A randomized clinical trial on inhaled ciclesonide for managing acute asthma in the emergency room

ABSTRACT BACKGROUND: Use of inhaled corticosteroids for managing acute asthma exacerbations has been tested since the 1990s. OBJECTIVE: To compare high doses of inhaled ciclesonide with systemic hydrocortisone for managing acute asthma exacerbations in the emergency department. DESIGN AND SETTING: Double-blind, randomized clinical trial in the public healthcare system of the city of São Paulo. METHODS: Fifty-eight patients with moderate or severe asthma with peak flow < 50% of predicted were randomized into two groups. Over the course of four hours, one group received 1440 mcg of inhaled ciclesonide plus hydrocortisone-identical placebo (ciclesonide + placebo), while the other received 500 mg of intravenous hydrocortisone plus ciclesonide-identical placebo (hydrocortisone + placebo). Both groups received short-acting bronchodilators (fenoterol hydrobromide and ipratropium bromide). The research protocol included spirometry, clinical evaluation, vital signs and electrocardiogram monitoring. Data were obtained at 30 (baseline), 60, 90, 120, 180, and 240 minutes. We compared data from baseline to hour 4, between and within groups. RESULTS: Overall, 31 patients received ciclesonide + placebo and 27 received hydrocortisone + placebo. Inhaled ciclesonide was as effective as intravenous hydrocortisone for improving clinical parameters (Borg-scored dyspnea, P = 0.95; sternocleidomastoid muscle use, P = 0.55; wheezing, P = 0.55; respiratory effort, P = 0.95); and spirometric parameters (forced vital capacity, P = 0.50; forced expiratory volume in the first second, P = 0.83; peak expiratory flow, P = 0.51). CONCLUSIONS: Inhaled ciclesonide was not inferior to systemic hydrocortisone for managing acute asthma exacerbations, and it improved both clinical and spirometric parameters. TRIAL REGISTRATION: RBR-6XWC26 - Registro Brasileiro de Ensaios Clínicos (http://www.ensaiosclinicos.gov.br/rg/RBR-6xwc26/).

Effects of Chronic Restraint Stress on Apoptosis of Amygdala Cells in Rats / 法医学杂志

OBJECTIVES@#To explore the damage effects of chronic restraint stress (CRS) on amygdala cells through the rat CRS model.@*METHODS@#The rat CRS model was established, and the changes in body weight and adrenal mass in control group and CRS group were monitored at 1 d, 7 d, 14 d and 21 d. The behavior changes were evaluated by the percentage of retention time of open arms and open arm entries using the elevated plus maze (EPM). ELISA was used to detect the concentrations of rat's corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH) and cortisol. The changes of expression of glucocorticoid receptor (GR) and glial fibrillary acidic protein (GFAP) in amygdala were determined by immunohistochemistry and Western blotting. Ultrastructure changes of glial cell were observed by transmission electron microscopy. The apoptosis rate of amygdala was measured by flow cytometry.@*RESULTS@#Compared with the control group at the same time points, body weight of CRS 1 d, 7 d, 14 d and 21 d groups increased slowly, but adrenal mass increased significantly; the serum level of CRH, cortisol and ACTH increased significantly at 7 d, 14 d and 21 d respectively; the expression of GR in amygdala was increased while that of GFAP was decreased; EPM test suggested that the percentage of retention time of open arms and open arm entries decreased significantly after 14 d. The CRS group showed different degrees of glial cell damage in amygdala, and the apoptosis rate of glial cell was significantly increased in 21 d group.@*CONCLUSIONS@#This study successfully established a CRS model in rats, and anxiety-like behavioral changes in model rats may be caused by apoptosis of amygdala astrocytes.

Cognitive functions in children with congenital adrenal hyperplasia

ABSTRACT Objective There is controversy regarding cognitive function in patients with congenital adrenal hyperplasia (CAH). This study is aimed at the assessment of cognitive functions in children with CAH, and their relation to hydrocortisone (HC) therapy and testosterone levels. Subjects and methods Thirty children with CAH due to 21 hydroxylase deficiency were compared with twenty age- and sex-matched healthy controls. HC daily and cumulative doses were calculated, the socioeconomic standard was assessed, and free testosterone was measured. Cognitive function assessment was performed using the Wechsler Intelligence Scale - Revised for Children and Adults (WISC), the Benton Visual Retention Test, and the Wisconsin Card Sorting Test (WCST). Results The mean age (SD) of patients was 10.22 (3.17) years [11 males (36.7%), 19 females (63.3%)]. Mean (SD) HC dose was 15.78 (4.36) mg/m 2 /day. Mean (SD) cumulative HC dose 44,689. 9 (26,892.02) mg. Patients had significantly lower scores in all domains of the WISC test, performed significantly worse in some components of the Benton Visual Retention Test, as well as in the Wisconsin Card Sorting Test. There was no significant difference in cognitive performance when patients were subdivided according to daily HC dose (< 10, 10 - 15, > 15 mg/m 2 /day). A positive correlation existed between cumulative HC dose and worse results of the Benton test. No correlation existed between free testosterone and any of the three tests. Conclusion Patients with CAH are at risk of some cognitive impairment. Hydrocortisone therapy may be implicated. This study highlights the need to assess cognitive functions in CAH.

