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1.
Skeletal Radiol ; 51(1): 161-169, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34136939

RESUMO

OBJECTIVE: A local anesthetic is frequently administered as part of a lumbar epidural steroid injection (LESI); however, there is a rare potential for this to result in transient paralysis if administered incorrectly. The purpose of this retrospective study is to determine if the addition of bupivacaine significantly improves patient-reported pain scores. MATERIALS AND METHODS: This retrospective review includes patients undergoing LESI over an approximately 1 year time span. Pre-procedure, immediate post-procedure, and 1-week integer scaled pain scores were recorded. Ordinal regression was used to compare the distributions of the aggregated ordinal pain score categories between bupivacaine- and non-bupivacaine-injected patients. RESULTS: Two hundred fifty-eight patients met the inclusion criteria (126F:132 M, mean age 64.7 years) with 164 receiving bupivacaine and steroids and 94 receiving steroids alone. The relative frequency distributions for pre-injection pain did not differ between the bupivacaine patients and the non-bupivacaine patients (p = 0.114). Similarly, the relative frequency distributions for immediate and 1-week post-procedure pain did not differ between the bupivacaine patients and the non-bupivacaine patients (p = 0.293 at immediate time point and p = 0.306 at 1-week time point). Odds ratios comparing pain severity change between the bupivacaine and non-bupivacaine patients also were not significantly different at either the immediate post-procedure (p = 0.769) or 1-week (p = 0.203) time points. CONCLUSION: The lack of a significant downward shift in the bupivacaine patients' post-procedure pain scores compared to the non-bupivacaine patients' post-procedure pain scores raises doubts about bupivacaine's utility as a standard component of a lumbar epidural injection.


Assuntos
Bupivacaína , Esteroides , Anestésicos Locais , Humanos , Injeções Epidurais , Pessoa de Meia-Idade , Dor , Estudos Retrospectivos , Resultado do Tratamento
2.
Theriogenology ; 177: 84-93, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34687940

RESUMO

MicroRNAs (miRNAs) are ∼22 nt RNAs that direct post-transcriptional repression of mRNA targets in diverse eukaryotic lineages. Granulosa cells (GCs) are the earliest differentiated follicular somatic cells. From the initiation of primordial follicles, their differentiation and growth are closely related to the development of follicles. The research on follicular development mostly focused on the granular layer, as well as the hormone synthesis induced by granulosa cell differentiation before and after follicular selection. In this study, we evaluated the effects of miR-23b-3p on chicken granulosa cells, including granulosa cell proliferation and steroid hormone synthesis. Elevated expression of miR-23b-3p significantly inhibited granulosa cell proliferation and steroid hormone synthesis, but did not affect apoptosis. Furthermore, it was observed that the forecast growth differentiation factor 9 (GDF9) is a target gene of miR-23b-3p and miR-23b-3p can down-regulate expression of GDF9. Overall, this study demonstrated that miR-23b-3p can regulate the proliferation and steroid hormone synthesis of chicken granulosa cells by inhibiting the expression of GDF9.


Assuntos
Fator 9 de Diferenciação de Crescimento , MicroRNAs , Animais , Proliferação de Células , Galinhas/genética , Feminino , Fator 9 de Diferenciação de Crescimento/genética , Hormônios , MicroRNAs/genética , Esteroides
3.
J Med Invest ; 68(3.4): 238-243, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34759137

