, with the latter exhibiting a far lower 60-minute value. Implications for treatment of brain abscesses are discussed.

  4. Pyoderma Gangrenosum with Ulcerative Colitis Successfully Treated by the Combination of Granulocyte and Monocyte Adsorption Apheresis and Corticosteroids.

    Science.gov (United States)

    Ohno, Masashi; Koyama, Shigeki; Ohara, Mariko; Shimamoto, Kazumi; Kobayashi, Yu; Nakamura, Fumiyasu; Mitsuru, Kazuki; Andoh, Akira

    2016-01-01

    A 36-year-old woman was admitted to our hospital due to swelling and redness of the left lateral malleolus and dorsum of the left foot with severe pain, with a flare-up of ulcerative colitis (UC). A pathologic examination by skin biopsy led to a diagnosis of pyoderma gangrenosum (PG). She was treated with the intravenous administration of prednisolone (60 mg/day), and granulocyte and monocyte adsorption apheresis (GMA) was performed twice-a-week for 5 weeks. This treatment dramatically improved both the skin and colonic mucosal lesions. These results suggest that a combination of GMA and corticosteroids might be recommendable to induce the remission of serious PG complicated with UC. PMID:26726081

  5. Fatal Nocardia farcinica Bacteremia Diagnosed by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry in a Patient with Myelodysplastic Syndrome Treated with Corticosteroids

    OpenAIRE

    Christian Leli; Amedeo Moretti; Francesco Guercini; Angela Cardaccia; Leone Furbetta; Giancarlo Agnelli; Francesco Bistoni; Antonella Mencacci

    2013-01-01

    Nocardia farcinica is a Gram-positive weakly acid-fast filamentous saprophytic bacterium, an uncommon cause of human infections, acquired usually through the respiratory tract, often life-threatening, and associated with different clinical presentations. Predisposing conditions for N. farcinica infections include hematologic malignancies, treatment with corticosteroids, and any other condition of immunosuppression. Clinical and microbiological diagnoses of N. farcinica infections are troubles...

  6. Simultaneous epstein barr virus and cytomegalovirus infection accompanied by leiomyomatous change in a well-differentiated liposarcoma in a patient with long-term corticosteroid treatment.

    NARCIS (Netherlands)

    Sars, P R; Molenaar, W M; Koudstaal, J; Hoekstra, H J

    1997-01-01

    Patient. A 59-year-old woman presented with a large tumour of the abdominal wall. She had been taking corticosteroids for severe chronic obstructive pulmonary disease for 15 years. On CT scan the tumour had the characteristics of lipomatous tissue with a dense core.Results. Histology showed a well-d

  7. Simultaneous Epstein Barr Virus and Cytomegalovirus Infection Accompanied by Leiomyomatous Change in a Well-Differentiated Liposarcoma in a Patient With Long-Term Corticosteroid Treatment

    Directory of Open Access Journals (Sweden)

    Harald J. Hoekstra

    1997-01-01

    Full Text Available Patient. A 59-year-old woman presented with a large tumour of the abdominal wall. She had been taking corticosteroids for severe chronic obstructive pulmonary disease for 15 years. On CT scan the tumour had the characteristics of lipomatous tissue with a dense core.

  8. Immunity to babesia in mice III. The effects of corticosteroids and anti-thymocyte serum on mice immune to babesia rodhaini

    NARCIS (Netherlands)

    Zivkovic, D.; Speksnijder, J.E.; Kuil, H.; Seinen, W.

    1985-01-01

    BALB/c mice, immunized against babesia rodhaini by an amicarbalide controlled infection, were exposed to selective immunosuppressive treatment with corticosteroids and anti-thymocyte serum (ATS) respectively. Hydrocortisone acetate, 100 mg/kg, given i.p. six times during the three weeks after challe

  9. A randomized, double-blind, controlled study of ultrasound-guided corticosteroid injection into the joint of patients with inflammatory arthritis.

    LENUS (Irish Health Repository)

    Cunnington, Joanna

    2010-07-01

    Most corticosteroid injections into the joint are guided by the clinical examination (CE), but up to 70% are inaccurately placed, which may contribute to an inadequate response. The aim of this study was to investigate whether ultrasound (US) guidance improves the accuracy and clinical outcome of joint injections as compared with CE guidance in patients with inflammatory arthritis.

  10. Hepatitis B and immunosuppressive therapies for chronic inflammatory diseases: When and how to apply prophylaxis,with a special focus on corticosteroid therapy

    Institute of Scientific and Technical Information of China (English)

    Pilar López-Serrano; Elsa de la Fuente Briongos; Elisa Carrera Alonso; Jose Lázaro Pérez-Calle; Conrado Fernández Rodríguez

    2015-01-01

    Currently immunosuppressive and biological agentsare used in a more extensive and earlier way inpatients with inflammatory bowel disease, rheumaticor dermatologic diseases. Although these drugs haveshown a significant clinical benefit, the safety of thesetreatments is a challenge. Hepatitis B virus (HBV)reactivations have been reported widely, even includingliver failure and death, and it represents a deep concernin these patients. Current guidelines recommend to preemptivetherapy in patients with immunosuppressantsin general, but preventive measures focused in patientswith corticosteroids and inflammatory diseases arescarce. Screening for HBV infection should be done atdiagnosis. The patients who test positive for hepatitisB surface antigen, but do not meet criteria for antiviraltreatment must receive prophylaxis before undergoingimmunosuppression, including corticosteroids at higherdoses than prednisone 20 mg/d during more than twoweeks. Tenofovir and entecavir are preferred thanlamivudine because of their better resistance profile inlong-term immunosuppressant treatments. There is nota strong evidence, to make a general recommendationon the necessity of prophylaxis therapy in patientswith inflammatory diseases that are taking low dosesof corticosteroids in short term basis or low systemicbioavailability corticosteroids such as budesonide orbeclomethasone dipropionate. In these cases regularlyHBV DNA monitoring is recommended, starting earlyantiviral therapy if DNA levels begin to rise. In patientswith occult or resolved hepatitis the risk of reactivationis much lower, and excepting for Rituximab treatment,the prophylaxis is not necessary.

  11. Inhaled corticosteroids for abnormal pulmonary function in children with a history of Chronic Lung Disease of Infancy: study protocol [ISRCTN55153521

    Directory of Open Access Journals (Sweden)

    Sauve Reginald

    2005-04-01

    Full Text Available Abstract Background There is considerable evidence from the literature that children with chronic lung disease of infancy (CLD have abnormal pulmonary function in childhood and this could have an impact on their life quality and overall health. There are similarities between CLD and asthma, and corticosteroids are the mainstay treatment for asthma. Many physicians use inhaled corticosteroids in children with CLD with no evidence. Therefore we wish to conduct a randomized double-blinded placebo controlled trial to test for the role of inhaled corticosteroids in children aged from3 to 9 years with a history of CLD. Our primary hypothesis will be that inhaled corticosteroids are beneficial in children with CLD. Methods Our primary hypothesis is that using inhaled steroids; Beclomethasone Dipropionate (QVAR 100 mcg 2 puffs 2 times a day for 6 weeks will improve the respiratory system resistance and the quality of life in children with CLD. Discussion We propose that Beclomethasone Dipropionate (QVAR will affect the pulmonary function after 6 weeks of treatment. In summary we think that our study will highlight knowledge on whether the use of inhaled steroids is clinically effective for CLD.

  12. Network of nuclear receptor ligands in multiple sclerosis : Common pathways and interactions of sex-steroids, corticosteroids and vitamin D3-derived molecules

    NARCIS (Netherlands)

    Rolf, Linda; Damoiseaux, Jan; Hupperts, Raymond; Huitinga, I.; Smolders, Joost

    2016-01-01

    Sex steroids, corticosteroids and vitamin D3-derived molecules have all been subject to experimental studies and clinical trials in a plethora of autoimmune diseases. These molecules are all derived from cholesterol metabolites and are ligands for nuclear receptors. Ligation of these receptors resul

  13. Reply to "Early resolution of subretinal fluid without high-dose corticosteroids in a pregnant patient with Vogt-Koyanagi Harada disease" by Sugita et al.

    Science.gov (United States)

    Babu, Kalpana; Parikh, Aditi

    2016-12-01

    We read with great interest the article by Sugita et al. on early resolution of subretinal fluid without high-dose corticosteroids in a pregnant patient with Vogt-Koyanagi-Harada disease. We would like to share a similar experience where the subretinal fluid resolved within 2 weeks without treatment in a pregnant woman who was in her second trimester. PMID:27142974

  14. SURVEY OF SHORT-TERM ORAL CORTICOSTEROID ADMINISTRATION BY ORTHOPAEDIC PHYSICIANS IN COLLEGE AND HIGH SCHOOL ATHLETES

    Directory of Open Access Journals (Sweden)

    Albert W. Pearsall IV

    2009-03-01

    Full Text Available The use of oral corticosteroid (OCS drugs is advocated because of their potent anti-inflammatory effects. They also possess many potential adverse effects. No study has assessed physician prescribing practices of OCS therapy in high school (HS or college (COL athletes. This paper reports the prescribing patterns of sports medicine physicians who used short-term OCS therapy and to describe associated complications in HS and COL athletes within a 24- month period. An internet link to a descriptive epidemiology survey was included in an e-mail to all members of the Arthroscopy Association of North America and the American Orthopaedic Society for Sports Medicine. Descriptive statistics and correlation analysis were used to examine responses. Total response rate was 32% (615/1,928. Sixty-six percent of the physicians indicated prescribing OCS to both groups of athletes, while 29% reported prescribing OCS to COL athletes and 5% to HS athletes for musculoskeletal injuries. Physicians who prescribed multiple OCS regimens to the same athlete within the same season (P = 0.01 and physicians who prescribed OCS to the skeletally immature athlete (P = 0.009 reported more complications than other physicians. Among the 412 physicians who did not prescribe OCS in the treatment of athletic induced musculoskeletal injury, 251 (61% cited a risk of developing medical complications as the primary reason for avoiding use. The reported number of medical complications was low with no cases of avascular necrosis reported for the 2-year recall period. Orthopaedic surgeons who treated athletic induced musculoskeletal injuries with a short-term course of oral corticosteroids reported that high school and college athletes benefited with few medical complications

  15. Histopathological analysis of corticosteroid-antibiotic preparation and propolis paste formulation as intracanal medication after pulpectomy: an in vivo study

    Directory of Open Access Journals (Sweden)

    Isabela França de Almeida Santos Ramos

    2012-02-01

    Full Text Available Intracanal medication in pulpectomy therapy is used between appointments with the objective of reducing pain and inflammatory processes in pulp and periapical tissues. Propolis has been known as a natural antibiotic and has been subject of medical and dental research due to its therapeutic properties such as antibiotic, analgesic and anti-inflammatory effects. OBJECTIVE: The aim was to carry out an in vivo evaluation of the periapical tissue response to propolis paste when used as an intracanal medication in the teeth of dogs after pulpectomy. MATERIAL AND METHODS: 72 dog's incisors were selected for the experiment. After biomechanical preparation the root canal was filled with a corticosteroid-antibiotic preparation, experimental propolis paste, non-medicament (negative control or non-pulpectomy at all (positive control. The medications were left inside the root canal for 7, 14 or 28 days. At the end of the experimental period histological sections were prepared and all laboratories processes for Harris hematoxylin and eosin staining was proceeded followed by the analysis using an optical microscope. Sections were classified according to a score representing the inflammatory events observed: the presence of polymorphonuclear neutrophils, polymorphonuclear eosinophils, lymphocytes and plasma cells, macrophages and/or giant cells, fibrous condensation and abscesses. RESULTS: There were statistically significant differences between the tissue reactions caused by the two substances being tested, after different experimental periods, with the periapical tissue that was in contact with propolis paste exhibiting fewer inflammatory reactions in comparison to corticosteroid-antibiotic preparation. CONCLUSIONS: The low tissue responses from propolis paste suggest that this material could be considered as an option for root canal medication after pulpectomy.