In vivo study of the action of a topical anti-inflammatory drug in rat teeth submitted to dental bleaching

Abstract Bleaching gel containing hydrogen peroxide (H2O2) cause damages in pulp tissue. This study investigated the action of a topical anti-inflammatory, the Otosporin®, in rats' bleached teeth with the null hypothesis of which the Otosporin® is no able to minimize the pulp inflammation that bleaching gel generates. The rat's molars were divided into groups: BLE: bleached (35% H2O2 concentration /single application of 30 min); BLE-O: bleached followed by Otosporin® (10 min); and control: placebo gel. In the second day after dental bleaching, the rats were killed, and the jaws were processed for hematoxylin-eosin and immunohistochemistry analysis for tumor necrosis factor alpha (TNF-α), interleukin (IL)-6 and IL-17. The data collected were subjected to Kruskal-Wallis and Dunn statistical tests with at a 5% level of significance (p<0.05). The BLE group had moderate to strong inflammation in the occlusal third of the coronary pulp, with necrotic areas; and BLE-O, mild inflammation (p<0.05). There was a significant difference in the occlusal and middle thirds of the coronary pulp between the BLE with BLE-O and control groups (p<0.05). There was no difference in the cervical third (p>0.05). The BLE group had a high immunoexpression of TNF-α than BLE-O and control groups (p<0.05), with moderate and mild immunoexpression, respectively. Regarding IL-6 and IL-17, the BLE group had higher immunoexpression than control (p<0.05); the BLE-O was similar to the control (p>0.05). The topical anti-inflammatory Otosporin® can reduce pulp inflammation after dental bleaching in the rat teeth.

Resumo O gel clareador à base de peróxido de hidrogênio (H2O2) causa danos ao tecido pulpar. Este estudo investigou a ação de um anti-inflamatório tópico, o Otosporin®, nos dentes de ratos clareados com a hipótese nula de que o Otosporin® não é capaz de minimizar a inflamação da polpa gerada pelo gel clareador. Os molares dos ratos foram divididos em grupos: ClA: clareado (H2O2 a 35% / aplicação única de 30 min); CLA-O: clareado seguido do Otosporin® (10 min); e controle: gel placebo. No segundo dia após a clareação dentária, os ratos foram mortos e suas maxilas foram processadas para análise de hematoxilina-eosina e imunohistoquímica para o fator de necrose tumoral alfa (TNF-a), interleucina (IL)-6 e IL-17. Os dados coletados foram submetidos aos testes estatísticos de Kruskal-Wallis e Dunn com um nível de significância de 5% (p<0,05). O grupo CLA apresentou inflamação moderada à severa no terço oclusal da polpa coronária, com áreas necróticas; e CLA-O, inflamação leve (p<0,05). Houve diferença significativa nos terços oclusal e médio da polpa coronária entre o grupo CLA com os grupos CLA-O e controle (p<0,05). Não houve diferença no terço cervical (p>0,05). O grupo CLA apresentou maior imunoexpressão para TNF-a comparado aos grupos CLA-O e controle (p<0,05), com imunoexpressão moderada e leve, respectivamente. Em relação a IL-6 e IL-17, o grupo CLA apresentou maior imunoexpressão comparado ao controle (p<0,05); o CLA-O foi semelhante ao controle (p>0,05). O anti-inflamatório tópico Otosporin® pode reduzir a inflamação pulpar após clareação em dentes de ratos.

Comparison of the efficacy of losartan, hydrocortisone and acetylsalicylic acid (ASA) in preventing the development of fibrous scar tissue in skeletal muscle / Comparação da eficácia de losartana, hidrocortisona e ácido acetilsalicílico (AAS) na prevenção do desenvolvimento de tecido cicatricial fibroso nos músculos esqueléticos / Comparación de la eficacia de losartán, hidrocortisona y ácido acetilsalicílico (AAS) en la prevención del desarrollo de tejido cicatricial fibroso en los músculos esqueléticos

OBJECTIVE: To analyze fibrous scar tissue inhibition capacity with the use of losartan, hydrocortisone and acetylsalicylic acid. METHOD: The sample consisted of 120 male heterogeneic Wistar rats with a muscle laceration model. The rats were divided into four groups of 30 animals each: control group, losartan group, ASA group and hydrocortisone group. The animals were anesthetized and a 2.5 cm longitudinal incision was made in the left thoracolumbar paravertebral region. The muscles were subjected to a Grade III lesion caused by applying Kelly hemostatic forceps for 60 seconds, followed by sectioning with scissors. The skin was sutured with 3-0 nylon monofilament thread. The animals were placed in individual cages with plenty of food and water. The losartan group received losartan diluted in water at a dose of 0.1 mg/mL (10 mg/kg/day), the ASA Group received a 3 mg/mL ASA solution (300 mg/kg/day), and the hydrocortisone group received a 0.2 mg/mL hydrocortisone solution (20 mg/kg/day). RESULTS: The control, losartan, hydrocortisone and aspirin groups had a fibrotic area of 0.95 ± 0.35 mm, 0.55 ± 0.34 mm, 0.93 ± 0.33 mm, and 0.66 ± 0.36 mm, respectively. We observed a significantly smaller fibrotic area in the losartan group compared to the control (p=0.01) and hydrocortisone (p=0.01) groups. There were no significant differences among the other groups. CONCLUSION: The healing of striated skeletal muscle produced less fibrous scar tissue when exposed to losartan in comparison to the control group or the hydrocortisone group. Level of Evidence I; Randomized double-blind placebo-controlled study.

