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2.
Transl Vis Sci Technol ; 13(6): 13, 2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38899953

RESUMEN

Purpose: To compare gene expression changes following branch retinal vein occlusion (BRVO) in the pig with and without bevacizumab (BEV) and triamcinolone acetonide (TA). Methods: Photothrombotic BRVOs were created in both eyes of four groups of nine pigs (2, 6, 10, and 20 days). In each group, six pigs received intravitreal injections of BEV in one eye and TA in the fellow eye, with three pigs serving as untreated BRVO controls. Three untreated pigs served as healthy controls. Expression of mRNA of vascular endothelial growth factor (VEGF), glial fibrillary acidic protein (GFAP), dystrophin (DMD), potassium inwardly rectifying channel subfamily J member 10 protein (Kir4.1, KCNJ10), aquaporin-4 (AQP4), stromal cell-derived factor-1α (CXCL12), interleukin-6 (IL6), interleukin-8 (IL8), monocyte chemoattractant protein-1 (CCL2), intercellular adhesion molecule 1 (ICAM1), and heat shock factor 1 (HSF1) were analyzed by quantitative reverse-transcription polymerase chain reaction. Retinal VEGF protein levels were characterized by immunohistochemistry. Results: In untreated eyes, BRVO significantly increased expression of GFAP, IL8, CCL2, ICAM1, HSF1, and AQP4. Expression of VEGF, KCNJ10, and CXCL12 was significantly reduced by 6 days post-BRVO, with expression recovering to healthy control levels by day 20. Treatment with BEV or TA significantly increased VEGF, DMD, and IL6 expression compared with untreated BRVO eyes and suppressed BRVO-induced CCL2 and AQP4 upregulation, as well as recovery of KCNJ10 expression, at 10 to 20 days post-BRVO. Conclusions: Inflammation and cellular osmohomeostasis rather than VEGF suppression appear to play important roles in BRVO-induced retinal neurodegeneration, enhanced in both BEV- and TA-treated retinas. Translational Relevance: Inner retinal neurodegeneration seen in this acute model of BRVO appears to be mediated by inflammation and alterations in osmohomeostasis rather than VEGF inhibition, which may have implications for more specific treatment modalities in the acute phase of BRVO.


Asunto(s)
Inhibidores de la Angiogénesis , Bevacizumab , Citocinas , Modelos Animales de Enfermedad , Inyecciones Intravítreas , Oclusión de la Vena Retiniana , Triamcinolona Acetonida , Animales , Bevacizumab/farmacología , Bevacizumab/uso terapéutico , Triamcinolona Acetonida/farmacología , Triamcinolona Acetonida/administración & dosificación , Triamcinolona Acetonida/uso terapéutico , Oclusión de la Vena Retiniana/tratamiento farmacológico , Oclusión de la Vena Retiniana/metabolismo , Inhibidores de la Angiogénesis/farmacología , Inhibidores de la Angiogénesis/uso terapéutico , Inhibidores de la Angiogénesis/administración & dosificación , Citocinas/metabolismo , Citocinas/genética , Porcinos , Factor A de Crecimiento Endotelial Vascular/metabolismo , Factor A de Crecimiento Endotelial Vascular/genética , ARN Mensajero/metabolismo , ARN Mensajero/genética , Glucocorticoides/farmacología , Glucocorticoides/uso terapéutico , Regulación de la Expresión Génica/efectos de los fármacos , Proteína Ácida Fibrilar de la Glía/metabolismo , Proteína Ácida Fibrilar de la Glía/genética , Canales de Potasio de Rectificación Interna
3.
Int Ophthalmol ; 44(1): 249, 2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-38907177