  16. Coping with pregnancy after 9months in the dark: Post-hibernation buffering of high maternal stress in arctic ground squirrels.

    Science.gov (United States)

    Edwards, Phoebe D; Boonstra, Rudy

    2016-06-01

    Pregnancy and lactation are key times in the life of female mammals when energetic resources must be brought to bear to produce and nurture offspring. Changes in glucocorticoid (GC) levels are central to this objective, due to their roles in modulating development and physiology and in mediating energetic tradeoffs. We examined GC changes over reproduction in a species living in a harsh seasonal environment: the arctic ground squirrel (Urocitellus parryii). Females become pregnant immediately after emerging from a ∼9month hibernation, and then must begin this pregnancy during an additional month of freezing temperatures and limited food availability. We measured plasma levels of total cortisol, corticosteroid-binding globulin (CBG), and free cortisol in unstressed females at three stages: not-visibly pregnant, visibly pregnant, and lactating. Total cortisol levels were similar in all stages, but CBG levels increased 4-fold from the not-visibly pregnant stage to visibly pregnant and lactating stage. As a result, the free cortisol fraction declined from 51% of total cortisol when females were not-visibly pregnant to only 5% when they were visibly pregnant (remaining low and stable throughout pregnancy) and 10% when they were lactating. This pattern is markedly different from that seen in other mammals, where 10% or less of GCs are free and these tend to increase during gestation. We postulate that the high free cortisol just prior to visible pregnancy is a seasonal adaptation relating either to the pronounced physiological changes the female must undergo after emerging from hibernation and immediately getting pregnant, or to the mobilization of body reserves for energy to permit pregnancy, or both. Thereafter, high CBG levels may shield the developing offspring from the negative effects of cortisol overexposure. PMID:26555380

  17. SHBG (Sex Hormone Binding Globulin)

    Science.gov (United States)

    ... as: Testosterone-estrogen Binding Globulin; TeBG Formal name: Sex Hormone Binding Globulin Related tests: Testosterone , Free Testosterone, ... I should know? How is it used? The sex hormone binding globulin (SHBG) test may be used ...

  18. Optimising corticosteroid injection for lateral epicondylalgia with the addition of physiotherapy: A protocol for a randomised control trial with placebo comparison

    Directory of Open Access Journals (Sweden)

    Brooks Peter

    2009-06-01

    Full Text Available Abstract Background Corticosteroid injection and physiotherapy are two commonly prescribed interventions for management of lateral epicondylalgia. Corticosteroid injections are the most clinically efficacious in the short term but are associated with high recurrence rates and delayed recovery, while physiotherapy is similar to injections at 6 weeks but with significantly lower recurrence rates. Whilst practitioners frequently recommend combining physiotherapy and injection to overcome harmful effects and improve outcomes, study of the benefits of this combination of treatments is lacking. Clinicians are also faced with the paradox that the powerful anti-inflammatory corticosteroid injections work well, albeit in the short term, for a non-inflammatory condition like lateral epicondylalgia. Surprisingly, these injections have not been rigorously tested against placebo injections. This study primarily addresses both of these issues. Methods A randomised placebo-controlled clinical trial with a 2 × 2 factorial design will evaluate the clinical efficacy, cost-effectiveness and recurrence rates of adding physiotherapy to an injection. In addition, the clinical efficacy and adverse effects of corticosteroid injection beyond that of a placebo saline injection will be studied. 132 participants with a diagnosis of lateral epicondylalgia will be randomly assigned by concealed allocation to one of four treatment groups – corticosteroid injection, saline injection, corticosteroid injection with physiotherapy or saline injection with physiotherapy. Physiotherapy will comprise 8 sessions of elbow manipulation and exercise over an 8 week period. Blinded follow-up assessments will be conducted at baseline, 4, 8, 12, 26 and 52 weeks after randomisation. The primary outcome will be a participant rating of global improvement, from which measures of success and recurrence will be derived. Analyses will be conducted on an intention-to-treat basis using linear

  19. Relationship between medication beliefs, self-reported and refill adherence, and symptoms in patients with asthma using inhaled corticosteroids

    Directory of Open Access Journals (Sweden)

    Van Steenis MNA

    2014-01-01

    Full Text Available MNA Van Steenis,1 JA Driesenaar,2 JM Bensing,2,3 R Van Hulten,4 PC Souverein,4 L Van Dijk,2,4 PAGM De Smet,5 AM Van Dulmen2,6,71Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands; 2NIVEL (Netherlands institute for health services research, Utrecht, The Netherlands; 3Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands; 4Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands; 5IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 6Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 7Department of Health Sciences, Buskerud University College, Drammen, NorwayBackground: Beliefs play a crucial role in medication adherence. Interestingly, the relationship between beliefs and adherence varies when different adherence measures are used. How adherence, in turn, is related to asthma symptoms is still unclear. Our aim was to investigate the relationship between beliefs (ie, necessities and concerns about inhaled corticosteroids (ICS and subjectively as well as objectively measure adherence and the agreement between these measures. Further, the relationship between adherence and asthma symptoms was examined.Methods: A total of 280 patients aged 18–80 years who filled at least two ICS prescriptions in the preceding year were recruited to complete a questionnaire. The questionnaire included the Beliefs about Medicines Questionnaire to assess necessity beliefs and concerns about ICS, four questions about ICS use to measure self-reported adherence, and the Asthma Control Questionnaire to assess asthma symptoms. Proportion of days covered was used to determine pharmacy refill adherence.Results: Data from 93 patients with asthma were analyzed. Necessities were positively related to self-reported adherence (P = 0.01. No other

  20. Effects of inhaled corticosteroids on airway inflammation in chronic obstructive pulmonary disease: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Jen R

    2012-09-01

    Full Text Available Rachel Jen,1 Stephen,1 Rennard,2 Don D Sin1,31Department of Medicine, Respiratory Division, University of British Columbia, Vancouver, BC, Canada; 2Internal Medicine Section of Pulmonary and Critical Care, Nebraska Medical Center, Omaha, NE, USA; 3Institute of Heart and Lung Health and the UBC James Hogg Research Center, St Paul's Hospital, Vancouver, BC, CanadaBackground: Chronic obstructive pulmonary disease (COPD is characterized by chronic inflammation in the small airways. The effect of inhaled corticosteroids (ICS on lung inflammation in COPD remains uncertain. We sought to determine the effects of ICS on inflammatory indices in bronchial biopsies and bronchoalveolar lavage fluid of patients with COPD.Methods: We searched Medline, Embase, Cinahl, and the Cochrane database for randomized, controlled clinical trials that used bronchial biopsies and bronchoalveolar lavage to evaluate the effects of ICS in stable COPD. For each chosen study, we calculated the mean differences in the concentrations of inflammatory cells before and after treatment in both intervention and control groups. These values were then converted into standardized mean differences (SMD to accommodate the differences in patient selection, clinical treatment, and biochemical procedures that were employed across the original studies. If significant heterogeneity was present (P < 0.1, then a random effects model was used to pool the original data; otherwise, a fixed effects model was used.Results: We identified eight original studies that met the inclusion criteria. Four studies used bronchial biopsies (n = 102 participants and showed that ICS were effective in reducing CD4 and CD8 cell counts (SMD, −0.52 units and −0.66 units, 95% confidence interval. The five studies used bronchoalveolar lavage fluid (n = 309, which together showed that ICS reduced neutrophil and lymphocyte counts (SMD, −0.64 units and −0.64 units, 95% confidence interval. ICS on the other hand

  1. Recurrent acute rhinosinusitis: a single blind clinical study of N-acetylcysteine vs ambroxol associated to corticosteroid therapy.

    Science.gov (United States)

    Macchi, A; Terranova, P; Castelnuovo, P

    2012-01-01

    The aim of rhinosinusitis treatment is to restore sinusal eutrophism and to normalize ventilation and mucociliary transport. Frequently the improvement of sinusal physiological conditions is associated with a reduction of infections and pulmonary symptoms. The treatment of these diseases often requires the combination of medical and surgical strategies. In particular, the aim of the medical therapy is multiple: to treat the infection (with antibiotics), to reduce the mucosal swelling (with corticosteroids) and to improve mucus drainage (with mucolytics or muco-regulators). The use of atomized nasal douche, as a washing of the nasal fossas, is chosen because of its local action minimizing systemic adverse effects. The surgical treatment is secondary to medical failure, and it is focused on clearing the sinusal ostia in the sphenoethmoidal recess and the osteomeatal complex. In case of recurrent sinonasal diseases the importance of the surgical operation is represented by the fact that the medical treatment better reaches the target in the sinusal space. This study is focused on the primary medical treatment of acute recurrent rhinosinusitis. The patients who immediately needed surgical treatment were excluded from the study (because of the presence of an anatomical obstruction of the osteomeatal complex and/or the sphenoethmoidal recess, hence non-susceptible to improvement by medical therapy alone), and these patients were immediately addressed to undergo a CT scan examination in order to be involved in a future surgical programme. The medical treatment for those forms which do not require antibiotics (i.e. when infections are not involved), is based on the use of topical corticosteroids. While there are controversies on the real efficacy of adding mucolytic agents to the steroids, they are commonly prescribed in clinical practice, with the rationale of reducing viscosity and improving clearance of mucus in order to help the restoration of the physiological sinus

  2. Low-density lipoprotein apheresis for corticosteroid-resistant skin lesions caused by cholesterol crystal embolism: a case report and review of the literature.

    Science.gov (United States)

    Kobayashi, Hiroki; Abe, Masanori; Murata, Yusuke; Maruyama, Takashi; Furukawa, Tetsuya; Oikawa, Osamu; Okada, Kazuyoshi

    2015-09-01

    Cholesterol crystal embolism (CCE) is an arterio-arterial embolism originating from the breakdown of atherosclerotic plaques in the aortic wall. The embolism affects the skin and kidney particularly, as well as frequently affects the gastrointestinal tract and other organs. Although there are no clearly effective direct therapies for CCE, corticosteroid therapy and combination therapy with low-density lipoprotein apheresis (LDL-A) followed by corticosteroids were recently reported to be effective for renal manifestations in some cases. However, few cases offer suggestions for the treatment of skin lesions caused by CCE. We report here a case of a 58-year-old man diagnosed with CCE with skin manifestations and kidney dysfunction who achieved complete remission after LDL-A. LDL-A may be a useful treatment for CCE, particularly in cases with skin manifestations. PMID:25821197

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

    International Nuclear Information System (INIS)

    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 washout curves. Topical application of beta-methasone valerate resulted 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

  4. Cyclophosphamide-refractory scleroderma-associated interstitial lung disease: remarkable clinical and radiological response to a single course of rituximab combined with high-dose corticosteroids.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2011-10-01

    We would like to report our experience of using rituximab in cyclophosphamide refractory, rapidly progressive interstitial lung disease (ILD) in a patient with limited scleroderma. A 40-year-old man presented with 10-week history of inflammatory polyarthritis, which responded to a short course of oral corticosteroids. However, 3 weeks later, he developed new onset of exertional dyspnoea. High-resolution CT of the thorax was suggestive of early ILD. Surgical lung biopsy showed features of fibrotic non-specific interstitial pneumonia. He was diagnosed with scleroderma on the basis of: presence of anticentromere antibodies, Raynaud\\'s phenomenon, pulmonary fibrosis, digital oedema and hypomotility along with a dilated oesophagus. He was treated aggressively with pulse doses of corticosteroids and cyclophosphamide; however, his ILD continued to deteriorate. At this stage, he received rituximab (two pulses of 1 g each), which led to a gradual clinical improvement. Now, 12 months since his rituximab infusion, he walks 2 miles daily without any exertional dyspnoea.