OBJETIVO: Analisar a capacidade de inibição de formação de tecido cicatricial fibroso com losartana, hidrocortisona e AAS. MÉTODOS: A amostra consistiu em 120 ratos Wistar heterogênicos machos com modelo de laceração muscular. Os ratos foram distribuídos em quatro grupos de 30 animais: grupo controle, grupo losartana, grupo AAS e grupo hidrocortisona. Os animais foram anestesiados e submetidos a uma incisão em sentido longitudinal de 2,5 cm de extensão na região paravertebral toracolombar esquerda, e os músculos sofreram uma lesão grau III com pinça hemostática de Kelly durante 60 segundos e posterior secção com tesoura. A pele foi suturada com nylon monofilamentar 3-0. Os animais foram colocados em gaiolas individuais, com água e alimento à vontade. O grupo losartana recebeu losartana diluída em água na dose de 0,1 mg/ml (10 mg/kg/dia), o grupo AAS recebeu solução de AAS 3 mg/ml (300 mg/kg/dia), o grupo hidrocortisona recebeu solução de hidrocortisona 0,2 mg/ml (20 mg/kg/ dia). RESULTADOS: Os grupos controle, losartana, hidrocortisona e AAS apresentaram área fibrótica de0,95 ± 0,35 mm, 0,55 ± 0,34 mm, 0,93 ± 0,33 mm, 0,66 ± 0,36 mm, respectivamente. Observou-se área fibrótica significativamente menor do grupo losartana em comparação com o grupo controle (p = 0,01) e hidrocortisona (p = 0,01). Nos demais grupos não houve diferença significativa. CONCLUSÃO: A cicatrização do músculo estriado esquelético produziu menos tecido cicatricial fibroso quando exposto à losartana do que quando comparado com o grupo controle ou o grupo hidrocortisona. Nível de Evidência I; Estudo duplo-cego randomizado controlado por placebo.

OBJETIVO: Analizar la capacidad de inhibición de formación de tejido cicatricial fibroso con losartán, hidrocortisona y AAS (ácido acetilsalicílico). MÉTODOS: La muestra consistió en 120 ratas Wistar heterogéneas machos con modelo de laceración muscular. Las ratas fueron distribuidas en cuatro grupos de 30 animales: grupo control; grupo losartán; grupo AAS y grupo hidrocortisona. Los animales fueron anestesiados y sometidos a una incisión longitudinal de 2,5 cm de extensión en la región paravertebral toracolumbar izquierda y los músculos sufrieron una lesión de grado III con pinza hemostática de Kelly durante 60 segundos y posterior sección con tijera. La piel se suturó con monofilamento de nylon 3-0. Los animales fueron dispuestos en jaulas individuales con abundante comida y agua. El grupo losartán recibió losartán diluido en agua a una dosis de 0,1 mg/ml (10 mg/kg/día), el grupo AAS recibió solución de AAS de 3 mg/ml (dosis 300 mg/kg/día), el grupo hidrocortisona recibió solución hidrocortisona de 0,2 mg/ml (20 mg/kg/día). RESULTADOS: Los grupos control, losartán, hidrocortisona y AAS mostraron área fibrótica de 0,95 ± 0,35 mm, 0,55 ± 0,34 mm, 0,93 ± 0,33 mm, 0,66 ± 0,36 mm, respectivamente. Se observó área fibrótica significativamente menor del grupo losartán en comparación con el grupo control (p = 0,01) e hidrocortisona (p = 0,01). En los demás grupos no hubo diferencias significativas. CONCLUSIÓN: La cicatrización del músculo estriado esquelético produjo menos tejido cicatricial fibroso cuando fue expuesto a losartán que cuando fue comparado con el grupo control o el grupo hidrocortisona. Nivel de Evidencia I; Estudio doble ciego aleatorio controlado por placebo.