RESUMEN

OBJECTIVE: To investigate the macular morphological and visual outcomes of combined idiopathic epiretinal membrane (iERM) removal with triamcinolone acetonide (TA) injection based on consideration of the ectopic inner foveal layer (EIFL) staging scheme. METHODS: Retrospective case-control study. The clinical data of 84 eyes of 84 patients who underwent vitrectomy for iERM between 2018 and 2022 were reviewed. The enrolled subjects were divided into the TA and non-TA groups. Fifty-one eyes received intravitreal TA injection following vitrectomy and ERM peeling (TA group), and 33 were only treated by standard vitrectomy and ERM peeling (non-TA group). Preoperative and postoperative EIFL stages, central foveal thickness (CFT), and best-corrected visual acuity (BCVA) were compared between both groups. RESULTS: After a mean follow-up of 7.69 ± 3.68 months, both groups exhibited significant improvement in EIFL stages (P < 0.01), with no discernible advantage observed in the TA group. The TA and non-TA groups demonstrated improvement in the EIFL stages in 56.86 and 63.64% of eyes, respectively (P = 0.43). The CFT and BCVA significantly improved in both groups at the final visit (P < 0.01). However, CFT in the non-TA group displayed a more significant reduction during the follow-up (P < 0.03). Subgroup analysis revealed no significant differences in postoperative CFT and BCVA between the two groups in cases with or without continuous EIFL (P > 0.10). CONCLUSION: Our findings indicate that combined intravitreal TA injection following ERM removal conferred no significant benefits in alleviating macular thickening or improving visual acuity in iERM.


Asunto(s)
Membrana Epirretinal , Fóvea Central , Glucocorticoides , Inyecciones Intravítreas , Tomografía de Coherencia Óptica , Triamcinolona Acetonida , Agudeza Visual , Vitrectomía , Humanos , Membrana Epirretinal/diagnóstico , Membrana Epirretinal/cirugía , Estudios Retrospectivos , Masculino , Femenino , Tomografía de Coherencia Óptica/métodos , Glucocorticoides/administración & dosificación , Fóvea Central/patología , Vitrectomía/métodos , Triamcinolona Acetonida/administración & dosificación , Estudios de Casos y Controles , Anciano , Persona de Mediana Edad , Estudios de Seguimiento , Resultado del Tratamiento
4.
Medicine (Baltimore) ; 103(23): e37584, 2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38847669

RESUMEN

PURPOSE: To evaluate the clinical effects between dexamethasone and triamcinolone acetonide (TA) after phacoemulsification and intraocular lens implantation among cataract patients. METHODS: Pubmed, Embase, and the Cochrane Library were searched for studies published up to August 2020. The primary outcome was intraocular pressure. The secondary outcomes were the logarithm of the minimum angle of resolution (logMAR), anterior chamber cell, and anterior chamber flare. The pooled effect sizes were expressed as weighted mean differences (WMDs) or standardized mean differences (SMDs) of 95% confidence intervals (95% CIs). Cochrane Collaboration risk of bias tool and Newcastle-Ottawa scale criteria were used for the quality assessment of included studies. RESULTS: Seven relevant studies met the inclusion criteria. For the primary outcome, there was no significant difference between TA injection and dexamethasone in comparing intraocular pressure (IOP) (SMD = 0.22, 95% confidence interval [CI] [-0.29, 0.73], P = .408; I²â€…= 86.9%) in the first day after treatment and last day of assessment. For the secondary outcomes, the logMAR (WMD = 0.01, 95% CI [-0.06, 0.08]) and the anterior chamber flare (SMD = 0.08, 95% CI [-0.01, 0.18], P = .087; I²â€…= 0%) showed no differences. However, the amount of anterior chamber cells (SMD = -0.21, 95% CI [-0.42, -0.01], P = .044; I²â€…= 0%) in the TA injection on the first day postoperative was higher than for dexamethasone. After treatment, there was no difference between the 2 groups. CONCLUSIONS: This study supports that there were no differences in IOP, logMAR, and anterior chamber flare between TA injection and dexamethasone among cataract patients. TA injection treatment on the first day showed higher amounts of anterior chamber cells than with dexamethasone.


Asunto(s)
Dexametasona , Glucocorticoides , Triamcinolona Acetonida , Humanos , Extracción de Catarata/métodos , Dexametasona/administración & dosificación , Dexametasona/uso terapéutico , Glucocorticoides/administración & dosificación , Glucocorticoides/uso terapéutico , Presión Intraocular/efectos de los fármacos , Implantación de Lentes Intraoculares , Facoemulsificación/métodos , Resultado del Tratamiento , Triamcinolona Acetonida/administración & dosificación , Triamcinolona Acetonida/uso terapéutico
5.
Arch Dermatol Res ; 316(7): 368, 2024 Jun 08.
Artículo en Inglés | MEDLINE | ID: mdl-38850361