RESUMO

Peripherally derived steroids affect steroid production in the brain via the blood-brain barrier. However, steroid concentrations are lower in the cerebrospinal fluid than those in the blood, indicating restricted influx of steroids because of their metabolization by choroid plexus (CP) epithelial cells. Here, we analyzed the gene expression of steroidogenic enzymes [cholesterol side-chain cleavage enzyme (P450scc), 17α-hydroxylase/C17-C20 lyase (P450c17), 3ß-hydroxysteroid dehydrogenase (3ß-HSD), 17ß-hydroxysteroid dehydrogenase type 1 (17ß-HSD1), aromatase (Cyp19a1), and 5α-reductase type 1 (5α-R1)]. These genes were expressed to a lesser extent in the CP than in the testis and to a similar extent in the cerebral cortex. However, P450scc levels were higher in the CP than in the cerebral cortex, whereas Cyp19a1 levels showed the opposite trend. We also evaluated the effects of orchiectomy and testosterone on the expression of these genes. P450c17 and 5α-R1 levels were unaffected by orchiectomy, whereas P450scc and 3ß-HSD levels were increased and decreased, respectively. Cyp19a1 expression increased upon testosterone treatment, whereas that of 17ß-HSD decreased upon orchiectomy or administration of testosterone. Immunohistochemistry analysis revealed that 17ß-HSD was expressed in the cytoplasm of CP epithelial cells. These results indicate that CP epithelial cells synthesize and convert the certain types of steroids to contribute to the homeostasis of steroids in the brain. J. Med. Invest. 68 : 238-243, August, 2021.


Assuntos
Enzima de Clivagem da Cadeia Lateral do Colesterol , Plexo Corióideo , Animais , Enzima de Clivagem da Cadeia Lateral do Colesterol/genética , Enzima de Clivagem da Cadeia Lateral do Colesterol/metabolismo , Plexo Corióideo/metabolismo , Masculino , Ratos , Esteroide 17-alfa-Hidroxilase/genética , Esteroide 17-alfa-Hidroxilase/metabolismo , Esteroides , Testosterona
4.
BMJ ; 375: n2599, 2021 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-34740898

RESUMO

The studyPujades-Rodríguez M, Morgan AW, Cubbon RM, Wu J. Dose-dependent oral glucocorticoid cardiovascular risks in people with immune-mediated inflammatory diseases: a population-based cohort study. PLoS Med 2020;17:e1003432.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/low-doses-steroids-increase-cardiovascular-risks-in-inflammatory-diseases/.


Assuntos
Doenças Cardiovasculares , Estudos de Coortes , Glucocorticoides , Humanos , Esteroides
5.
Am J Case Rep ; 22: e934460, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34767543

RESUMO

BACKGROUND Ulcerative colitis (UC) is a chronic autoimmune inflammatory disease of the colon that infrequently affects children. The disease requires immunosuppressive therapy to achieve remission and keep the disease in remission. Currently, many therapies are approved for use in pediatric patients with UC, including steroid, 5-aminosalicylic acid (5-ASA), azathioprine, and biologic therapy with anti-tumor necrosis factor (TNF) inhibitors. Despite their efficacy, many patients have refractory severe disease that fails therapy and may require surgical interventions. Recently, the small molecule Janus Kinase (JAK) inhibitor tofacitinib has been approved for moderate to severe UC that fails biologic therapy in adults. However, the safety and efficacy of this drug has not been tested in pediatric UC patients. CASE REPORT We describe a case of a 13-year-old girl with 2-year history of severe UC who had secondary loss response to both infliximab and adalimumab over 2 years, despite adequate trough serum drug levels and the concomitant use of azathioprine. She was also dependent on steroid to control her disease. Infectious work-ups were always negative for infectious organisms. She was then successfully treated with tofacitinib 5 mg orally twice daily. She went into complete clinical, endoscopic, and steroid-free remission. CONCLUSIONS This case report highlights the safety and efficacy of tofacitinib in pediatric patients with severe refractory UC, potentially avoiding proctocolectomy in this young patient population. Future research should study the role of tofacitinib in patients with moderate to severe UC in children.