Comparative randomized controlled blind study of the anti-shivering effect of hydrocortisone, granisetron and meperidine in post-spinal anesthesia in patients undergoing cesarean section

Background: it was observed that a considerable proportion of patients undergoing surgery experience intraoperative and postoperative hypothermia and it was found that misregulation of body temperature due to anesthesia as well as the cold temperature of the operation room were the main cause

Purpose: to compare the anti-shivering effect of meperidine, hydrocortisone and granisetron after spinal anesthesia during elective cesarean section

Patients and Methods: this study presents a placebo-controlled prospective randomized blind study. Included patients were randomly [using computer generated randomization table] allocated into four equal groups each group consists of 28 patients

Results: in our study, age, sex, and ASA grade distribution of patients were nearly identical in the four groups. Furthermore, the duration of surgery and amount of irrigation fluid used in the four different groups were also similar. We did not observe a change in temperature gradient between the four groups. A study with a more prolonged duration of postoperative temperature monitoring is needed to note if core-periphery temperature changes occur with passage of time

Conclusion: the results indicate that IV granisetron 40 micro g/kg was effective as IV meperidine 0.4 mg/kg and both are slightly effective than IV hydrocortisone 2 mg/kg in reducing the incidence and intensity of shivering during spinal anesthesia compared to control group

Frequency of serum cortisol suppression in patients using 0.05% clobetasol propionate as topical steroid for more than 3 weeks

Objective: To determine the frequency of serum cortisol suppression in patients using 0.05% clobetasol propionate as topical steroid for more than 3 weeks

Study Design: Cross sectional Study

Place and Duration of Study: Both outdoor and indoor patients of Dermatology Department, Military Hospital [MH] Rawalpindi for duration of 6 months i.e. from 18[th] April 2012 to 17[th] October 2012 were selected

Patients and Methods: A total of 189 patients were included in the study. Non-probability purposive sampling technique was used. Early morning [0800 hrs] serum for cortisol levels was taken before starting the treatment and same was repeated after 3 weeks at AFIP. Effect modifiers like age and gender were controlled through stratification. The data was analyzed using SPSS version 10. The quantitative variables like age, duration of illness were calculated by taking standard deviation and mean whereas the qualitative variables like gender, suppression of serum cortisol levels were calculated by taking percentages and frequency. Frequency of serum cortisol suppression was presented according to gender and age groups

Results: Majority of the patients selected were between 31-40 years i.e. 44.98% [n=85]. Gender distribution was 61.90% [n=117] males and 38.10% [n=72] females. Frequency of serum cortisol suppression in patients using 0.05% Clobetasol propionate as topical steroid for more than 3 weeks was seen in 33.33% [n=63]

Conclusion: The frequency of serum cortisol suppression was significantly higher amongst patients using clobetasol propionate 0.05%. Therefore patients prescribed clobetasol propionate 0.05% topically should be checked for serum cortisol suppression regularly if the application is intended to be used for more than 3 weeks

Hydrocortisone supresses inflammatory activity of metalloproteinase - 8 in carotid plaque / Hidrocortisona suprime a atividade inflamatória da metaloproteinase - 8 presente na placa carotídea

AbstractObjective:Matrix metalloproteinases are inflammatory biomarkers involved in carotid plaque instability. Our objective was to analyze the inflammatory activity of plasma and carotid plaque MMP-8 and MMP-9 after intravenous administration of hydrocortisone.Methods:The study included 22 patients with stenosis ≥ 70% in the carotid artery (11 symptomatic and 11 asymptomatic) who underwent carotid endarterectomy. The patients were divided into two groups: Control Group - hydrocortisone was not administered, and Group 1 - 500 mg intravenous hydrocortisone was administered during anesthetic induction. Plasma levels of MMP-8 and MMP-9 were measured preoperatively (24 hours before carotid endarterectomy) and at 1 hour, 6 hours and 24 hours after carotid endarterectomy. In carotid plaque, tissue levels of MMP-8 and MMP-9 were measured.Results:Group 1 showed increased serum levels of MMP- 8 (994.28 pg/ml and 408.54 pg/ml, respectively; P=0.045) and MMP-9 (106,656.34 and 42,807.69 respectively; P=0.014) at 1 hour after carotid endarterectomy compared to the control group. Symptomatic patients in Group 1 exhibited lower tissue concentration of MMP-8 in comparison to the control group (143.89 pg/ml and 1317.36 respectively; P=0.003). There was a correlation between preoperative MMP-9 levels and tissue concentrations of MMP-8 (P=0.042) and MMP-9 (P=0.019) between symptomatic patients in the control group.Conclusion:Hydrocortisone reduces the concentration of MMP- 8 in carotid plaque, especially in symptomatic patients. There was an association between systemic and tissue inflammation.