RESUMEN

Intralesional corticosteroid injections are a first-line treatment for keloids; yet clinical treatment results are highly variable and often suboptimal. Variation in triamcinolone acetonide (TAC) biodistribution may be an important reason for the variable effects of TAC treatment in keloids. In this exploratory study we investigated the biodistribution of TAC in keloids and normal skin using different drug delivery techniques. Fluorescent-labeled TAC suspension was administered into keloids and normal skin with a hypodermic needle and an electronic pneumatic jet injector. TAC biodistribution was represented by the fluorescent TAC volume and 3D biodistribution shape of TAC, using a 3D-Fluorescence-Imaging Cryomicrotome System. Twenty-one keloid and nine normal skin samples were analyzed. With needle injections, the mean fluorescent TAC volumes were 990 µl ± 479 in keloids and 872 µl ± 227 in normal skin. With the jet injector, the mean fluorescent TAC volumes were 401 µl ± 252 in keloids and 249 µl ± 67 in normal skin. 3D biodistribution shapes of TAC were highly variable in keloids and normal skin. In conclusion, TAC biodistribution in keloids is highly variable for both needle and jet injection. This may partly explain the variable treatment effects of intralesional TAC in keloids. Future research is needed to confirm this preliminary finding and to optimize drug delivery in keloids.


Asunto(s)
Queloide , Triamcinolona Acetonida , Queloide/tratamiento farmacológico , Queloide/patología , Humanos , Triamcinolona Acetonida/farmacocinética , Triamcinolona Acetonida/administración & dosificación , Adulto , Femenino , Distribución Tisular , Masculino , Persona de Mediana Edad , Inyecciones Intralesiones , Piel/metabolismo , Piel/patología , Piel/diagnóstico por imagen , Crioultramicrotomía/métodos , Adulto Joven , Imagenología Tridimensional , Sistemas de Liberación de Medicamentos/métodos
6.
Swiss Med Wkly ; 154: 3363, 2024 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-38885613

RESUMEN

BACKGROUND: Benign tracheal stenosis is relatively rare but remains a significant chronic disease due to its drastic symptoms including dyspnoea and inspiratory stridor, and consequent negative effect on quality of life. Traditionally, the surgical approach by resection of the stenotic tracheal segment has been the therapy of choice. However, endoscopic techniques have arisen and may offer a safe and less invasive alternative. OBJECTIVES: The aim of the retrospective study was to evaluate procedure-related safety and outcome of endoscopic treatment of benign tracheal stenosis at a single centre. METHODS: The study included all patients at our institution who between 2013 and 2022 had received endoscopic treatment of benign tracheal stenosis by rigid tracheoscopy, radial incision by electric papillotomy needle and dilation (endoscopic tracheoplasty) followed by triamcinolone acetonide as a local submucosal injection and additionally, from 2020, budesonide inhalation. RESULTS: A total of 22 patients were treated in a total of 38 interventions, each resulting in immediate improvement of symptoms. There were no peri-interventional complications or mortality. Of the 38 interventions, 11 received no triamcinolone acetonide administration, resulting in a 54.5% recurrence rate after an average of 21.1 (±18.0) months, while 27 had local triamcinolone acetonide, with a 37% recurrence rate. Since 2020, we additionally initiated post-interventional budesonide inhalation as recurrence prophylaxis for newly admitted patients and patients with recurrences(n = 8), of whom only one (12.5%) has to date experienced a recurrence. CONCLUSION: Our results indicate that endoscopic tracheoplasty offers a safe and successful, minimally invasive alternative to open surgery for patients with benign tracheal stenosis. We recommend local administration of triamcinolone into the mucosa as an additional treatment to decrease the risk of recurrence. However, given the uncontrolled study design and low sample size, safety and effectiveness cannot be conclusively demonstrated. Nonetheless, our findings suggest promising avenues for further investigation. Further studies on the additional benefit of inhaled corticosteroids are warranted.