Assuntos
Colite Ulcerativa , Adolescente , Adulto , Criança , Colite Ulcerativa/tratamento farmacológico , Feminino , Humanos , Piperidinas/uso terapêutico , Pirimidinas/uso terapêutico , Esteroides
6.
Medicina (Kaunas) ; 57(11)2021 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-34833499

RESUMO

Background and Objectives: Meconium aspiration syndrome (MAS) is a condition caused by the aspiration of meconium-stainted amniotic fluid into the lungs, resulting in pulmonary inflammation, neonatal morbidity, and mortality. It is important that these MAS infants receive appropriate care to avoid further complications. Steroids have an anti-inflammatory effect and may be effective in the management of MAS. The objective of the this study was to evaluate the effect of different steroids on clinical outcomes in infants with MAS. Materials and Methods: We systematically searched of PubMed/Medline, Scopus, Embase, Clinical Trials.gov, and Cochrane Library databases from inception to 24 January 2021 without language restriction. Only randomized controlled trials (RCTs) evaluating the effects of steroids in neonates with MAS were included. We calculated relative risks and weighted mean differences (MDs) with 95% confidence intervals (CIs) using a random-effects model to determine the associations between MAS and steroids and GRADE approach was employed for quality of evidence. The main outcomes measures were duration of respiratory distress, oxygen requirement, hospitalization, need for mechanical ventilation, death, and adverse drug reactions. Results: Seven RCTs involving 397 patients were analyzed. Nebulized budesonide and intravenous (IV) methylprednisolone shortened the duration of respiratory distress (MD, -2.46 days; 95% CI, -3.09 to -1.83 and MD, -3.30 days; 95% CI, -4.07 to -2.52, respectively) (moderate certainty). There was a reduction in duration of oxygen requirement in nebulized budesonide use (MD, -2.40 days; 95% CI, -3.40 to -1.40) (low certainty) and IV methylprednisolone use (MD, -3.30 days; 95% CI, -4.07 to -2.52) (moderate certainty). Nebulized budesonide shortened hospitalization stay (MD, -4.47 days; 95% CI, -8.64 to -0.30 days) (low certainty) as IV methylprednisolone use (MD, -7.23 days; 95% CI, -8.19 to -6.07 days) (moderate certainty). None of steroids benefits in death (low certainty). Conclusions: Certain types of steroids may benefit the respiratory aspect, but there was no decrease in mortality in MAS infants.


Assuntos
Síndrome de Aspiração de Mecônio , Budesonida/uso terapêutico , Abordagem GRADE , Humanos , Lactente , Recém-Nascido , Síndrome de Aspiração de Mecônio/tratamento farmacológico , Respiração Artificial , Esteroides
7.
Pol Merkur Lekarski ; 49(293): 382-384, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34800030

RESUMO

A significant increase is currently being observed in the number of patients hospitalized due to respiratory system diseases, such as chronic obstructive pulmonary disease (COPD), and bronchial asthma with a predominantly allergic component. Treatment of COPD and bronchial asthma is mainly based on the use of beta-2-mimetics and glucocorticosteroids (GCS). However, the GCS inhalation therapy may be associated with developing a risk of various types of complications, which are especially manifested in the initial part of the respiratory system. In the paper the side effects resulting from the chronic use of inhaled GCS was presented with discussion how to reduce their negative effects. The negative side effects of chronic GCS therapy for the treatment of pulmonary diseases result mainly from their modifying effect on the proper functioning of the immune system, and on their generation of salivary secretion disorders. When using inhaled GCS, drugs deposit on the mucosa membrane of the throat and oral cavity, which promotes the development of candidiasis which accompanied by xerostomia leads to difficulty in swallowing and speaking. The reduced salivation promotes the development of caries disease due to the impairment of the physiological mechanism of tooth surface cleaning. Attention to proper oral hygiene is fundamental and an appropriate antifungal therapy is required. When conducting a physical examination, it is important to pay attention to those patients using inhaled steroids, especially on a chronic basis. This is because with careful clinical evaluation, the side effects of these drugs can be detected at an early stage and the appropriate treatment of their negative effects can be applied.