ResumoObjetivo:As metaloproteinases são biomarcadores inflamatórios envolvidos na instabilidade da placa carotídea. O objetivo deste estudo foi analisar a atividade inflamatória da MMP-8 e MMP-9 plasmática e presente na placa carotídea, após administração intravenosa de hidrocortisona.Métodos:Participaram do estudo 22 pacientes portadores de estenose ≥ 70% em artéria carótida (11 sintomáticos e 11 assintomáticos), submetidos à endarterectomia de artéria carótida. Os pacientes foram divididos em dois grupos: Grupo Controle - não foi administrado hidrocortisona e Grupo 1 - foi administrado 500 mg intravenoso de hidrocortisona durante a indução anestésica. As dosagens plasmáticas de MMP-8 e MMP-9 foram efetuadas no pré-operatório (24 horas antes da endarterectomia de artéria carótida) e em 1 hora, 6 horas e 24 horas após endarterectomia de artéria carótida. Na placa carotídea foram mensurados os níveis teciduais de MMP-8 e MMP-9.Resultados:O grupo 1 exibiu elevação dos níveis séricos da MMP-8 (994,28 pg/ml e 408,54 pg/ml, respectivamente; P=0.045) e MMP-9 (106.656,34 e 42.807,69, respectivamente; P=0.014) em 1 hora após a endarterectomia de artéria carótida, em relação ao grupo controle. Os pacientes sintomáticos do grupo 1 exibiram menor concentração tecidual de MMP-8, em relação ao grupo controle (143,89 pg/ml e 1317,36, respectivamente; P=0.003). Houve correlação entre os níveis pré-operatórios de MMP-9 e as concentrações teciduais de MMP-8 (P=0.042) e MMP-9 (P=0.019) entre os pacientes sintomáticos do grupo controle.Conclusão:A hidrocortisona reduz a concentração de MMP-8 na placa carotídea, em especial nos pacientes sintomáticos. Houve associação entre a inflamação sistêmica e a tecidual.

Nível de cortisol salivar entre crianças em tratamento odontológico - Um estudo piloto / Salivary cortisol levels in children undergoing dental treatment - A pilot study

Objetivo: Situações capazes de induzir à ansiedade, como o tratamento odontológico, correlacionam-se com o aumento do cortisol livre circulante, o qual pode ser utilizado como indicador de estresse. O presente estudo determinou os níveis de cortisol salivar de crianças em tratamento odontológico.Métodos: Foram incluídas crianças com idade entre sete e dez anos atendidas em uma Faculdade de Odontologia no segundo semestre de 2010. Após preenchimento do prontuário clínico, duas amostras de saliva foram coletadas empregando o kit Salivettes®. As amostras foram coletadas em um dia de consulta odontológica, antes da realização do exame físico e imediatamente após o mesmo, enviadas para análise laboratorial por meio de ensaio de quimioluminescência. Os resultados obtidos foram expressos em µg/dL. O teste de Wilcoxon foi aplicado para verificar a diferença dos níveis de cortisol salivar antes e após a consulta na amostra total e entre crianças de mesmo sexo. O teste U de Mann-Whitney foi utilizado para análise da diferença entre grupos de crianças do sexo masculino e feminino. Adotou-se o nível de significância de 5%. Resultados: Dezenove crianças participaram da amostra final (9 meninos e 10 meninas). Para a amostra total, as médias de cortisol determinadas foram 0,14 µg/dL e 0,09 µg/dL, nas coletas antes e após a consulta, respectivamente, com diferença significativa (P=0.002). Observou-se redução significativa no nível de cortisol salivar após a realização da consulta (P=0.011) entre as meninas. Conclusão: O período anterior a uma consulta odontológica pode gerar maior ansiedade/estresse entre crianças do que a própria consulta...

Objective: Situations capable of inducing anxiety, such as dental treatment, are associated with an increase of circulating free cortisol, which may be used as a stress indicator. This study measured the salivary cortisol levels of children undergoing dental treatment. Method: Children aged 7 to 10 years undergoing dental treatment at a Dental School in the 2nd semester of 2010 were enrolled in the study. After filling dental chat, two samples of saliva were collected with a Salivettes® kit on the consultation day before and immediately after the physical examination. The samples were sent for laboratory analysis by the chemiluminescence assay. The obtained results were expressed in Ág/dL. The Wilcoxon test was used to verify the difference in the salivary cortisol levels before and after the dental consultation in the whole population and among children of the same gender. The Mann-Whitney U test was used to analyze the differences between the female and male children. The significance level was set at 5%. Results: Nineteen children (9 boys and 10 girls) comprised the final sample. The whole population exhibited cortisol levels of 0.14 Ág/dL and 0.09 Ág/dL before and after the consultation, respectively, with a statistically significant difference between them (p=0.002). Among the girls, there was a significant decrease of salivary cortisol levels after the consultation (p=0.011). Conclusion: The period that antecedes a dental consultation may produce greater anxiety/stress in children than the consultation itself...

Effects of Postnatal Dexamethasone or Hydrocortisone in a Rat Model of Antenatal Lipopolysaccharide and Neonatal Hyperoxia Exposure