Asunto(s)
Estenosis Traqueal , Humanos , Estenosis Traqueal/cirugía , Femenino , Masculino , Estudios Retrospectivos , Persona de Mediana Edad , Endoscopía/métodos , Adulto , Triamcinolona Acetonida/administración & dosificación , Triamcinolona Acetonida/uso terapéutico , Resultado del Tratamiento , Dilatación/métodos , Recurrencia , Anciano , Budesonida/administración & dosificación , Budesonida/uso terapéutico , Calidad de Vida , Glucocorticoides/administración & dosificación , Glucocorticoides/uso terapéutico
7.
Clin Exp Dent Res ; 10(3): e886, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38798063

RESUMEN

OBJECTIVE: This study evaluates the efficacy of a novel mucoadhesive patch containing Nigella sativa 10% extract compared to triamcinolone 0.1% in alleviating symptoms and reducing lesion severity in patients with erosive-atrophic oral lichen planus. METHODS AND MATERIALS: A pilot study comprising two groups, each with 10 patients, was conducted. The intervention group received mucoadhesive patches containing N. sativa 10% extract, while the control group received triamcinolone acetonide 0.1% patches. Pain and burning intensity, measured through visual analog scale, and lesion severity based on the Thongprasom scale were assessed weekly for 4 weeks. Descriptive records were kept for side effects and patient satisfaction. RESULTS: Pain and burning intensity decreased in both groups throughout the sessions, with the N. sativa group showing a greater reduction than the triamcinolone group. The reduction in burning intensity within each group was significant (p < .001), and there was a significant difference between groups only in the second session (p = .045). The overall difference between groups was not significant (p > .05). Lesion severity also decreased significantly in both groups (p < .001), with a significant difference between groups observed in the third session (p = .043) and overall throughout the study (p = .006). CONCLUSION: The use of N. sativa extract in mucoadhesive patches was as effective as corticosteroids in reducing pain, burning, and lesion severity in patients with oral lichen planus, with N. sativa showing superior results in some sessions. Notably, no significant complications were observed with N. sativa use, making it a promising treatment option for lichen planus.


Asunto(s)
Liquen Plano Oral , Nigella sativa , Extractos Vegetales , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antiinflamatorios/administración & dosificación , Liquen Plano Oral/tratamiento farmacológico , Nigella sativa/química , Dimensión del Dolor , Fitoterapia/métodos , Proyectos Piloto , Extractos Vegetales/administración & dosificación , Resultado del Tratamiento , Triamcinolona/administración & dosificación , Triamcinolona/uso terapéutico , Triamcinolona Acetonida/administración & dosificación , Triamcinolona Acetonida/uso terapéutico
9.
Front Endocrinol (Lausanne) ; 15: 1342530, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38586457

RESUMEN

Introduction: The aim of this study was to better understand the efficacy of various drugs, such as glucocorticoids and anti-vascular endothelial growth factors (VEGF), in the treatment of diabetic macular edema (DME), and to evaluate various clinical treatment regimens consisting of different therapeutic measures. Methods: This study included randomized controlled trials up to February 2023 comparing the efficacy of corticosteroid-related therapy and anti-VEGF therapy. PubMed, the Cochrane Library, and Embase were searched, and the quality of the studies was carefully assessed. Finally, 39 studies were included. Results: Results at 3-month followup showed that intravitreal injection of bevacizumab (IVB) + triamcinolone acetonide (TA) was the most beneficial in improving best-corrected visual acuity and reducing the thickness of macular edema in the center of the retina in patients with DME. Results at 6-month follow-up showed that intravitreal dexamethasone (DEX) was the most effective in improving patients' bestcorrected visual acuity and reducing the thickness of central macular edema. Discussion: Overall, IVB+TA was beneficial in improving best-corrected visual acuity and reducing central macular edema thickness over a 3-month follow-up period, while DEX implants had a better therapeutic effect than anti-VEGF agents at 6 months, especially the patients with severe macular edema and visual acuity impaired. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=397100, identifier CRD42023397100.


Asunto(s)
Diabetes Mellitus , Retinopatía Diabética , Edema Macular , Humanos , Diabetes Mellitus/tratamiento farmacológico , Retinopatía Diabética/tratamiento farmacológico , Glucocorticoides/uso terapéutico , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Triamcinolona Acetonida , Factor A de Crecimiento Endotelial Vascular
10.
J Vet Med Sci ; 86(5): 592-595, 2024 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-38616122

RESUMEN

In human and veterinary medicine, the treatment of synovial cysts involves medical or surgical approach. When medical treatment is chosen, triamcinolone acetonide is one of the most used drugs. In this case, intracystic triamcinolone was administered for the treatment of a non-infectious elbow synovial cyst in a subadult female Golden eagle (Aquila chrysaetos), unable to fly. The bird was brought to a wildlife rescue center after an aerial fight with a conspecific. After the treatment, no clinically detectable adverse effects were noted and there was no recurrence within two weeks. Given the improvement of the clinical conditions and the recovery of flight ability, the animal was released back into the wild 17 days after administration of the drug.