Assuntos
Asma , Doença Pulmonar Obstrutiva Crônica , Administração por Inalação , Asma/induzido quimicamente , Asma/tratamento farmacológico , Humanos , Boca , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Esteroides/uso terapêutico
8.
Anticancer Res ; 41(11): 5333-5342, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732403

RESUMO

BACKGROUND/AIM: Leptomeningeal disease (LMD) is a debilitating complication of advanced malignancies. Immune-checkpoint inhibitors (ICIs) may alter disease course. We analyzed the role and toxicity of ICIs in LMD. MATERIALS AND METHODS: We systematically reviewed the literature reporting on outcome data of patients with LMD treated with ICIs. RESULTS: We included 14 studies encompassing 61 patients. Lung-cancer (44.3%), breast-cancer (27.9%), and melanoma (23.0%) were the most frequent primary tumors. Median duration of ICI-treatment was 7-months (range=0.5-58.0): pembrolizumab (49.2%), nivolumab (32.8%), ipilimumab (18.0%). Radiological responses included complete response (33.3%), partial response (12.5%), stable disease (33.3%), progressive disease (20.8%). Twenty-two patients developed ICI-related adverse-events, mild (100%) and/or severe (15.6%). Median progression-free and overall survival were 5.1 and 6.3 months, and 12-month survival was 32.1%. Survival correlated with ICI agents (p=0.042), but not with primary tumors (p=0.144). Patients receiving concurrent steroids showed worse survival (p=0.040). CONCLUSION: ICI therapy is well-tolerated in patients with LMD, but concurrent steroids may worsen survival.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Inibidores de Checkpoint Imunológico/uso terapêutico , Neoplasias Meníngeas/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Progressão da Doença , Feminino , Humanos , Inibidores de Checkpoint Imunológico/efeitos adversos , Masculino , Neoplasias Meníngeas/imunologia , Neoplasias Meníngeas/mortalidade , Neoplasias Meníngeas/secundário , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Medição de Risco , Fatores de Risco , Esteroides/efeitos adversos , Fatores de Tempo , Microambiente Tumoral
9.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(12): 1233-1236, 2021 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-34839514

RESUMO

OBJECTIVE: To explore the clinical characteristics and genetic basis of a child with 5α-reductase type 2 deficiency. METHODS: Clinical data of the child was retrospectively analyzed. Targeted capture-next generation sequencing and Sanger sequencing were carried out to detect potential variants. RESULTS: The patient's main features included micropenis and hypospadia. He was found to harbor compound heterozygous c.680G>A (p.R227Q) and c.3G>T (p.M1I) variants of the SRD5A2 gene. Among these, c.680G>A (p.R227Q) was inherited from his father and was a known pathogenic mutation, while c.3G>T (p.M1I) was inherited from his mother and was unreported previously. CONCLUSION: The compound heterozygous variants of the SRD5A2 gene probably underlay the disease in this child, who was eventually diagnosed with 5α-reductase 2 deficiency.


Assuntos
Transtorno 46,XY do Desenvolvimento Sexual , Hipospadia , Erros Inatos do Metabolismo de Esteroides , 3-Oxo-5-alfa-Esteroide 4-Desidrogenase/genética , Criança , Humanos , Masculino , Proteínas de Membrana/genética , Mutação , Estudos Retrospectivos , Esteroides
10.
Anal Chem ; 93(40): 13589-13596, 2021 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-34597017

RESUMO

Stereospecific recognition of amino acids (AAs) plays a crucial role in chiral biomarker-based diagnosis and prognosis. Separation of AA enantiomers is a long and tedious task due to the requirement of AA derivatization prior to the chromatographic or electrophoretic steps which are also time-consuming. Here, a mass-tagged chiral selector named [d0]/[d5]-estradiol-3-benzoate-17ß-chloroformate ([d0]/[d5]-17ß-EBC) with high reactivity and good enantiomeric resolution in regard to AAs was developed. After a quick and easy chemical derivatization step of AAs using 17ß-EBC as the single chiral selector before ion mobility-mass spectrometry analysis, good enantiomer separation was achieved for 19 chiral proteinogenic AAs in a single analytical run (∼2 s). A linear calibration curve of enantiomeric excess was also established using [d0]/[d5]-17ß-EBC. It was demonstrated to be capable of determining enantiomeric ratios down to 0.5% in the nanomolar range. 17ß-EBC was successfully applied to investigate the absolute configuration of AAs among peptide drugs and detect trace levels of d-AAs in complex biological samples. These results indicated that [d0]/[d5]-17ß-EBC may contribute to entail a valuable step forward in peptide drug quality control and discovering chiral disease biomarkers.