  5. Inhibition of selectin binding

    Energy Technology Data Exchange (ETDEWEB)

    Nagy, Jon O. (Rodeo, CA); Spevak, Wayne R. (Albany, CA); Dasgupta, Falguni (New Delhi, IN); Bertozzi, Caroline (Albany, CA)

    2001-10-09

    This invention provides compositions for inhibiting the binding between two cells, one expressing P- or L-selectin on the surface and the other expressing the corresponding ligand. A covalently crosslinked lipid composition is prepared having saccharides and acidic group on separate lipids. The composition is then interposed between the cells so as to inhibit binding. Inhibition can be achieved at an effective oligosaccharide concentration as low as 10.sup.6 fold below that of the free saccharide. Since selectins are involved in recruiting cells to sites of injury, these composition scan be used to palliate certain inflammatory and immunological conditions.

  6. Inhibition of selectin binding

    Energy Technology Data Exchange (ETDEWEB)

    Nagy, J.O.; Spevak, W.R.; Dasgupta, F.; Bertozzi, C.

    1999-10-05

    This invention provides a system for inhibiting the binding between two cells, one expressing P- or L-selectin on the surface and the other expressing the corresponding ligand. A covalently crosslinked lipid composition is prepared having saccharides and acidic group on separate lipids. The composition is then interposed between the cells so as to inhibit binding. Inhibition can be achieved at an effective oligosaccharide concentration as low as 10{sup 6} fold below that of the free saccharide. Since selectins are involved in recruiting cells to sites of injury, this system can be used to palliate certain inflammatory and immunological conditions.

  7. Inhibition of selectin binding

    Energy Technology Data Exchange (ETDEWEB)

    Nagy, Jon O. (Rodeo, CA); Spevak, Wayne R. (Albany, CA); Dasgupta, Falguni (New Delhi, IN); Bertozzi, Caroline (Albany, CA)

    1999-01-01

    This invention provides compositions for inhibiting the binding between two cells, one expressing P- or L-selectin on the surface and the other expressing the corresponding ligand. A covalently crosslinked lipid composition is prepared having saccharides and acidic group on separate lipids. The composition is then interposed between the cells so as to inhibit binding. Inhibition can be achieved at an effective oligosaccharide concentration as low as 10.sup.6 fold below that of the free saccharide. Since selectins are involved in recruiting cells to sites of injury, these composition scan be used to palliate certain inflammatory and immunological conditions.

  8. Inhibition of selectin binding

    Energy Technology Data Exchange (ETDEWEB)

    Nagy, J.O.; Spevak, W.R.; Dasgupta, F.; Bertozzi, C.

    1999-11-16

    This invention provides compositions for inhibiting the binding between two cells, one expressing P- or L-selectin on the surface and the other expressing the corresponding ligand. A covalently crosslinked lipid composition is prepared having saccharides and acidic group on separate lipids. The composition is then interposed between the cells so as to inhibit binding. Inhibition can be achieved at an effective oligosaccharide concentration as low as 10{sup 6} fold below that of the free saccharide. Since selectins are involved in recruiting cells to sites of injury, these composition scan be used to palliate certain inflammatory and immunological conditions.

  9. Inhibition of selectin binding

    Energy Technology Data Exchange (ETDEWEB)

    Nagy, Jon O. (Rodeo, CA); Spevak, Wayne R. (Albany, CA); Dasgupta, Falguni (New Delhi, IN); Bertozzi, Carolyn (Albany, CA)

    1999-10-05

    This invention provides a system for inhibiting the binding between two cells, one expressing P- or L-selectin on the surface and the other expressing the corresponding ligand. A covalently crosslinked lipid composition is prepared having saccharides and acidic group on separate lipids. The composition is then interposed between the cells so as to inhibit binding. Inhibition can be achieved at an effective oligosaccharide concentration as low as 10.sup.6 fold below that of the free saccharide. Since selectins are involved in recruiting cells to sites of injury, this system can be used to palliate certain inflammatory and immunological conditions.

  10. Pericardial tamponade and pancytopenia as the first manifestation of mixed connective tissue disorder and its complete reversal with corticosteroids

    Directory of Open Access Journals (Sweden)

    Ankur Jain

    2014-09-01

    Full Text Available We report a case of a 25-year-old lady who presented to our department with complaints of easy fatigability and shortness of breath since one week. She had a history of Raynaud’s phenomenon. Examination revealed scleroderma like skin changes and pericardial friction rub. Investigations revealed high titer of anti-U1 RNP antibodies along with co-existing pancytopenia. Chest x-ray and echocardiography confirmed pericardial tamponade. Patient was diagnosed as having mixed connective tissue disorder (MCTD and she was started on high dose prednisolone, which led to complete reversal of pancytopenia and pericardial tamponade after 1 month of treatment. There are only 6 reported cases of pericardial tamponade in a patient with MCTD, and none of them had pancytopenia. Present case highlights the need to investigate the patient of pericardial tamponade for MCTD, especially in the presence of pancytopenia and relevant clinical history, as prompt treatment with corticosteroids can avoid invasive procedures like pericardiocentesis.

  11. Potent corticosteroid cream (mometasone furoate) significantly reduces acute radiation dermatitis: results from a double-blind, randomized study

    International Nuclear Information System (INIS)

    Purpose: Radiation-induced dermatitis is a very common side effect of radiation therapy, and may necessitate interruption of the therapy. There is a substantial lack of evidence-based treatments for this condition. The aim of this study was to investigate the effect of mometasone furoate cream (MMF) on radiation dermatitis in a prospective, double-blind, randomized study. Material and methods: The study comprised 49 patients with node-negative breast cancer. They were operated on with sector resection and scheduled for postoperative radiotherapy using photons with identical radiation qualities and dosage to the breast parenchyma. The patients were randomized to receive either MMF or emollient cream. The cream was applied on the irradiated skin twice a week from the start of radiotherapy until the 12th fraction (24 Gy) and thereafter once daily until 3 weeks after completion of radiation. Both groups additionally received non-blinded emollient cream daily. The intensity of the acute radiation dermatitis was evaluated on a weekly basis regarding erythema and pigmentation, using a reflectance spectrophotometer together with visual scoring of the skin reactions. Results: MMF in combination with emollient cream treatment significantly decreased acute radiation dermatitis (P=0.0033) compared with emollient cream alone. There was no significant difference in pigmentation between the two groups. Conclusions: Adding MMF, a potent topical corticosteroid, to an emollient cream is statistically significantly more effective than emollient cream alone in reducing acute radiation dermatitis

  12. High incidence of acute myeloid leukemia in SJL/J mice after X-irradiation and corticosteroids

    Energy Technology Data Exchange (ETDEWEB)

    Resnitzky, P.; Estrov, Z.; Haran-Ghera, N.

    1985-01-01

    SJL/J mice which developed a high incidence of spontaneous reticulum cell neoplasms, developed a low rate incidence (20-25%) of myeloid leukemia (ML) after X-irradiation. The possible effect of adrenal steroid imbalance to radiation-induced ML in SJL/J mice was tested. Intact and thymectomized animals were exposed to a single dose of 300 r whole body irradiation and treated with either hydrocortisone acetate, prednisone, metyrapone and adrenocorticotropin as coleukemogenic agents. Hydrocortisone and prednisone exerted a marked coleukemogenic effect, increasing the ML incidence to a similar rate of about 50-70%, at a mean latent period of 300 days. Prominent leukemic infiltration were observed in the bone marrow, spleen, lymph nodes and liver of the leukemic animals. Results of cytological and histological studies, including cytochemistry and ultrastructure, were all consistent with the diagnosis of acute myeloid leukemia (AML). Since AML is the type of human secondary leukemia which appears increasingly in patients treat with alkylating drugs and/or irradiation and corticosteroids for Hodgkin's disease or other neoplastic diseases, the experimental model of AML induced in SJL/J mice could be used for elucidation of mechanisms of leukemogenesis in secondary leukemia.

  13. Recovery of the hypothalamus-pituitary-adrenal axis after short term high dose corticosteroid treatment in neurosurgical practice.

    Science.gov (United States)

    Hedner, P; Kullberg, G; Bostedt, I

    1984-01-01

    The recovery of the hypothalamus-pituitary-adrenal axis after high-dose short-term steroid treatment was investigated in 18 patients undergoing stereotactic thalamotomy during local anaesthesia, in whom perioperative betamethasone was given in a high dose for 4-5 days and withdrawn without tapering. There were no untoward clinical effects of the abrupt withdrawal of the steroid. Seven patients undergoing the same operation without steroid treatment served as controls. The recovery of the hypothalamus-pituitary-adrenal axis after steroid treatment was studied by basal plasma cortisol levels. In 12 patients the reserve capacity of the system was investigated by the cortisol response to insulin induced hypoglycemia as well. It was found that the basal plasma cortisol levels had normalized 2 days after the abrupt withdrawal of betamethasone. In spite of normalized basal cortisol levels the capacity to respond to stress was reduced for a further 3 days. Six to seven days after the steroid withdrawal the stress response was, however, completely restored. It is concluded that high dose, short term steroid treatment can be withdrawn abruptly, omitting the usual tapering of the dose. During the first week after steroid withdrawal the cortisol response to stress is reduced even in the presence of normal basal cortisol levels. During this period extra corticosteroids must be supplied in case of an emergency situation or an operation. PMID:6393724

  14. Effects of seawater acclimation on mRNA levels of corticosteroid receptor genes in osmoregulatory and immune systems in trout

    Science.gov (United States)

    Yada, T.; Hyodo, S.; Schreck, C.B.

    2008-01-01

    Influence of environmental salinity on expression of distinct corticosteroid receptor (CR) genes, glucocorticoid receptor (GR)-1 and -2, and mineralcorticoid receptor (MR), was examined in osmoregulatory and hemopoietic organs and leucocytes of steelhead trout (Oncorhynchus mykiss). There was no significant difference in plasma cortisol levels between freshwater (FW)- or seawater (SW)-acclimated trout, whereas Na+, K+-ATPase was activated in gill of SW fish. Plasma lysozyme levels also showed a significant increase after acclimation to SW. In SW-acclimated fish, mRNA levels of GR-1, GR-2, and MR were significantly higher in gill and body kidney than those in FW. Head kidney and spleen showed no significant change in these CR mRNA levels after SW-acclimation. On the other hand, leucocytes isolated from head kidney and peripheral blood showed significant decreases in mRNA levels of CR in SW-acclimated fish. These results showed differential regulation of gene expression of CR between osmoregulatory and immune systems. ?? 2008 Elsevier Inc. All rights reserved.

  15. Effectiveness of intramuscular corticosteroid injection versus placebo injection in patients with hip osteoarthritis: design of a randomized double-blinded controlled trial

    OpenAIRE

    Dorleijn Desirée MJ; Luijsterburg Pim AJ; Reijman Max; Kloppenburg Margreet; Verhaar Jan AN; Bindels Patrick JE; Bos P Koen; Bierma-Zeinstra Sita MA

    2011-01-01

    Abstract Background Recent international guidelines recommend intra-articular corticosteroid injections for patients with hip osteoarthritis who have moderate to severe pain and do not respond satisfactorily to oral analgesic/anti-inflammatory agents. Of the five available randomized controlled trials, four showed positive effects with respect to pain reduction. However, intra-articular injection in the hip is complex because the joint is adjacent to important neurovascular structures and can...

  16. Montelukast as an Alternative to Low-Dose Inhaled Corticosteroids in the Management of Mild Asthma (The SIMPLE Trial): An Open-Label Effectiveness Trial

    OpenAIRE

    R Andrew McIvor; Alan Kaplan; Caroline Koch; Sampalis, John S

    2009-01-01

    OBJECTIVE: To evaluate the effectiveness of montelukast as monotherapy for patients with mild asthma who remain uncontrolled or unsatisfied while on inhaled corticosteroid (ICS) monotherapy.DESIGN: A multicentre, open-label study. Patients (six years of age or older) had ICS therapy discontinued and were treated with orally administered montelukast once daily for six weeks.MAIN OUTCOME MEASURES: The primary outcome measure was the rate at which asthma symptom control was achieved or maintaine...