Asunto(s)
Enfermedades de las Aves , Águilas , Quiste Sinovial , Triamcinolona Acetonida , Animales , Femenino , Triamcinolona Acetonida/uso terapéutico , Triamcinolona Acetonida/administración & dosificación , Enfermedades de las Aves/tratamiento farmacológico , Quiste Sinovial/veterinaria , Quiste Sinovial/tratamiento farmacológico , Antiinflamatorios/uso terapéutico
11.
Skin Res Technol ; 30(4): e13713, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38634160

RESUMEN

OBJECTIVE: Alopecia areata (AA) is often characterized by sudden onset of patchy hair loss. Topical corticosteroid injection is the most common treatment. This study retrospectively observed the clinical efficacy of microneedle minoxidil combined with triamcinolone acetonide in the treatment of AA. METHODS: A total of 230 patients with AA were selected. The experimental group (n = 120) received physician training and home microneedle treatment with minoxidil combined with triamcinolone acetonide once a week. Topical minoxidil and triamcinolone acetonide were used twice daily at other times. The control group (n = 110) was treated with minoxidil combined with triamcinolone acetonide, twice a day. Cure rate, response rate, SALT, dermatological Quality of Life Index (DLQI), visual analogue (VAS), and cost were assessed at weeks 4 and 12. RESULTS: Treated group SALT score(Severity of Alopecia Tool) remarkable lower than control group after treated 4 and 12 weeks. After 12 weeks treatment, DLQI score of the treated group (1.8 ± 1.67) were significantly lower than those of the control group (2.45 ± 1.88) (p < 0.05). VAS score and adverse reaction between two group showed no significant different (p = 0.823, p = 0.484 respectively). The total cost was 53.93 ± 15.85 in the treatment group and 53.26 ± 11.51 in the control group. There was no significant difference between the two groups (p = 0.72). In the treated group, the complete response rate (CR: 78.33%) and total effective rate (CR+PR: 95%) were significantly higher than those in the control group (CR: 40.91% and CR+PR: 51.82%), with statistically significant differences (p < 0.001). CONCLUSION: Microneedle introduction of minoxidil and triamcinolone acetonide in the treatment of AA is a safe, effective, economical, and convenient method, with few adverse reactions, and has a good application prospect.


Asunto(s)
Alopecia Areata , Humanos , Alopecia Areata/tratamiento farmacológico , Triamcinolona Acetonida/uso terapéutico , Minoxidil/uso terapéutico , Estudios Retrospectivos , Calidad de Vida , Alopecia/tratamiento farmacológico , Resultado del Tratamiento
12.
Rom J Ophthalmol ; 68(1): 2-7, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38617715

RESUMEN

Objectives: The first purpose is to present the diagnosis and therapeutic approach in a patient with sterile endophthalmitis associated with triamcinolone acetonide injection. The secondary objective is to assess the incidence of this complication and to summarize the risk factors described in the literature. Case presentation: A 76-year-old male patient presented for painless, unilateral, decreased visual acuity, four days after cataract surgery and simultaneously intravitreal triamcinolone acetonide injection for diabetic macular edema in the right eye. The diagnosis of sterile endophthalmitis was made. Eight days after the presentation, the symptoms subsided, the maximum corrected visual acuity reaching that before the procedures. Discussions: The incidence of sterile endophthalmitis varies in the literature between 0% and 23.8%. Visual prognosis is good, although the pathogenesis is not fully understood. Preservatives in injectable solutions have been suggested, however, there are studies in which inflammation was also present with preservative-free products. The particle size of triamcinolone was analyzed, demonstrating an association between smaller particles and an increased frequency of adverse reactions of this type. History of uveitis, posterior capsule rupture following cataract surgery, and Irvine-Gass syndrome are other associations described. Conclusion: The physiopathological mechanism of sterile endophthalmitis is not fully understood. However, the visual prognosis is good, the final vision being dependent on the underlying pathology.