The aim of our study was to investigate the differential effects of dexamethasone (DXM) and hydrocortisone (HCS) on somatic growth and postnatal lung development in a rat model of bronchopulmonary dysplasia (BPD). A rat model of BPD was induced by administering intra-amniotic lipopolysaccharide (LPS) and postnatal hyperoxia. The rats were treated with a 6-day (D1-D6) tapering course of DXM (starting dose 0.5 mg/kg/day), HCS (starting dose 2 mg/kg/day), or an equivalent volume of normal saline. DXM treatment in a rat model of BPD induced by LPS and hyperoxia was also associated with a more profound weight loss compared to control and LPS + O2 groups not exposed to corticosteroid, whereas HCS treatment affected body weight only slightly. Examination of lung morphology showed worse mean cord length in both LPS + O2 + DXM and LPS + O2 + HCS groups as compared to the LPS + O2 alone group, and the LPS + O2 + DXM group had thicker alveolar walls than the LPS + O2 group at day 14. The HCS treatment was not significantly associated with aberrant alveolar wall thickening and retarded somatic growth. The use of postnatal DXM or HCS in a rat model of BPD induced by intra-amniotic LPS and postnatal hyperoxia appeared detrimental to lung growth, but there was less effect in the case of HCS. These findings suggest that effect of HCS on somatic growth and pulmonary outcome may be better tolerated in neonates for preventing and/or treating BPD.

Tissue reaction to Endométhasone sealer in root canal fillings short of or beyond the apical foramen

OBJECTIVE: This study evaluated the response of periapical tissues to the endodontic sealer Endométhasone in root canal fillings short of or beyond the apical foramen. MATERIAL AND METHODS: Twenty root canals of premolars and incisors of 2 mongrel dogs were used. After coronal access and pulp extirpation, the canals were instrumented up to a size 55 K-file and the apical cemental barrier was penetrated with a size 15 K-file to obtain a main apical foramen, which was widened to a size 25 K-file. The canals were irrigated with saline at each change of file. The root canals were obturated either short of or beyond the apical foramen by the lateral condensation of gutta-percha and Endométhasone, originating 2 experimental groups: G1: Endométhasone/short of the apical foramen; G2: Endométhasone/beyond the apical foramen. The animals were killed by anesthetic overdose 90 days after endodontic treatment. The individual roots were obtained and serial histological sections were prepared for histomorphological analysis (H&E and Brown & Brenn techniques) under light microscopy. The following parameters were examined: closure of the apical foramen of the main root canal and apical opening of accessory canals, apical cementum resorption, intensity of the inflammatory infiltrate, presence of giant cells and thickness and organization of the apical periodontal ligament. Each parameter was scored 1 to 4, 1 being the best result and 4 the worst. Data were analyzed statistically by the Wilcoxon nonparametric tests (p=0.05). RESULTS: Comparing the 2 groups, the best result (p<0.05) was obtained with root canal filling with Endométhasone short of the apical foramen but a chronic inflammatory infiltrate was present in all specimens. CONCLUSIONS: Limiting the filling material to the root canal space apically is important to determine the best treatment outcome when Endométhasone is used as sealer.

Effects of hydrocortisone and aminophylline on the aggregation of equine platelets in vitro

The purpose of this study was to evaluate in vitro the effects of hydrocortisone and aminophylline on adenosine diphosphate (ADP)-induced platelet aggregation in horses. Blood samples from 30 healthy Thoroughbred horses were collected by via jugular venipuncture to assess platelet aggregation. Platelet-rich and platelet-poor plasma were prepared from all samples by centrifugation and divided into three different aliquots. In the first aliquot, platelet aggregation was measured after platelet activation with 1 microM and 0.5 microM ADP (Group A). In the other two aliquots, the effect of a 10 min preincubation with hydrocortisone (Group B) or aminophylline (Group C) on ADP-induced aggregation at final ADP concentrations of 1 microM and 0.5 microM was observed. Platelet aggregation, recorded by an aggregometer, was evaluated by measuring the maximum degree of platelet aggregation and the initial velocities of platelet aggregation were obtained. Our results demonstrated the inhibitory effect of hydrocortisone and the induction effect of aminophylline on equine platelet responses in vitro.

Cardioprotective effects of exogenous and endogenous hydrocortisone in the rabbit model of ischemia-reperfusion / Efectos cardioprotectores de la hidrocortisona exógena y endógena en el modelo isquemia-reperfusión de conejo

Reducing the infarct size in acute myocardial infarction is one of the most important goals driving new drug research and development. During the last two decades, many clinical studies have found cardioprotective effects of corticosteroids, but their exact role in ischemic preconditioning remains questionable. The aim of the present study was to determine the protective effects of hydrocortisone sodium succinate on myocardial preconditioning in rabbit hearts. Twenty-four male New Zealand rabbits were divided randomly & equally in four groups: 1) control, 2) Infarct, 3) Ischemic preconditioning (IP) and 4) Hydrocortisone (HYD). The HYD group received 50mg/kg Hydrocortisone 45min before major ischemia. Serum levels of cardiac troponin-T(cTNT) and cortisole were measured before and after the protocols. Triphenyl-tetrazolium chloride staining was used to determine the infarcted area. In the present study, exogenous hydrocortisone decreased infarct size by 53 percent in comparison to the infarct group. Serum level of cortisole was increased in the IP and HYD groups, and was significant in the HYD group (p<0.01). An increasing trend in cortisole level was associated with a decreasing trend in infarct size and cTNT in the IP and HYD groups (p>0.01). In conclusion, we showed that hydrocortisone has cardioprotective effects when injected before the onset of myocardial infarction. In addition, we have proposed for the first time that endogenous hydrocortisone may play a role in ischemic preconditioning phenomena.