  17. Role of intra-articular corticosteroid injections in pain management during physical rehabilitation of moderate to severe cases of knee osteoarthritis

    International Nuclear Information System (INIS)

    Objective: To determine the role of intra-articular corticosteroid injections in pain management during physical rehabilitation of moderate to severe cases of knee osteoarthritis. Study Design: Randomized control trial (RCT). Place and Duration of Study: Department of Rheumatology and Rehabilitation, Fauji Foundation Hospital Rawalpindi during June 2011 to February 2012. Patients and Methods: Sixty patients with moderate to severe knee osteoarthritis were randomly selected by using probability simple random sampling technique, and randomly placed into two groups A and B through flip a coin method. The intra-articular corticosteroid injections were administered into 30 patients, including 22 female and 08 male, followed by a 2 weeks physical rehabilitation program. In group B all 30 patients, 19 female and 11 male, underwent through a 2 weeks physical rehabilitation program. The visual analog scale (VAS) was used to assess the intensity of pain and was measured at the start and at completion of the 2 week treatment program. Results: There were 60 cases in the study; 30 in each treatment groups A and B, and no drop outs. Mean age of the patients in group A was 56.25 and group B it was 58.75 years. Majority of patients in both the groups were between 44 - 77 years of age. The pain intensity was calculated in group A (p-value=0.007) and group B (p-value=0.009) at baseline. The patients in group A was treated by intra-articular corticosteroid injections followed by physical rehabilitation and group B was treated only with physical rehabilitation for two months. The pain intensity was measured at the completion of treatment for group A (p - value = 0.006) and B (p - value 0.271). Conclusion: The study concluded that intra-articular corticosteroid injections combined with physical therapy management are more effective in pain management during physical rehabilitation of moderate to severe cases of knee osteoarthritis as compare with physical therapy alone. (author)

  18. Aspergillosis Superinfection as a Cause of Death of Crizotinib-Induced Interstitial Lung Disease Successfully Treated with High-Dose Corticosteroid Therapy

    OpenAIRE

    Deiana, Laura; Grisanti, Salvatore; Ferrari, Vittorio; Tironi, Andrea; Brugnoli, Giulia; Ferrari, Laura; Bozzola, Giordano; Berruti, Alfredo

    2015-01-01

    Crizotinib is an efficacious and well-tolerated drug in the management of ALK-positive lung cancer. Crizotinib treatment, however, is rarely complicated by the occurrence of acute interstitial lung disease (ILD) that is often fatal. There is no treatment for this serious adverse event. We report a female non-small cell lung cancer patient who developed ILD after a few days of crizotinib therapy. She showed a significant improvement after a high dose of pulse corticosteroid therapy, both radio...

  19. TGF-β1 induced epithelial to mesenchymal transition (EMT) in human bronchial epithelial cells is enhanced by IL-1β but not abrogated by corticosteroids

    OpenAIRE

    Doerner, Astrid M; Zuraw, Bruce L

    2009-01-01

    Background Chronic persistent asthma is characterized by ongoing airway inflammation and airway remodeling. The processes leading to airway remodeling are poorly understood, and there is increasing evidence that even aggressive anti-inflammatory therapy does not completely prevent this process. We sought to investigate whether TGFβ1 stimulates bronchial epithelial cells to undergo transition to a mesenchymal phenotype, and whether this transition can be abrogated by corticosteroid treatment o...

  20. A randomized clinical trial on comparison of corticosteroid injection with or without splinting versus saline injection with or without splinting in patients with lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Tahririan

    2014-01-01

    Full Text Available Background: Lateral epicondylitis is a common problem affecting 1-3% of the population. There has been much debate about the best treatment modality for this condition. There is, however, no conclusive evidence in support of any of the proposed treatment modalities. In this trial, we have studied the effect of corticosteroid injection (with or without splinting with normal saline injection (with or without splinting. Materials and Methods: In this double-blind, randomized clinical trial, individuals were randomly assigned to either of four treatment groups and received either 40 mg depomedrol injection alone, 40 mg depomedrol injection with splinting, normal saline injection alone, or normal saline injection with splinting. They were evaluated using the visual analog scale (VAS at weeks 2, 4 and 24 and with the Oxford elbow scale (OES at 24 weeks. Results: A total of 79 patients were participated in the study. The corticosteroid injection groups had better pain relief as measured by VAS at 2 and 4 weeks compared with the two saline injection groups. Mean VAS difference at week 0 versus week 2 was 4.5 ± 0.9 and 2.8 ± 0.6 in corticosteroid injection groups and saline injection groups respectively (P < 0.01 but at 24 weeks, there was only moderate benefit reported for the group which received steroid injection and splinting (P < 0.01 compared to the saline injection groups. The saline injection groups reported better improvement in OES scores (20.1 ± 3.7 at the end of the trial compared corticosteroid injection groups (16.1 ± 2.9 (P < 0.05. Conclusion: Our results indicate that despite the clear pain reduction benefit associated with steroid injection in short term, this benefit in comparison with normal saline injection fades by the 24 th week of follow-up.

  1. Rituximab in Combination with Corticosteroids for the Treatment of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: A NICE Single Technology Appraisal

    OpenAIRE

    Latimer, Nicholas R.; Carroll, Christopher; Wong, Ruth; Tappenden, Paul; Venning, Michael C.; Luqmani, Raashid

    2014-01-01

    As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of rituximab (Roche Products) to submit evidence of the clinical and cost effectiveness of rituximab in combination with corticosteroids for treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as...

  2. Prolonged Treatment with Inhaled Corticosteroids does not Normalize High Activity of Matrix Metalloproteinase-9 in Exhaled Breath Condensates of Children with Asthma

    OpenAIRE

    Grzela, Katarzyna; Zagorska, Wioletta; Krejner, Alicja; Litwiniuk, Malgorzata; Zawadzka-Krajewska, Anna; Banaszkiewicz, Aleksandra; Kulus, Marek; Grzela, Tomasz

    2015-01-01

    The airway remodeling in asthma is associated with increased amount of matrix metalloproteinase (MMP)-9. High levels of MMP-9 were found in mucosal biopsies, sputum and in exhaled breath condensates (EBC) of asthma patients. However, there are no data concerning real in vivo activity. Inhaled corticosteroids are effective in asthma control, but it is unclear, whether they only attenuate inflammation, or also protect against progressive remodeling of respiratory tract. Therefore, the aim of th...

  3. A Case of Bilateral Acute Calcific Tendinitis of the Gluteus Medius, Treated by Ultrasound-guided Needle Lavage and Corticosteroid Injection

    OpenAIRE

    Vereecke, Elke; Mermuys, Koen; Casselman, Jan

    2015-01-01

    Calcium hydroxyapatite deposition disease is a common pathology, most frequently located in the rotator cuff tendons of the shoulder, for which different therapeutic approaches are used. Ultrasound guided needle lavage and injection of anesthetic/corticosteroid is a well-known and extensively described treatment for calcific tendinits of the rotator cuff. We present a case of bilateral calcific tendinitis of the gluteus medius tendon, both sides successfully treated using ultrasound guided ne...

  4. Baseline proteinuria, urinary osmotic pressure, and renal function as positive predictors of corticosteroids plus cyclophosphamide treatment efficacy in IgA nephropathy

    Institute of Scientific and Technical Information of China (English)

    Fang Jing; Li Wenge; Li Duo; Tan Zhao

    2014-01-01

    Background Very limited data are available on factors predictive of corticosteroids plus cyclophosphamide treatment efficacy on IgA nephropathy (IgAN).The aim of the study was to research the clinical factors predictive of treatment efficacy in IgAN.Methods One hundred and fifty-nine patients with IgAN (proteinuria ≥2 g/d and estimated glomerular filtration rate 30-89 ml·min-1·1.73 m-2) were treated with corticosteroids/cyclophosphamide followed by a 12-month follow-up.According to their response,these patients were divided into remission group (proteinuria <0.5 g/d) and non-remission group (proteinuria ≥0.5 g/d),and their clinical data collected.Results In the present study,72.96% of the individuals underwent a complete remission,and their response was related to baseline proteinuria,urinary osmotic pressure,and renal function (P <0.05).Patients with baseline proteinuria more than 3 g/d,urinary osmotic pressure greater than 600 mOsm/L,and eGFR 60-89 ml·min-1·1.73 m-2 responded well to the combination of corticosteroids and cyclophosphamide (86.90% vs.57.33%,P=0.000; 81.48% vs.64.10%,P=0.014; 83.17% vs.55.17%,P=0.000).Conclusion The response to the combination of corticosteroids and cyclophosphamide might be well associated with baseline proteinuria,urinary osmotic pressure,and renal function in patients with IgAN.

  5. Randomised controlled trial of short bursts of a potent topical corticosteroid versus prolonged use of a mild preparation for children with mild or moderate atopic eczema

    OpenAIRE

    Thomas, K.S.; Armstrong, S J; Avery, A J; Li Wan Po, A; O'Neill, C; Young, S.; Williams, H C

    2002-01-01

    Objective To determine whether a three day burst of a potent corticosteroid is more effective than a mild preparation used for seven days in children with mild or moderate atopic eczema. Design Randomised, double blind, parallel group study of 18 weeks' duration. Setting 13 general practices and a teaching hospital in the Nottingham area. Participants 174 children with mild or moderate atopic eczema recruited from general practices and 33 from a hospital outpatie...

  6. Cue-responding behaviors during pharmacy counseling sessions with patients with asthma about inhaled corticosteroids: Potential relations with medication beliefs and self-reported adherence.

    OpenAIRE

    Driesenaar, J.A.; de Smet, P A G M; Van Hulten, R; Noordman, J.; van Dulmen, A M

    2016-01-01

    The aim of this study was to examine cue-responding behavior at the pharmacy while counseling about inhaled corticosteroids (ICS) in relation to medication adherence and medication beliefs. Patients with asthma aged ≥18 years using ICS were recruited from 12 pharmacies. Counseling sessions were video-recorded. Patients' emotional and informational cues and pharmacists' and pharmacy technicians' cue-responding behaviors were coded using an expanded version of the Medical Interview Aural Rating...

  7. Ultrasound-guided retro-calcaneal bursa corticosteroid injection for refractory Achilles tendinitis in patients with seronegative spondyloarthropathy: efficacy and follow-up study.

    Science.gov (United States)

    Srivastava, Puja; Aggarwal, Amita

    2016-06-01

    Ultrasound (US)-guided corticosteroid injection has been shown to be safe and effective for varied causes of plantar fasciitis; however, its use for Achilles tendinitis is controversial. We studied the efficacy and changes in US findings at Achilles enthesitis after corticosteroid injection in patients with spondyloarthropathy (SpA). Patients with SpA with symptomatic Achilles enthesitis, refractory to 6 weeks of full-dose NSAIDs, were offered US-guided local corticosteroid injection. Injected entheses were examined by US (both B mode and power Doppler) at baseline and 6 weeks after injection. Standard OMERACT definitions were used to define enthesitis. Achilles tendon thickness >5.29 mm, 2 cm proximal to insertion in long axis, was considered thickened. Twenty-seven symptomatic Achilles tendons (in 18 patients) were injected with 20 mg methylprednisolone under US guidance baseline, and 6-week follow-up US features were compared. All patients reported improvement in pain (VAS) in the affected tendon after injection (p < 0.0001). Simultaneously, improvement in local inflammatory changes were noted, in the form of significant reduction in tendon thickness (p < 0.0001), vascularity (p < 0.0001), peritendinous oedema (p = 0.001), bursitis and bursal vascularity (p < 0.001 and < 0.0001, respectively). There was no change in bone erosions and enthesophyte. None of the patients had tendon rupture or other injection-related complications at 6 weeks of follow-up. US-guided local corticosteroid injection is an effective and safe modality for refractory Achilles enthesitis in patients with SpA and leads to reversion of acute changes at entheseal site. PMID:26894910

  8. Predictors of treatment with antibiotics and systemic corticosteroids for acute exacerbations of asthma and chronic obstructive pulmonary disease in primary care

    OpenAIRE

    Al-ani, Salwan Tariq; Spigt, Marcus; Laue, Johanna; Melbye, Hasse

    2015-01-01

    Background: Antibiotic and oral corticosteroid prescribing rate in patients suffering from acute exacerbations of chronic obstructive pulmonary disease (COPD) or asthma in general practice are only sparsely described. Our aim was to identify predictors for such prescribing when results from CRP testing, spirometry, and pulse oximetry are available. Methods: Patients aged 40 years or more diagnosed with asthma, COPD or both, the previous five years from seven general practice offices in Norway...