Asunto(s)
Catarata , Retinopatía Diabética , Endoftalmitis , Edema Macular , Masculino , Humanos , Anciano , Triamcinolona Acetonida/efectos adversos , Inyecciones Intravítreas , Edema Macular/diagnóstico , Edema Macular/tratamiento farmacológico , Edema Macular/etiología , Endoftalmitis/diagnóstico , Endoftalmitis/etiología
13.
Rom J Ophthalmol ; 68(1): 37-44, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38617725

RESUMEN

Aim: To assess the incidence, risk factors, and treatment outcomes in intravitreal triamcinolone acetonide injection (IVTA) induced intraocular pressure rise and to compare IOP rise in 1-mg and 2-mg IVTA. Materials and methods: Prospective observational study conducted in all eyes receiving IVTA. Any pre-existing glaucoma and patients who received IVTA or dexamethasone implant in the last 6 months were excluded. Results: 9 between 61-70 years of age developed an IOP spike. The mean and standard deviation of age in years was 61.95 ± 8.70. Maximum eyes had ME due to Diabetic Retinopathy (53.3%). All cases of uveitic ME were reported to have an IOP spike. 2 out of 3 high myopic eyes and 1 eye with thyroid abnormality had an IOP spike. High IOP was found in 13 eyes, with more than 25 mm Hg rise in 4 eyes and more than 5 mm Hg rise from baseline IOP in 9 eyes. The mean and standard deviation of time taken for IOP raise (in days) was 46.39 ± 37.68. A total of 38 eyes received 1 mg of IVTA and the rest 22 received 2 mg of IVTA. 23.7% of 1 mg eyes experienced an IOP rise while it was 18.2% in eyes with 2 mg IVTA. The injection was repeated in 12 eyes and 41.7% developed an IOP spike among them. The independent "t" test results showed that there was a significant difference in the mean of IOP (Pre-injection) concerning the IOP rise (P=0.007*). 1 eye had IVTA crystals in the anterior chamber with raised IOP of 30 mm Hg. 1 out of 13 eyes with raised IOP needed 2 AGMs, the other 12 eyes responded well to 1 AGM. Discussion: IVTA is widely used in refractory cases of ME and steroid-induced glaucoma is the most common side effect of IVTA. To the best of our knowledge, there is a lack of literature on prospective studies on IVTA-associated risk factors, patterns of IOP elevation, and treatment outcomes. The pre-injection mean ± SD baseline IOP for uneventful eyes was 12.87±2.65 and the pre-injection mean IOP for eyes with IOP event was 15.23±2.89 (P=0.007*). Conclusion: We proposed that TA is an independent risk factor for post-intravitreal injection IOP spike. IVTA causes a maximum IOP spike at 1 to 2 months and has a protracted course that responds to anti-glaucoma medications. High baseline IOP, a repeated dose of IVTA, the presence of TA crystals in the anterior chamber, and high myopia were associated with significant IOP elevation. Abbreviations: ACD = Anterior chamber depth, AS = Anterior segment, AGM = Anti-glaucoma medications, ARMD = Age-related macular degeneration, BCVA = Best-corrected visual acuity, BRVO = Branch retinal vein occlusion, CCT = Central corneal thickness, CRVO = Central retinal vein occlusion, CME = Cystoid macular edema, CNVM = Choroidal neovascularization membrane, CSME = Clinically significant macular edema, DR = Diabetic retinopathy, ERM = Epiretinal membrane, IOP = Intraocular pressure, IGS = Irvine-Grass syndrome, GAGs = Glycosaminoglycans, IVTA = Intravitreal triamcinolone acetonide injection, ME = Macular edema, NVG = Neovascular glaucoma, OHT = Ocular hypertension, PDS = Pigment dispersion syndrome, PACG = Primary closed angle glaucoma, POAG = Primary open-angle glaucoma, PXF = Pseudoexfoliation, VA = Visual acuity, VEGF = Vascular endothelial growth factors, VH = Vonherick's grading, SD = Standard deviation, TA = Triamcinolone acetonide, TIGR = Trabecular meshwork inducible glucocorticoid response.