La reducción del tamaño del infarto en el infarto agudo de miocardio es una de las metas más importantes que impulsan la investigación y el desarrollo de nuevos fármacos. Durante las dos últimas décadas, muchos estudios clínicos han encontrado efectos cardioprotectores de los corticosteroides, pero su papel exacto en el preacondicionamiento isquémico sigue siendo cuestionable. El objetivo del presente estudio fue determinar los efectos protectores de succinato sódico de hidrocortisona en el preacondicionamiento del miocardio en el corazón de conejo. Veinticuatro conejos neozelandeses machos fueron divididos al azar en cuatro grupos : 1) control, 2) infarto, 3) preacondicionamiento isquémico (PI) y 4) Hidrocortisona (HYD). El grupo HYD recibió 50 mg/kg de hidrocortisona 45 minutos antes de la isquemia mayor. Los niveles séricos de troponina cardíaca T (cTNT) y cortisol se midieron antes y después de los protocolos. Se utilizó la tinción cloruro de trifenil-tetrazolio para determinar el área infartada. En el presente estudio, la hidrocortisona exógena disminuyó el tamaño del infarto en un 53 por ciento en comparación con el grupo de infarto. Los niveles séricos de cortisol se incrementaron en los grupos IP y HYD, siendo significativa en el grupo de HYD (p <0,01). Un aumento en el nivel cortisol se asoció con la disminución del tamaño del infarto y la cTNT en los grupos IP y HYD (p> 0,01). En conclusión, hemos demostrado la hidrocortisona tiene efectos cardioprotectores cuando se inyecta antes de la aparición del infarto al miocardio. Además, hemos propuesto, por primera vez que la hidrocortisona endógena puede jugar un papel en los fenómenos de preacondicionamiento isquémico.

Efeito do ácido ascórbico e da hidrocortisona na cicatrização anastomótica intestinal / Effect of ascorbic acid and hidrocortisone on intestinal anastomotic tension

OBJETIVO: Comparar a resistência cicatricial de anastomoses jejunais em ratos, submetidos à administração de vitamina C e de hidrocortisona, em distintos períodos pós-operatórios. MÉTODOS: Foram estudados 40 ratos Wistar, submetidos à secção e subsequente anastomose término-terminal de segmento jejunal, a 10 cm da flexura duodenojejunal. Os animais foram distribuídos em quatro grupos (n=10): Grupo I - controle; Grupo II - administração de vitamina C oral 100 mg/kg; Grupo III - administração de hidrocortisona intraperitoneal 10 mg/kg; Grupo IV - administração de vitamina C mais hidrocortisona nas doses e vias de administração acima. Avaliaram-se as pressões de ruptura anastomótica no 5º e 21º dias do pós-operatório. RESULTADOS: Os ratos que receberam vitamina C isolada ou associada a hidrocortisona tenderam a ter pressão de ruptura maior do que os demais grupos, tanto no 5º quanto no 21º dia pós-operatório. CONCLUSÃO: A vitamina C contribui para aumentar a resistência das anastomoses jejunais dos ratos durante os primeiros cinco dias do pós-operatório. A resistência das anastomoses jejunais murinas foi pouco influenciada pela administração de corticóide intraperitoneal.

OBJECTIVE: The effects of vitamin C and hidrocortisone on anastomotic healing process are controversial. The objective of the present paper was to compare the jejunal anastomotic tension in different postoperative periods. METHODS: 40 male rats weighing 200 to 400 grams were submitted to laparotomy. The jejunum was transversally cut 10 cm from the duodenojejunal flexure, and subsequently anastomosed. The rats were divided into four groups (n=10). Group I - control, Group II - oral administration of vitamin C (100 mg/kg), Group III - intraperitoneal administration of hidrocortisone (10 mg/kg), and Group IV - administration of vitamin C and hidrocortisone at the above mentioned doses. The anastomotic resistance was determined by using bursting pressure test on the 5th and 21st postoperative days. RESULTS: The resistances of the groups with vitamin C, isolated or associated to hidrocortisone trend to be higher in both postoperative periods. However, the administration of intraperitoneal steroid did not change the resistance of murine jejunal anastomosis. CONCLUSION: The results of the present study suggest that vitamin C enhances the resistance of jejunal anastomosis in the rat.

Effect of cortisol on female freshwater fish Notopterus notopterus.

In the present study, effect of cortisol on the ovary of the freshwater fish Notopterus notopterus was studied during four phases of the reproductive cycle. The hormone was injected 60microg/fish for ten days. Cortisol in fish is known to increase the metabolic activity. After the hormone treatment the ovarian somatic index and the hepatosomatic index increases during non breeding phase. The young oocytes transferred into vitellogenic oocytes in all the phases after cortisol treatment. The cortisol induced increased ovarian activity may be due to increase in the metabolic activity through the involvement of hepatic cells specially during non-breeding period providing support for energy production for reproductive activity in the freshwater fish N. notopterus.