  9. Fatal Nocardia farcinica Bacteremia Diagnosed by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry in a Patient with Myelodysplastic Syndrome Treated with Corticosteroids

    Science.gov (United States)

    Moretti, Amedeo; Guercini, Francesco; Cardaccia, Angela; Furbetta, Leone; Agnelli, Giancarlo; Bistoni, Francesco; Mencacci, Antonella

    2013-01-01

    Nocardia farcinica is a Gram-positive weakly acid-fast filamentous saprophytic bacterium, an uncommon cause of human infections, acquired usually through the respiratory tract, often life-threatening, and associated with different clinical presentations. Predisposing conditions for N. farcinica infections include hematologic malignancies, treatment with corticosteroids, and any other condition of immunosuppression. Clinical and microbiological diagnoses of N. farcinica infections are troublesome, and the isolation and identification of the etiologic agent are difficult and time-consuming processes. We describe a case of fatal disseminated infection in a patient with myelodysplastic syndrome, treated with corticosteroids, in which N. farcinica has been isolated from blood culture and identified by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry. The patient died after 18 days of hospitalization in spite of triple antimicrobial therapy. Nocardia farcinica infection should be suspected in patients with history of malignancy, under corticosteroid therapy, suffering from subacute pulmonary infection,and who do not respond to conventional antimicrobial therapy. Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry can be a valuable tool for rapid diagnosis of nocardiosis. PMID:23690786

  10. Fatal Nocardia farcinica Bacteremia Diagnosed by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry in a Patient with Myelodysplastic Syndrome Treated with Corticosteroids

    Directory of Open Access Journals (Sweden)

    Christian Leli

    2013-01-01

    Full Text Available Nocardia farcinica is a Gram-positive weakly acid-fast filamentous saprophytic bacterium, an uncommon cause of human infections, acquired usually through the respiratory tract, often life-threatening, and associated with different clinical presentations. Predisposing conditions for N. farcinica infections include hematologic malignancies, treatment with corticosteroids, and any other condition of immunosuppression. Clinical and microbiological diagnoses of N. farcinica infections are troublesome, and the isolation and identification of the etiologic agent are difficult and time-consuming processes. We describe a case of fatal disseminated infection in a patient with myelodysplastic syndrome, treated with corticosteroids, in which N. farcinica has been isolated from blood culture and identified by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry. The patient died after 18 days of hospitalization in spite of triple antimicrobial therapy. Nocardia farcinica infection should be suspected in patients with history of malignancy, under corticosteroid therapy, suffering from subacute pulmonary infection,and who do not respondto conventional antimicrobial therapy. Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry can be a valuable tool for rapid diagnosis of nocardiosis.

  11. HPLC-UV Method for the Identification and Screening of Hydroquinone, Ethers of Hydroquinone and Corticosteroids Possibly Used as Skin-Whitening Agents in Illicit Cosmetic Products.

    Science.gov (United States)

    Gimeno, Pascal; Maggio, Annie-Françoise; Bancilhon, Marjorie; Lassu, Nelly; Gornes, Hervé; Brenier, Charlotte; Lempereur, Laurent

    2016-03-01

    Corticosteroids, hydroquinone and its ethers are regulated in cosmetics by the Regulation 1223/2009. As corticosteroids are forbidden to be used in cosmetics and cannot be present as contaminants or impurities, an identification of one of these illicit compounds deliberately introduced in these types of cosmetics is enough for market survey control. In order to quickly identify skin-whitening agents present in illegal cosmetics, this article proposes an HPLC-UV method for the identification and screening of hydroquinone, 3 ethers of hydroquinone and 39 corticosteroids that may be found in skin-whitening products. Two elution gradients were developed to separate all compounds. The main solvent gradient (A) allows the separation of 39 compounds among the 43 compounds considered in 50 min. Limits of detection on skin-whitening cosmetics are given. For compounds not separated, a complementary gradient elution (B) using the same solvents is proposed. Between 2004 and 2009, a market survey on "skin-whitening cosmetic" was performed on 150 samples and highlights that more than half of the products tested do not comply with the Cosmetic Regulation 1223/2009 (amending the Council Directive 76/768/EEC). PMID:26462503

  12. Improved outcome with pulses of vincristine and corticosteroids in continuation therapy of children with average risk acute lymphoblastic leukemia (ALL) and lymphoblastic non-Hodgkin lymphoma (NHL): report of the EORTC randomized phase 3 trial 58951

    OpenAIRE

    De Moerloose, Barbara; Suciu, Stefan; Bertrand, Yves; Mazingue, Françoise; Robert, Alain; Uyttebroeck, Anne; Yakouben, Karima; Ferster, Alice; Margueritte, Geneviève; Lutz, Patrick; Munzer, Martine; Sirvent, Nicolas; Norton, Lucilia; Boutard, Patrick; Plantaz, Dominique

    2010-01-01

    The European Organisation for Research and Treatment of Cancer 58951 trial for children with acute lymphoblastic leukemia (ALL) or non-Hodgkin lymphoma (NHL) addressed 3 randomized questions, including the evaluation of dexamethasone (DEX) versus prednisolone (PRED) in induction and, for average-risk patients, the evaluation of vincristine and corticosteroid pulses during continuation therapy. The corticosteroid used in the pulses was that assigned at induction. Overall, 411 patients were ran...

  13. Sequential memory: Binding dynamics

    Science.gov (United States)

    Afraimovich, Valentin; Gong, Xue; Rabinovich, Mikhail

    2015-10-01

    Temporal order memories are critical for everyday animal and human functioning. Experiments and our own experience show that the binding or association of various features of an event together and the maintaining of multimodality events in sequential order are the key components of any sequential memories—episodic, semantic, working, etc. We study a robustness of binding sequential dynamics based on our previously introduced model in the form of generalized Lotka-Volterra equations. In the phase space of the model, there exists a multi-dimensional binding heteroclinic network consisting of saddle equilibrium points and heteroclinic trajectories joining them. We prove here the robustness of the binding sequential dynamics, i.e., the feasibility phenomenon for coupled heteroclinic networks: for each collection of successive heteroclinic trajectories inside the unified networks, there is an open set of initial points such that the trajectory going through each of them follows the prescribed collection staying in a small neighborhood of it. We show also that the symbolic complexity function of the system restricted to this neighborhood is a polynomial of degree L - 1, where L is the number of modalities.

  14. Efficacy and safety of different doses of a slow-release corticosteroid implant for macular edema: meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Liu QY

    2015-05-01

    Full Text Available Qingyu Liu,1,2,* Mengmei He,1,2,* Hui Shi,1,3 Qianyi Wang,1,2 Yaru Du,1,3 Junling Liu,1,2 Chengda Ren,1,2 Ding Xu,1 Jing Yu1 1Department of Ophthalmology, Shanghai Tenth People’s Hospital, Shanghai, 2Tongji University School of Medicine, Shanghai, 3Department of First Clinical Medical College, Nanjing Medical University, Nanjing, People’s Republic of China *These authors contributed equally to this work Background: The purpose of this meta-analysis was to assess the efficacy and safety of intravitreal corticosteroid implants for macular edema. Methods: A total of 3,586 patients from previously reported randomized controlled trials were included. The meta-analysis was performed using RevMan 5.2. Summary odds ratios (ORs and 95% confidence intervals (CIs were calculated, employing random-effects or fixed-effects models according to between-study heterogeneity. The main outcome measures were the ORs for effects and safety of intravitreal corticosteroid implants. Results: Four eligible studies were included. Compared with the sham group, the ORs for ≥15 letter improvement of visual acuity in the high-dose and low-dose groups were 1.89 (95% CI 1.33–2.69, P=0.0004 and 1.62 (95% CI 1.10–2.41, P=0.02, respectively. The weight mean differences in central retinal thickness increases were -75.46 (95% CI -90.29, -60.63, P<0.0001 and -46.47 (95% CI -92.08, -0.86, P=0.05, respectively. However, the ORs for increased intraocular pressure in both intervention groups were higher than in the sham group, and were 11.50 (95% CI 7.24–18.28, P<0.00001 and 10.30 (95% CI 6.49–16.36, P<0.00001, respectively. The incidence of cataract was 7.25 (95% CI 5.68–9.25, P<0.00001 and 3.56 (95% CI 1.28–9.96, P=0.02 in the two intervention groups, respectively. There was no significant difference between the intervention groups except for the incidence of cataract in which the OR was 1.59 (95% CI 1.28–1.97, P<0.001.  Conclusion: Intravitreal corticosteroid

  15. 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

    Full Text Available OBJETIVO: Avaliar o efeito das injeções intra-articulares de corticosteroide e dos ácidos: hialurônico nativo e com cadeias ramificadas, na osteoartrose induzida experimentalmente. MÉTODOS: 44 coelhos submetidos à ressecção do ligamento cruzado anterior foram divididos em quatro grupos de 11. Grupo 1: uma injeção intra-articular com solução salina por semana, durante 3 semanas. Grupo 2: três injeções, com intervalo semanal, de ácido hialurônico nativo. Grupo 3: três injeções, com intervalo semanal, de ácido hialurônico ramificado. Grupo 4: duas injeções de betametasona com intervalo de três semanas. Após 12 semanas da cirurgia a cartilagem articular dos planaltos tibiais foi avaliada por macroscopia. As alterações na superfície articular foram graduadas da seguinte maneira: grau 0 - superfície articular lisa, sem alterações de relevo; grau 1 - superfície rugosa, sem depressões; grau 2 - semelhante ao grau 1 porém com depressões na superfície; grau 3 - exposição do osso subcondral. A análise estatística consistiu na utilização do teste t de Student, teste do Qui-quadrado e da análise de variância (Anova. O nível de significância utilizado foi de 5%. RESULTADOS: Observou-se haver diferença estatística entre os grupos 2, 3 e 4 e o grupo controle no desenvolvimento e gravidade da artrose, porém não houve diferença entre os grupos das drogas estudadas. CONCLUSÃO: Constatou-se atenuação da evolução do processo de osteoartrose, na mesma magnitude, com a utilização de injeções intra-articulares dos glicosaminoglicanos de baixo peso molecular e de alto peso molecular, assim como do corticosteroide betametasona quando comparados com placebo em joelhos de coelhos.OBJECTIVE: The aim of this study was to evaluate the effects of intraarticular injections of corticosteroids, native hyaluronic acid and branched-chain hyaluronic acid in experimentally-induced osteoarthrosis. METHODS: 44 rabbits

  16. Effects of nasal corticosteroids on boosts of systemic allergen-specific IgE production induced by nasal allergen exposure.