Asunto(s)
Retinopatía Diabética , Glaucoma de Ángulo Abierto , Glaucoma , Degeneración Macular , Edema Macular , Miopía , Oclusión de la Vena Retiniana , Humanos , Agentes Antiglaucoma , Presión Intraocular , Edema Macular/diagnóstico , Edema Macular/tratamiento farmacológico , Estudios Prospectivos , Triamcinolona Acetonida , Persona de Mediana Edad , Anciano
14.
Eur Rev Med Pharmacol Sci ; 28(7): 2696-2700, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38639509

RESUMEN

OBJECTIVE: Patients with pollybeak deformity who underwent rhinoplasty were analyzed retrospectively and across centers to identify their primary risk factors, preventative measures, and treatment modalities. PATIENTS AND METHODS: The retrospective data of 100 pollybeak deformity cases (61 males and 39 females) were enrolled in our study. The causes leading to pollybeak deformity were evaluated and classified as (1) Over-resected bony dorsum, (2) Excessive supra tip scarring, and (3) Inefficient tip support causing an under-projected tip. The treatments applied to patients with pollybeak deformity were retrospectively evaluated and classified as (1) Triamcinolone acetonide injections (one or two injections), (2) Filler injection over the bony dorsum to balance, (3) Using a graft to achieve the desired nose shape, (4) Trimming down the excessive supra tip soft tissue and/or tip cartilage, and (5) Enforcing the tip support. RESULTS: Our results showed that the major cause of pollybeak deformity was excessive supra-tip scarring (48%). The other reasons are inefficient tip support, causing an under-projected tip (28%), and over-resected bony dorsum (24%). The modalities for the treatment of pollybeak deformity were (1) Trimming down the excessive supra tip soft tissue and/or tip cartilage (30%), (2) Triamcinolone acetonide injections (one or two injections) (28%), or (3) Enforcing the tip support (28%), (4) Using a graft to achieve the desired nose shape (14%) and (5) Filler injection over the bony dorsum to balance (6%). In some patients, more than one treatment modality was applied. Triamcinolone acetonide or filler injections were the non-surgical therapies for pollybeak deformities. CONCLUSIONS: We concluded that excessive supra-tip scarring is not directly related to a surgical error but rather depends on the patient and tissue healing. Care should be taken to avoid over-resecting the bony dorsum. Tip support should be provided to prevent inefficient tip support from causing an under-projected tip. However, efforts should be made to minimize supra-tip dead space and possibly proceeding pollybeak formation through proper bandaging.


Asunto(s)
Rinoplastia , Masculino , Femenino , Humanos , Rinoplastia/efectos adversos , Rinoplastia/métodos , Estudios Retrospectivos , Triamcinolona Acetonida/uso terapéutico , Cicatriz , Nariz
15.
J Drugs Dermatol ; 23(4): e102-e103, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38564383

RESUMEN

Inflammatory alopecia is an increasingly reported side effect of targeted cancer therapies. Here we report one case of inflammatory alopecia secondary to mitogen-activated protein kinase kinase (MEK) inhibitor agent Trametinib in a woman with ovarian cancer. Biopsies of the scalp were consistent with early scarring alopecia compatible with drug-induced alopecia. Significant improvement in hair loss occurred after treatment with intralesional Kenalog (ILK) injections and oral isotretinoin. Though acute alopecia has been described in patients using MEK inhibitors, this is the first reported case of inflammatory alopecia.  J Drugs Dermatol. 2024;23(4):7802.     doi:10.36849/JDD.7802e  .


Asunto(s)
Alopecia , Neoplasias Ováricas , Humanos , Femenino , Alopecia/inducido químicamente , Alopecia/diagnóstico , Alopecia/tratamiento farmacológico , Triamcinolona Acetonida , Inhibidores de Proteínas Quinasas/efectos adversos , Neoplasias Ováricas/tratamiento farmacológico , Quinasas de Proteína Quinasa Activadas por Mitógenos/efectos adversos , Proteínas Quinasas Activadas por Mitógenos
16.
Skeletal Radiol ; 53(8): 1573-1582, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38430274