Behavior in Mus musculus of Schistosoma mansoni from mollusks treated with hydrocortisone

Vinte camundongos foram expostos a cercárias oriundas de moluscos tratados com hidrocortisona e outros vinte receberam cercárias de moluscos não tratados. O comportamento dos parasitas dos dois grupos foi comparado com base na habilidade das cercárias em penetrar nos camundongos, no número total de vermes recuperados, após oito semanas de infecção, na relação entre o número de cercárias penetrantes e o número de vermes recuperados e o número de ovos nas fezes. O tratamento dos moluscos com hidrocortisona não alterou a habilidade das cercárias em penetrar nos camundongos nem afetou o número total de vermes recuperados. O número de vermes fêmeas, o número de vermes acasalados e o número de ovos nas fezes aumentaram em camundongos infectados por cercárias de moluscos tratados com hidrocortisona.

Scanning electron microscopic evaluation of effect of cortisol on chloride cells of tilapia, Oreochromis mossambicus.

The effect of exogenous administration of cortisol (0.2 microg/g body weight) for 24, 48 and 72 hr on the gill epithelium of Tilapia has been studied. The results clearly revealed that out of the three sub-types of chloride cells viz., shallow basin, wavy convex and deep hole, the shallow basin ones are the most abundant in number. In vivo administration of cortisol conspicuously increased the number of the shallow basin chloride cells and caused noticeable changes in the microridges of pavement cells right from 24 hr treatment onwards. The present study confirms heterogeneity of chloride cells in teleosts.

Effects of steroid hormones on total brain Na(+)-k+ ATPase activity in Oreochromis mossambicus.

The effects of administration of cortisol, corticosterone, testosterone, progesterone and a synthetic estrogen. diethylstilbestrol (DES) on total brain Na(+)-K+- ATPase were investigated in tilapia, O. mossambicus. Exogenous administration of 0.125 and 0.25 microg/g body weight of glucocorticoids and 0.125, 0.25 and 0.5 microg/g body weight of DES for 5 days significantly stimulated Na+(-) K+ ATPase activity by 14-41% in the brain, while 0.5 microg/g body weight of glucocorticoids did not evoke any response on the activity of the enzyme. Progesterone (0.125 and 0.25 microg/g body weight) administration significantly decreased the enzyme activity by 21-36% and high dose (0.5 microg/g body weight) was ineffective. Testosterone exhibited a biphasic effect on Na(+)-K+ ATPase activity--a low dose stimulated by 14% while middle and high doses inhibited it by 19-24%. The results seem to be the first report on the effect of steroids on brain ATPase activity in a teleost. When 0.25microg/g body weight of actinomycin D or puromycin was administered prior to the treatment of similar doses of hormones, the inhibitors significantly inhibited the effect of the hormones by 24-52%. This clearly shows that the effect of the hormones was sensitive to the action of inhibitors suggesting a possible genomic mode of action under long-term treatment. The results suggest that cortisol, corticosterone and DES may possibly stimulate the co-transport of glucose and excitation of membrane potential while progesterone and testosterone inhibit them in the brain of O. mossambicus by regulating the activity of Na(+)-K+ ATPase.

Metallothionein in male reproductive organs of adrenalectomized and hydrocortisone-treated Wistar rats.

Adrenalectomy resulted in an increase in metallothionein (MT) levels in testes, caput and cauda epididymis and prostate of rats but not in seminal vesicles where its levels decreased significantly. Inspite of administration of hydrocortisone, MT in testes, prostate (1.2 mg), caput (0.3 mg days 2, 8; 0.6 mg and 1.2 mg) and seminal vesicles (0.3 mg day 2, 4; 0.6 mg and 1.2 mg) remained increased. Thus adrenal insufficiency/hydrocortisone has no direct influence on MT levels. However, the increased levels of MT can be related to its ability to protect the cells from free radical damage caused by atrophy of reproductive tissues in adrenalectomised rats. Exogenously administered hydrocortisone to ADX rats resulted in return to ADX state as hydrocortisone metabolizes (half-life < 12 hr) and hence MT levels remained increased. The observations could provide a clue for the physiological functioning of the male reproductive tissue in a state of adrenal deprivation and hormonal supplementation.

Morphometrical and stereological analysis of the superior cervical ganglion of rattus norvegicus submitted to chronic treatment with cortisol

The present work investigates the corticoid action on the growth of the superior cervical ganglion of the rat and describes the cortisol effect during early stages of development. The study was based on morphometric and stereological analysis of the perikarya. Eight rats were treated intraperitoneally with cortisol (1mg/Kg/day) during 36 days. Treatment was initiated in the 8th day after birth and was withdrawn one day before the sacrifice. There was a significant difference (úP0,05) for the neural mean diameter between the control group (16.78 ± 1.11mm) and treated animals (15.84 ± 0.99mm). The decrease of perikarya neuronal diameter was also demonstrated by stereological methods. Morphometrical findings may suggest alterations in superior cervical ganglion neuronal activity in rats treated for long term with cortisol.