    Directory of Open Access Journals (Sweden)

    Cornelia Egger

    Full Text Available Allergen exposure via the respiratory tract and in particular via the nasal mucosa boosts systemic allergen-specific IgE production. Intranasal corticosteroids (INCS represent a first line treatment of allergic rhinitis but their effects on this boost of allergen-specific IgE production are unclear.Here we aimed to determine in a double-blind, placebo-controlled study whether therapeutic doses of an INCS preparation, i.e., nasal fluticasone propionate, have effects on boosts of allergen-specific IgE following nasal allergen exposure.Subjects (n = 48 suffering from grass and birch pollen allergy were treated with daily fluticasone propionate or placebo nasal spray for four weeks. After two weeks of treatment, subjects underwent nasal provocation with either birch pollen allergen Bet v 1 or grass pollen allergen Phl p 5. Bet v 1 and Phl p 5-specific IgE, IgG1-4, IgM and IgA levels were measured in serum samples obtained at the time of provocation and one, two, four, six and eight weeks thereafter.Nasal allergen provocation induced a median increase to 141.1% of serum IgE levels to allergens used for provocation but not to control allergens 4 weeks after provocation. There were no significant differences regarding the boosts of allergen-specific IgE between INCS- and placebo-treated subjects.In conclusion, the application of fluticasone propionate had no significant effects on the boosts of systemic allergen-specific IgE production following nasal allergen exposure.http://clinicaltrials.gov/NCT00755066.

  17. Local adverse effects associated with the use of inhaled corticosteroids in patients with moderate or severe asthma

    Directory of Open Access Journals (Sweden)

    Charleston Ribeiro Pinto

    2013-06-01

    Full Text Available OBJECTIVE: To describe and characterize local adverse effects (in the oral cavity, pharynx, and larynx associated with the use of inhaled corticosteroids (ICSs in patients with moderate or severe asthma. METHODS: This was a cross-sectional study involving a convenience sample of 200 asthma patients followed in the Department of Pharmaceutical Care of the Bahia State Asthma and Allergic Rhinitis Control Program Referral Center, located in the city of Salvador, Brazil. The patients were ≥ 18 years of age and had been using ICSs regularly for at least 6 months. Local adverse effects (irritation, pain, dry throat, throat clearing, hoarseness, reduced vocal intensity, loss of voice, sensation of thirst, cough during ICS use, altered sense of taste, and presence of oral candidiasis were assessed using a 30-day recall questionnaire. RESULTS: Of the 200 patients studied, 159 (79.5% were women. The mean age was 50.7 ± 14.4 years. In this sample, 55 patients (27.5% were using high doses of ICS, with a median treatment duration of 38 months. Regarding the symptoms, 163 patients (81.5% reported at least one adverse effect, and 131 (65.5% had a daily perception of at least one symptom. Vocal and pharyngeal symptoms were identified in 57 (28.5% and 154 (77.0% of the patients, respectively. The most commonly reported adverse effects were dry throat, throat clearing, sensation of thirst, and hoarseness. CONCLUSIONS: Self-reported adverse effects related to ICS use were common among the asthma patients evaluated here.

  18. Effect of outpatient therapy with inhaled corticosteroids on decreasing in-hospital mortality from pneumonia in patients with COPD

    Science.gov (United States)

    Yamauchi, Yasuhiro; Yasunaga, Hideo; Hasegawa, Wakae; Sakamoto, Yukiyo; Takeshima, Hideyuki; Jo, Taisuke; Matsui, Hiroki; Fushimi, Kiyohide; Nagase, Takahide

    2016-01-01

    Background and objectives Inhaled corticosteroids (ICS) and long-acting inhaled bronchodilators (IBD) are beneficial for the management of COPD. Although ICS has been reported to increase the risk of pneumonia in patients with COPD, it remains controversial whether it influences mortality. Using a Japanese national database, we examined the association between preadmission ICS therapy and in-hospital mortality from pneumonia in patients with COPD. Methods We retrospectively collected data from 1,165 hospitals in Japan on patients with COPD who received outpatient inhalation therapy and were admitted with pneumonia. Patients were categorized into those who received ICS with IBD and those who received IBD alone. We performed multivariate logistic regression analysis to examine the association between outpatient ICS therapy and in-hospital mortality, adjusting for the patients’ backgrounds. Results Of the 7,033 eligible patients, the IBD alone group (n=3,331) was more likely to be older, have lower body mass index, poorer general conditions, and more severe pneumonia than the ICS with IBD group (n=3,702). In-hospital mortality was 13.2% and 8.1% in the IBD alone and the ICS with IBD groups, respectively. After adjustment for patients’ backgrounds, the ICS with IBD group had significantly lower mortality than the IBD alone group (adjusted odds ratio, 0.80; 95% confidence interval, 0.68–0.94). Higher mortality was associated with older age, being male, lower body mass index, poorer general status, and more severe pneumonia. Conclusion Outpatient inhaled ICS and IBD therapy was significantly associated with lower mortality from pneumonia in patients with COPD than treatment with IBD alone.

  19. The Evaluation of The Impact of Pulse Corticosteroid Therapy on Bone Mineral Density in Multiple Sclerosis Patients

    Directory of Open Access Journals (Sweden)

    Pınar CE

    2005-12-01

    Full Text Available Objectives: Osteoporosis is one of the most common complication of long term corticosteroid therapy. Pulsed methylprednisolone therapy is proceeded several times to multiple sclerosis(MS patients as attack treatment throughout their lives. Little is known about the effect of this treatment on bone mineral density (BMD. In order to asses this aspect of treatment, we evaluated the BMD of patients who have taken pulse steroid therapy versus MS patients without any steroid therapy.Material and methods: Fiftythree patients were included in the study. The patients who received methylprednisolone at least 10g during the last two years, or at least 15g during the course of the whole disease were assigned as treatment group (n=32. Twenty one additional MS patients who did not receive pulse steroid served as controls.All of the patients were ambulatory (EDSS<4. We evaluated Blood calcium, inorganic phosporus, alkaline phosphatase, parathormon levels and urine Ca/creatinin ratios, lumbar BMD, femur neck BMD, lumbar total T-score, femur neck T-score, lumbar Z-score, femur neck Z-scores of the treatment and the control groups.Results: We found no meaningful relationship between the groups for lumbar BMD, femur neck BMD, lumbar total T-score, femur neck T-score, lumbar Z-score, femur neck Z-score (p=0,317; p=0,78; p=0.54; p=0.77; p=0,59; p=0,94 respectively. Blood calcium, inorganic phosporus, alkaline phosphatase, parathormon levels and urine Ca/creatinin ratios were similar between the two groups (p=0.07; p=0.87; p=0.77; p=0.32; p=0.57 respectively.Conclusions: Our results showed that pulsed steroid therapy had no effect on BMD of MS patients.

  20. DNA-binding residues and binding mode prediction with binding-mechanism concerned models

    OpenAIRE

    Oyang Yen-Jen; Liu Yu-Cheng; Huang Chun-Chin; Huang Yu-Feng; Huang Chien-Kang

    2009-01-01

    Abstract Background Protein-DNA interactions are essential for fundamental biological activities including DNA transcription, replication, packaging, repair and rearrangement. Proteins interacting with DNA can be classified into two categories of binding mechanisms - sequence-specific and non-specific binding. Protein-DNA specific binding provides a mechanism to recognize correct nucleotide base pairs for sequence-specific identification. Protein-DNA non-specific binding shows sequence indepe...

  1. Carboplatin binding to histidine

    International Nuclear Information System (INIS)

    An X-ray crystal structure showing the binding of purely carboplatin to histidine in a model protein has finally been obtained. This required extensive crystallization trials and various novel crystal structure analyses. Carboplatin is a second-generation platinum anticancer agent used for the treatment of a variety of cancers. Previous X-ray crystallographic studies of carboplatin binding to histidine (in hen egg-white lysozyme; HEWL) showed the partial conversion of carboplatin to cisplatin owing to the high NaCl concentration used in the crystallization conditions. HEWL co-crystallizations with carboplatin in NaBr conditions have now been carried out to confirm whether carboplatin converts to the bromine form and whether this takes place in a similar way to the partial conversion of carboplatin to cisplatin observed previously in NaCl conditions. Here, it is reported that a partial chemical transformation takes place but to a transplatin form. Thus, to attempt to resolve purely carboplatin binding at histidine, this study utilized co-crystallization of HEWL with carboplatin without NaCl to eliminate the partial chemical conversion of carboplatin. Tetragonal HEWL crystals co-crystallized with carboplatin were successfully obtained in four different conditions, each at a different pH value. The structural results obtained show carboplatin bound to either one or both of the N atoms of His15 of HEWL, and this particular variation was dependent on the concentration of anions in the crystallization mixture and the elapsed time, as well as the pH used. The structural details of the bound carboplatin molecule also differed between them. Overall, the most detailed crystal structure showed the majority of the carboplatin atoms bound to the platinum centre; however, the four-carbon ring structure of the cyclobutanedicarboxylate moiety (CBDC) remained elusive. The potential impact of the results for the administration of carboplatin as an anticancer agent are described

  2. Carboplatin binding to histidine

    Energy Technology Data Exchange (ETDEWEB)

    Tanley, Simon W. M. [University of Manchester, Brunswick Street, Manchester M13 9PL (United Kingdom); Diederichs, Kay [University of Konstanz, D-78457 Konstanz (Germany); Kroon-Batenburg, Loes M. J. [Utrecht University, Padualaan 8, 3584 CH Utrecht (Netherlands); Levy, Colin [University of Manchester, 131 Princess Street, Manchester M1 7DN (United Kingdom); Schreurs, Antoine M. M. [Utrecht University, Padualaan 8, 3584 CH Utrecht (Netherlands); Helliwell, John R., E-mail: john.helliwell@manchester.ac.uk [University of Manchester, Brunswick Street, Manchester M13 9PL (United Kingdom)

    2014-08-29

    An X-ray crystal structure showing the binding of purely carboplatin to histidine in a model protein has finally been obtained. This required extensive crystallization trials and various novel crystal structure analyses. Carboplatin is a second-generation platinum anticancer agent used for the treatment of a variety of cancers. Previous X-ray crystallographic studies of carboplatin binding to histidine (in hen egg-white lysozyme; HEWL) showed the partial conversion of carboplatin to cisplatin owing to the high NaCl concentration used in the crystallization conditions. HEWL co-crystallizations with carboplatin in NaBr conditions have now been carried out to confirm whether carboplatin converts to the bromine form and whether this takes place in a similar way to the partial conversion of carboplatin to cisplatin observed previously in NaCl conditions. Here, it is reported that a partial chemical transformation takes place but to a transplatin form. Thus, to attempt to resolve purely carboplatin binding at histidine, this study utilized co-crystallization of HEWL with carboplatin without NaCl to eliminate the partial chemical conversion of carboplatin. Tetragonal HEWL crystals co-crystallized with carboplatin were successfully obtained in four different conditions, each at a different pH value. The structural results obtained show carboplatin bound to either one or both of the N atoms of His15 of HEWL, and this particular variation was dependent on the concentration of anions in the crystallization mixture and the elapsed time, as well as the pH used. The structural details of the bound carboplatin molecule also differed between them. Overall, the most detailed crystal structure showed the majority of the carboplatin atoms bound to the platinum centre; however, the four-carbon ring structure of the cyclobutanedicarboxylate moiety (CBDC) remained elusive. The potential impact of the results for the administration of carboplatin as an anticancer agent are described.