RESUMEN

OBJECTIVE: To assess the clinical impact of diagnostic musculoskeletal (MSK) injections on treatment decision-making in adolescent and adult patients at a children's hospital. MATERIALS AND METHODS: Retrospective study in patients who underwent diagnostic MSK injections by fluoroscopy or ultrasound (US) between 8/2020 and 3/2023 at a children's hospital. Patients received ropivacaine and triamcinolone acetonide at pain site, reporting quantitative FACES pain score prior to, immediately following, and 2-3 days following injection. Impact on patient care was subsequently assessed. RESULTS: A total of 109 diagnostic fluoroscopic or US MSK injection referrals (mean: 17.6 years old) were included, most commonly hip (76.2%), ankle (9.2%), and iliopsoas tendon sheath (8.3%). Pain improvement occurred in 89.0% immediately and 67.9% 2-3 days after MSK injection, with net 84.4% exhibiting improvement based on pain scores and clinical exams. When there was pain improvement at the site of injection, there was a statistically higher incidence of operative intervention or additional therapeutic injections compared with the cohort that did not have symptom improvement (88% versus 35.3%, P < 0.0001). For the 15.6% (N = 17) of referrals that did not have pain improvement, 17.6% (n = 3) ultimately had an operative intervention at a separate site from the diagnostic injection, as an alternative etiology for the pain was found. CONCLUSION: Image-guided MSK injections play an important role in the management of musculoskeletal disorders. 84.4% of referrals experienced symptom relief, improving confidence for treatment decision-making. Importantly, 15.6% of patients were found to have an alternative etiology for symptoms, altering management altogether.


Asunto(s)
Anestésicos Locales , Hospitales Pediátricos , Dolor Musculoesquelético , Dimensión del Dolor , Ultrasonografía Intervencional , Humanos , Adolescente , Femenino , Masculino , Dolor Musculoesquelético/tratamiento farmacológico , Dolor Musculoesquelético/diagnóstico por imagen , Estudios Retrospectivos , Ultrasonografía Intervencional/métodos , Anestésicos Locales/administración & dosificación , Adulto , Fluoroscopía , Ropivacaína/administración & dosificación , Triamcinolona Acetonida/administración & dosificación , Niño , Radiografía Intervencional/métodos
18.
BMJ Case Rep ; 17(3)2024 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-38471701

RESUMEN

This report presents a unique case of recurrent idiopathic inferior oblique myositis (IOM) with a focus on clinico-radiological characteristics and histological features. A woman in her early 40s presented with a third episode of IOM following a 12-year period of quiescence. The first two episodes were characterised by unilateral IOM with rapid resolution following oral prednisone treatment. MRI revealed anterior focal enlargement of the left inferior oblique muscle with ipsilateral lacrimal gland enlargement. An inferior oblique muscle and lacrimal gland biopsy demonstrated significant inflammatory infiltrate. An intraorbital injection of triamcinolone acetonide was administered with complete resolution of symptoms within 1 week.


Asunto(s)
Miositis , Músculos Oculomotores , Femenino , Humanos , Inyecciones , Miositis/diagnóstico , Músculos Oculomotores/patología , Prednisona , Triamcinolona Acetonida , Adulto
19.
BMB Rep ; 57(4): 200-205, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38523372

RESUMEN

We conducted a comprehensive series of molecular biological studies aimed at unraveling the intricate mechanisms underlying the anti-fibrotic effects of triamcinolone acetonide (TA) when used in conjunction with fully covered self-expandable metal stents (FCSEMS) for the management of benign biliary strictures (BBS). To decipher the molecular mechanisms responsible for the anti-fibrotic effects of corticosteroids on gallbladder mucosa, we conducted a comprehensive analysis. This analysis included various methodologies such as immunohistochemistry, ELISA, real-time PCR, and transcriptome analysis, enabling us to examine alterations in factors related to fibrosis and inflammation at both the protein and RNA levels. Overall, our findings revealed a dose-dependent decrease in fibrosisrelated signaling with higher TA concentrations. The 15 mg of steroid treatment (1X) exhibited anti-fibrosis and anti-inflammatory effects after 4 weeks, whereas the 30 mg of steroid treatment (2X) rapidly reduced fibrosis and inflammation within 2 weeks in BBS. Transcriptomic analysis results consistently demonstrated significant downregulation of fibrosis- and inflammation-related pathways and genes in steroid-treated fibroblasts. Use of corticosteroids, specifically TA, together with FCSEMS was effective for the treatment of BBS, ameliorating fibrosis and inflammation. Our molecular biological analysis supports the potential development of steroid-eluted FCSEMS as a therapeutic option for BBS in humans resulting from various surgical procedures. [BMB Reports 2024; 57(4): 200-205].


Asunto(s)
Fibrosis , Inflamación , Triamcinolona Acetonida , Triamcinolona Acetonida/farmacología , Triamcinolona Acetonida/uso terapéutico , Inflamación/tratamiento farmacológico , Inflamación/patología , Humanos , Animales , Constricción Patológica/tratamiento farmacológico , Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéutico , Masculino , Stents
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