  3. TGF-β1 induced epithelial to mesenchymal transition (EMT in human bronchial epithelial cells is enhanced by IL-1β but not abrogated by corticosteroids

    Directory of Open Access Journals (Sweden)

    Zuraw Bruce L

    2009-10-01

    Full Text Available Abstract Background Chronic persistent asthma is characterized by ongoing airway inflammation and airway remodeling. The processes leading to airway remodeling are poorly understood, and there is increasing evidence that even aggressive anti-inflammatory therapy does not completely prevent this process. We sought to investigate whether TGFβ1 stimulates bronchial epithelial cells to undergo transition to a mesenchymal phenotype, and whether this transition can be abrogated by corticosteroid treatment or enhanced by the pro-inflammatory cytokine IL-1β. Methods BEAS-2B and primary normal human bronchial epithelial cells were stimulated with TGFβ1 and expression of epithelial and mesenchymal markers assessed by quantitative real-time PCR, immunoblotting, immunofluorescence microscopy and zymography. In some cases the epithelial cells were also incubated with corticosteroids or IL-1β. Results were analyzed using non-parametric statistical tests. Results Treatment of BEAS-2B or primary human bronchial epithelial cells with TGFβ1 significantly reduced the expression level of the epithelial adherence junction protein E-cadherin. TGFβ1 then markedly induced mesenchymal marker proteins such as collagen I, tenascin C, fibronectin and α-smooth muscle actin mRNA in a dose dependant manner. The process of mesenchymal transition was accompanied by a morphological change towards a more spindle shaped fibroblast cell type with a more motile and invasive phenotype. Corticosteroid pre-treatment did not significantly alter the TGFβ1 induced transition but IL-1β enhanced the transition. Conclusion Our results indicate, that TGFβ1 can induce mesenchymal transition in the bronchial epithelial cell line and primary cells. Since asthma has been strongly associated with increased expression of TGFβ1 in the airway, epithelial to mesenchymal transition may contribute to the contractile and fibrotic remodeling process that accompanies chronic asthma.

  4. Collagen binding to Staphylococcus aureus

    International Nuclear Information System (INIS)

    Staphylococcus aureus can bind soluble collagen in a specific, saturable manner. We have previously shown that some variability exists in the degree of collagen binding between different strains of heat-killed, formaldehyde-fixed S. aureus which are commercially available as immunologic reagents. The present study demonstrates that live S. aureus of the Cowan 1 strain binds amounts of collagen per organism equivalent to those demonstrated previously in heat-killed, formaldehyde-fixed bacteria but has an affinity over 100 times greater, with Kd values of 9.7 X 10(-11) M and 4.3 X 10(-8) M for live and heat-killed organisms, respectively. Studies were also carried out with S. aureus killed by ionizing radiation, since this method of killing the organism seemed less likely to alter the binding moieties on the surface than did heat killing. Bacteria killed by exposure to gamma radiation bound collagen in a manner essentially indistinguishable from that of live organisms. Binding of collagen to irradiated cells of the Cowan 1 strain was rapid, with equilibrium reached by 30 min at 22 degrees C, and was fully reversible. The binding was not inhibited by fibronectin, fibrinogen, C1q, or immunoglobulin G, suggesting a binding site for collagen distinct from those for these proteins. Collagen binding was virtually eliminated in trypsin-treated organisms, indicating that the binding site has a protein component. Of four strains examined, Cowan 1 and S. aureus ATCC 25923 showed saturable, specific binding, while strains Woods and S4 showed a complete lack of binding. These results suggest that some strains of S. aureus contain high-affinity binding sites for collagen. While the number of binding sites per bacterium varied sixfold in the two collagen-binding strains, the apparent affinity was similar

  5. The impact of generic-only drug benefits on patients' use of inhaled corticosteroids in a Medicare population with asthma

    Directory of Open Access Journals (Sweden)

    Newhouse Joseph P

    2008-07-01

    Full Text Available Abstract Background Patients face increasing insurance restrictions on prescription drugs, including generic-only coverage. There are no generic inhaled corticosteroids (ICS, which are a mainstay of asthma therapy, and patients pay the full price for these drugs under generic-only policies. We examined changes in ICS use following the introduction of generic-only coverage in a Medicare Advantage population from 2003–2004. Methods Subjects were age 65+, with asthma, prior ICS use, and no chronic obstructive pulmonary disorder (n = 1,802. In 2004, 74.0% switched from having a $30 brand-copayment plan to a generic-only coverage plan (restricted coverage; 26% had $15–25 brand copayments in 2003–2004 (unrestricted coverage. Using linear difference-in-difference models, we examined annual changes in ICS use (measured by days-of-supply dispensed. There was a lower-cost ICS available within the study setting and we also examined changes in drug choice (higher- vs. lower-cost ICS. In multivariable models we adjusted for socio-demographic, clinical, and asthma characteristics. Results In 2003 subjects had an average of 188 days of ICS supply. Restricted compared with unrestricted coverage was associated with reductions in ICS use from 2003–2004 (-15.5 days-of-supply, 95% confidence interval (CI: -25.0 to -6.0. Among patients using higher-cost ICS drugs in 2003 (n = 662, more restricted versus unrestricted coverage subjects switched to the lower-cost ICS in 2004 (39.8% vs. 10.3%. Restricted coverage was not associated with decreased ICS use (2003–2004 among patients who switched to the lower-cost ICS (18.7 days-of-supply, CI: -27.5 to 65.0, but was among patients who did not switch (-38.6 days-of-supply, CI: -57.0 to -20.3. In addition, restricted coverage was associated with decreases in ICS use among patients with both higher- and lower-risk asthma (-15.0 days-of-supply, CI: -41.4 to 11.44; and -15.6 days-of-supply, CI: -25.8 to -5

  6. Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Rodriguez-Roisin R

    2016-08-01

    in 1 second values recorded at home and in the clinic (mean difference of -0.05 L, which may be due to suboptimal patient effort in performing unsupervised recordings. However, this difference remained consistent over time. Overall, these data demonstrate that home-based and in-clinic spirometric measurements were equally valid and reliable for assessing lung function in patients with COPD, and suggest that home-based spirometry may be a useful tool to facilitate analysis of changes in lung function on a day-to-day basis. Keywords: FEV1, home-based spirometry, inhaled corticosteroid, lung function, severe COPD

  7. Development and validation of a predictive model of failed stepping-down of inhaled corticosteroids in adult asthmatics

    Science.gov (United States)

    Yamasaki, Akira; Tomita, Katsuyuki; Kato, Kazuhiro; Fukutani, Kouji; Sano, Hiroyuki; Tohda, Yuji; Shimizu, Eiji

    2016-01-01

    Background Asthma guidelines suggest stepping-down of inhaled corticosteroids (ICSs) when asthma is stable. Objective To determine outcomes of stepping-down and prediction of outcome after stepping-down of ICSs in controlled adult asthma. Methods We performed a retrospective study on 21–81 year-old hospital-based outpatients with asthma in Japan. Protocol for stepping-down of ICSs was performed according to the GINA guideline. Failure/success of stepping-down is judged as occurring exacerbation or not for stepping-down of ICSs. Multiple logistic regression analysis was used to develop a prediction model for failed stepping-down, and then was validated by the leave-one-out cross-validation method. Our model of prediction score was calculated using receiver-operating characteristic area under the curve (AUC) analysis. The Nelson–Aalen curve demonstrated time to failure of stepping-down of ICSs. Results A total of 126 patients with asthma attempted the stepping-down of ICSs according to the guideline. Of patients with follow-up, 97 (77.0%) of stepping-down attempts were successful. Using multivariate logistic regression analysis, comorbidity with rhinitis/rhinosinusitis and phlegm grade were independent predictors of failed stepping-down of ICSs, with odds ratios of 3.8 (95% confidence interval, 1.04–13.3; P=0.04) and 1.3 (95% confidence interval, 1.01–11.5; P=0.04), respectively. These variables were then used to build a prediction score in terms of the prediction of failed stepping-down events. When the two variables were added to form the prediction score, the discriminative power of scores calculated by the prediction model using the AUC was 0.75 (range: 0.62–0.88) for naïve prediction and 0.72 (range: 0.60–0.86) after cross-validation. In the time-to-failure models, cumulative hazard ratio of failed stepping-down have fixed 1 year after stepping-down. Conclusion Our results suggest that comorbidity with rhinitis/rhinosinusitis and phlegm grade are

  8. Immunity to babesia in mice III. The effects of corticosteroids and anti-thymocyte serum on mice immune to babesia rodhaini

    OpenAIRE

    Zivkovic, D.; Speksnijder, J.E.; Kuil, H.; Seinen, W.

    1985-01-01

    BALB/c mice, immunized against babesia rodhaini by an amicarbalide controlled infection, were exposed to selective immunosuppressive treatment with corticosteroids and anti-thymocyte serum (ATS) respectively. Hydrocortisone acetate, 100 mg/kg, given i.p. six times during the three weeks after challenge inoculation caused a rising parasitaemia and high mortality (6/7). Dexamethasone in the drinking water at 20 mg/l or 10 mg/l for 22 days had a similar suppressive effect on the protection again...

  9. Melanin binding radiopharmaceuticals

    International Nuclear Information System (INIS)

    We have determined the biodistribution an uptake by the Greene melanoma in the Syrian golden hamster with 21 radiopharmaceuticals. Maximum % uptake and the time at which this occurred are listed. It is essential to know maximum tumor to background ration and the time after injection that this occurs to determine suitability for tumor scanning. The importance of species variation deserves mention. Detection of eye melanoma in humans was quite variable whereas in hamsters it was quite easy to obtain a positive scan with a single pinhole. We then looked at brain uptake in man and found it (the brain scan) to be significant. In addition, we found a high uptake by the lung, something not found in hamsters but not entirely unsuspected of a amine, such as 123I-4,3DMQ. Finally, our clinical experience has shown us some of the vagaries of melanoma-seeking radiopharmaceuticals. This reflects the complexity of melanin and melanin-binding and points out the necessity for a more detailed analysis of the mechanisms involved in melanin binding radionuclides

  10. Vitamin A status regulates glucocorticoid availability in Wistar rats: consequences on cognitive functions and hippocampal neurogenesis ?

    Directory of Open Access Journals (Sweden)

    Damien eBonhomme

    2014-02-01

    Full Text Available A disruption of the vitamin A signaling pathway has been involved in age-related memory decline and hippocampal plasticity alterations. Using vitamin A deficiency (VAD, a nutritional model leading to a hyposignaling of the retinoid pathway, we have recently demonstrated that retinoic acid (RA, the active metabolite of vitamin A, is efficient to reverse VAD-induced spatial memory deficits and adult hippocampal neurogenesis alterations. Besides, excess of glucocorticoids (GCs occurring with aging is known to strongly inhibit hippocampal plasticity and functions and few studies report on the counteracting effects of RA signaling pathway on GCs action. Here, we have addressed whether the modulation of brain GCs availability could be one of the biological mechanisms involved in the effects of vitamin A status on hippocampal plasticity and functions. Thus, we have studied the effects of a vitamin A-free diet for 14 weeks and a 4-week vitamin A supplementation on plasma and hippocampal corticosterone (CORT levels in Wistar rats. We have also investigated corticosteroid binding globulin (CBG binding capacity and 11beta-Hydrosteroid Dehydrogenase type 1 (11β-HSD1 activity, both important modulators of CORT availability at the peripheral and hippocampal levels respectively. Interestingly, we show that the vitamin A status regulates levels of free plasma CORT and hippocampal CORT levels, by acting through a regulation of CBG binding capacity and 11β-HSD1 activity. Moreover, our results suggest that increased CORT levels in VAD rats could have some deleterious consequences on spatial memory, anxiety-like behavior and adult hippocampal neurogenesis whereas these effects could be corrected by a vitamin A supplementation. Thus, the modulation of GCs availability by vitamin A status is an important biological mechanism that should be taken into account in order to prevent age-related cognitive decline and hippocampal plasticity alterations.

  11. Development and validation of a liquid chromatography-tandem mass spectrometry method for the simultaneous determination of nine corticosteroid residues in bovine liver samples

    Energy Technology Data Exchange (ETDEWEB)

    Dusi, Guglielmo, E-mail: guglielmo.dusi@izsler.it [Istituto Zooprofilattico Sperimentale della Lombardia e dell' Emilia Romagna, ' B. Ubertini' , Via Bianchi 9, 25124 Brescia (Italy); Gasparini, Mara; Curatolo, Michele; Assini, Walter; Bozzoni, Eros; Tognoli, Nadia; Ferretti, Enrica [Istituto Zooprofilattico Sperimentale della Lombardia e dell' Emilia Romagna, ' B. Ubertini' , Via Bianchi 9, 25124 Brescia (Italy)

    2011-08-26

    A liquid chromatography tandem mass spectrometry (LC-MS/MS) confirmatory method for the simultaneous determination of nine corticosteroids in liver, including the four MRL compounds listed in Council Regulation 37/2010, was developed. After an enzymatic deconjugation and a solvent extraction of the liver tissue, the resulting solution was cleaned up through an SPE Oasis HLB cartridge. The analytes were then detected by liquid chromatography-negative-ion electrospray tandem mass spectrometry, using deuterium-labelled internal standards. The procedure was validated as a quantitative confirmatory method according to the Commission Decision 2002/657/EC criteria. The results showed that the method was suitable for statutory residue testing regarding the following performance characteristics: instrumental linearity, specificity, precision (repeatability and intra-laboratory reproducibility), recovery, decision limit (CC{alpha}), detection capability (CC{beta}) and ruggedness. All the corticosteroids can be detected at a concentration around 1 {mu}g kg{sup -1}; the recoveries were above 62% for all the analytes. Repeatability and reproducibility (within-laboratory reproducibility) for all the analytes were below 7.65% and 15.5%, respectively.

  12. Development and validation of a liquid chromatography-tandem mass spectrometry method for the simultaneous determination of nine corticosteroid residues in bovine liver samples

    International Nuclear Information System (INIS)

    A liquid chromatography tandem mass spectrometry (LC-MS/MS) confirmatory method for the simultaneous determination of nine corticosteroids in liver, including the four MRL compounds listed in Council Regulation 37/2010, was developed. After an enzymatic deconjugation and a solvent extraction of the liver tissue, the resulting solution was cleaned up through an SPE Oasis HLB cartridge. The analytes were then detected by liquid chromatography-negative-ion electrospray tandem mass spectrometry, using deuterium-labelled internal standards. The procedure was validated as a quantitative confirmatory method according to the Commission Decision 2002/657/EC criteria. The results showed that the method was suitable for statutory residue testing regarding the following performance characteristics: instrumental linearity, specificity, precision (repeatability and intra-laboratory reproducibility), recovery, decision limit (CCα), detection capability (CCβ) and ruggedness. All the corticosteroids can be detected at a concentration around 1 μg kg-1; the recoveries were above 62% for all the analytes. Repeatability and reproducibility (within-laboratory reproducibility) for all the analytes were below 7.65% and 15.5%, respectively.

  13. Network of nuclear receptor ligands in multiple sclerosis: Common pathways and interactions of sex-steroids, corticosteroids and vitamin D3-derived molecules.

    Science.gov (United States)

    Rolf, Linda; Damoiseaux, Jan; Hupperts, Raymond; Huitinga, Inge; Smolders, Joost

    2016-09-01

    Sex-steroids, corticosteroids and vitamin D3-derived molecules have all been subject to experimental studies and clinical trials in a plethora of autoimmune diseases. These molecules are all derived from cholesterol metabolites and are ligands for nuclear receptors. Ligation of these receptors results in direct regulation of multiple gene transcription involved in general homeostatic and adaptation networks, including the immune system. Indeed, the distinct ligands affect the function of both myeloid and lymphoid cells, eventually resulting in a less pro-inflammatory immune response which is considered beneficial in autoimmune diseases. Next to the immune system, also the central nervous system is prone to regulation by these nuclear receptor ligands. Understanding of the intricate interactions between sex-steroids, corticosteroids and vitamin D3 metabolites, on the one hand, and the immune and central nervous system, on the other hand, may reveal novel approaches to utilize these nuclear receptor ligands to full extent as putative treatments in multiple sclerosis, the prototypic immune-driven disease of the central nervous system. PMID:27395031

  14. Determination of betamethasone and triamcinolone acetonide by GC-NCI-MS in excreta of treated animals and development of a fast oxidation procedure for derivatisation of corticosteroids.

    Science.gov (United States)

    Courtheyn, D; Vercammen, J; Logghe, M; Seghers, H; De Wasch, K; De Brabander, H

    1998-12-01

    The use of corticosteroids in combination with other hormonal substances has long been known to result in increased mass gain with bovines. Practice has demonstrated, however, that even the single use of a glucocorticoid may result in growth promoting effects. In addition to the popular dexamethasone, more recently other corticosteroids have also been misused for fattening purposes. The first part of this study deals with the detection of two of them, namely betamethasone and triamcinolone acetonide. Betamethasone was administered orally to a cow at a dose of 50 mg d-1 for 5 d, then later the same cow was injected intramuscularly with a dose of 50 mg of betamethasone dipropionate. Excretion in urine and faeces was followed with both HPLC-enzyme immunoassay and a previously described method based on negative chemical ionization mass spectrometry (NCI-MS) after oxidation. For the triamcinolone acetonide study a cow was treated with 50 mg d-1 of the drug during a 7 d period. Excretion in faeces was followed with GC-NCI-MS. As triamcinolone acetonide is resistant to the previously described oxidation procedure, however, a hydrolysis step had to be introduced prior to oxidation. In addition to this specific modification necessary for triamcinolone acetonide, in a subsequent part of this study the original oxidation procedure with pyridinium chlorochromate was re-investigated especially to shorten the procedure. With the introduction of potassium dichromate the reaction time could be decreased from 3 h to 10 min. PMID:10435270

  15. Quarkonium Binding and Entropic Force

    CERN Document Server

    Satz, Helmut

    2015-01-01

    A Q-Qbar bound state represents a balance between repulsive kinetic and attractive potential energy. In a hot quark-gluon plasma, the interaction potential experiences medium effects. Color screening modifies the attractive binding force between the quarks, while the increase of entropy with Q-Qbar separation gives rise to a growing repulsion. We study the role of these phenomena for in-medium Q-Qbar binding and dissociation. It is found that the relevant potential for Q-Qbar binding is the free energy F; with increasing Q-Qbar separation, further binding through the internal energy U is compensated by repulsive entropic effects.

  16. Alcohol Binding to the Odorant Binding Protein LUSH: Multiple Factors Affecting Binding Affinities

    OpenAIRE

    Ader, Lauren; Jones, David N. M.; Lin, Hai

    2010-01-01

    Density function theory (DFT) calculations have been carried out to investigate the binding of alcohols to the odorant binding protein LUSH from Drosophila melanogaster. LUSH is one of the few proteins known to bind to ethanol at physiologically relevant concentrations and where high-resolution structural information is available for the protein bound to alcohol at these concentrations. The structures of the LUSH–alcohol complexes identify a set of specific hydrogen-bonding interactions as cr...

  17. Expression of surface markers on peripheral CD4+CD25high T cells in patients with atopic asthma: role of inhaled corticosteroid

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background CD4+CD25+ regulatory T cells (Tregs) mediate immune suppression through cell-cell contact with surface molecules,particularly cytotoxic T lymphocyte-associated antigen 4 (CTLA-4),glucocorticoid-induced tumor necrosis factor receptor family-related protein (GITR),and transforming growth factor β(TGF-β),but little is known about the exact role of Tregs in the pathogenesis of asthma.This study sought to characterize the expression of surface markers on peripheral blood mononuclear cells-derived Tregs in patients with atopic asthma and healthy subjects,and to investigate the effect of inhaled corticosteroid on them.Methods The expression of surface molecules on CD4+CD25hign Tregs was detected by flow cytometry.The effect of inhaled corticosteroid on expression of the surface molecules on Tregs was determined in vivo and in vitro.Total serum immunoglobulin E (IgE) and high-sensitivity C-reactive protein were measured by enzyme linked immunosorbent assay and latex enhanced immunoturbidimetric assay,respectively.Results Equivalent numbers of peripheral Tregs were found in patients with atopic asthma (stable and acute) and healthy subjects.Tregs preferentially expressed CTLA-4, GITR,toll-like receptor 4 (TLR4),latency-associated peptide (LAP/TGF-β1),and forkhead box P3 (FOXP3).Patients with acute asthma had decreased numbers of CD4+CD25high LAP+ T cells compared to healthy subjects and stable asthmatics.Inhaled corticosteroid enhanced the percentage of Tregs expressing LAP in vivo and in vitro dose-dependently.Furthermore,the percentages of Tregs expressing LAP were negatively correlated with total serum IgE levels and severity of asthma,but positively correlated with forced expiratory volume in one second percentage of the predicted value in patients with asthma.Concluslons The results suggest that membrane-bound TGF-β1 is a potential candidate for predicting the severity of asthma,and may contribute to the sustained remission of asthma,Strategies targeting

  18. [3]tetrahydrotrazodone binding. Association with serotonin binding sites

    International Nuclear Information System (INIS)

    High (17 nM) and low (603 nM) affinity binding sites for [3]tetrahydrotrazodone ([3] THT), a biologically active analogue of trazodone, have been identified in rat brain membranes. The substrate specificity, concentration, and subcellular and regional distributions of these sites suggest that they may represent a component of the serotonin transmitter system. Pharmacological analysis of [3]THT binding, coupled with brain lesion and drug treatment experiments, revealed that, unlike other antidepressants, [3] THT does not attach to either a biogenic amine transporter or serotonin binding sites. Rather, it would appear that [3]THT may be an antagonist ligand for the serotonin binding site. This probe may prove of value in defining the mechanism of action of trazodone and in further characterizing serotonin receptors

  19. Reversion of severe hepatopulmonary syndrome in a non cirrhotic patient after corticosteroid treatment for granulomatous hepatitis: A case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Nikolaos Tzovaras; Aggelos Stefos; Sarah P Georgiadou; Nikolaos Gatselis; Georgia Papadamou; Eirini Rigopoulou; Maria Ioannou; Ioannis Skoularigis; Georgios N Dalekos

    2006-01-01

    Hepatopulmonary syndrome (HPS) is defined as a clinical triad including liver disease, abnormal pulmonary gas exchange and evidence of intrapulmonary vascular dilatations. We report a 61-year-old male presented with fatigue, long-lasting fever, loss of weight, signs of portal hypertension, hepatosplenomegaly, cholestasis and progressive dyspnoea over the last year. Clinical, laboratory and histological findings confirmed the diagnosis of granulomatous hepatitis. HPS due to hepatic granulomainduced portal hypertension was proved to be the cause of severe hypoxemia of the patient as confirmed by contrast-enhanced echocardiography. Reversion of HPS after corticosteroid therapy was confirmed by a new contrastenhanced echocardiography along with the normalization of cholestatic enzymes and improvement of the patient's conditions. This is the first case of complete reversion of HPS in a non-cirrhotic patient with hepatic granuloma,indicating that intrapulmonary shunt in liver diseases is a functional phenomenon and HPS can be developed even in miscellaneous liver involvement as in this case.

  20. Applicability of an exaggerated forearm wash test for efficacy testing of two corticosteroids, tacrolimus and glycerol, in topical formulations against skin irritation induced by two different irritants

    DEFF Research Database (Denmark)

    Clemmensen, A; Andersen, F; Petersen, T K;

    2011-01-01

    applied, we tested the efficacy of four anti-irritant compounds using the two different irritants sodium lauryl sulfate (SLS) and nonanoic acid (NON). Methods: In a randomized, double-blind, controlled trial, healthy volunteers were exposed to 5% SLS and 50% NON (the right and the left forearm......Background/Purpose: Alternatives to corticosteroids in the treatment of irritant contact dermatitis (ICD) are needed and may include glycerol and topical immunomodulators like tacrolimus. Because the efficacy of different treatments in experimentally induced ICD may vary depending on the irritant...... toward worsened irritancy by tacrolimus on SLS-irritated skin. Explained variance in the experiment by anova revealed a very small effect of treatments compared with an immense and significant subject effect. Conclusion: No claims of effective anti-irritant properties for any of the ointments can be...