Assuntos
Aminoácidos , Espectrometria de Mobilidade Iônica , Espectrometria de Massas , Estereoisomerismo , Esteroides
11.
G Ital Nefrol ; 38(Suppl 77)2021 Sep 07.
Artigo em Italiano | MEDLINE | ID: mdl-34669312

RESUMO

Steroid minimization has always been one of the most desired goals regarding immunosuppressive therapy after renal transplantation. Following the introduction of cyclosporine different steroid-free protocols became available, but their implementation was limited due to the high risk of acute rejection. In the last few years, the use of a very low dose of prednisone (5 mg/day) has been deemed to guarantee a good balance between steroid toxicity and efficacy. However, high interpatient variability in prednisolone exposure prevented the standard low dose to be as safe as expected in all patients. Therefore, steroid side effects can still be observed in a variable percentage of patients. In this setting, the personalization of steroid dosage might prevent an over exposure to the drug, but this strategy is not available yet. Thus, steroid withdrawal remains the only available strategy to limit side effects. In the last 40 years, we learned that steroid free protocols are associated with a higher risk of acute rejection, but they do not reduce graft survival. Hence, patients at higher risk for acute rejection or recurrence of their primary renal disease are usually excluded from these protocols. Early steroid withdrawal (within 7 days after transplantation) has been widely used and also suggested by American guidelines. However, steroid withdrawal 3-4 months after transplantation has been preferred by many Authors and deemed equally efficient. In addition, early but not late steroid withdrawal should always be associated to induction therapy. Lastly, Tacrolimus plus Mycophenolic Acid has become the most used association in steroid minimization protocols.


Assuntos
Rejeição de Enxerto , Imunossupressores , Esteroides , Rejeição de Enxerto/prevenção & controle , Humanos , Imunossupressores/efeitos adversos , Ácido Micofenólico , Prednisona , Esteroides/efeitos adversos , Tacrolimo
12.
J Sex Med ; 18(10): 1807-1817, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34600646

RESUMO

BACKGROUND: Little information is available on steroid hormone profiles in transwomen on the day of gender affirming surgery (GAS) after gender affirming hormone therapy (GAHT). AIM: We compared extended serum steroid hormone profiles of 77 transwomen with 3 different treatment regimens in order to get more insight on how GAHT changes the hormone system. METHODS: Samples were obtained from 3 independent clinics. Individuals in clinic A (n = 13) and B (n = 51) discontinued GAHT 4-6 weeks and 2 weeks before GAS, individuals in clinic C (n = 13) continued treatment. Testicular tissue, blood samples and questionnaires on age, weight, height, and medication use were received from each patient. Steroid hormones were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS), 6 sex hormones were determined by immunofluorometric assays, and ELISA. Spermatogenesis was scored using the Bergman/Kliesch score. OUTCOMES: Participants were not different with regard to age, BMI, treatment duration, and dosage. Feminized blood serum levels with low LH, low FSH and low testosterone, however, were achieved in persons taking GAHT until GAS. Significantly reduced cortisone levels were seen after stopping GAHT before GAS. RESULTS: GAHT had marked effects on the sex-steroid profile in each person. Factor analysis provided a model explaining 78% of the variance and interdependency of sex steroid levels. Stopping treatment was inversely associated with intactness of the corticosteroid-axis with adrenal steroidogenesis as well as it was inversely associated with pituitary-gonadal hormone production. CLINICAL IMPLICATIONS: Transwomen generally did not have elevated cortisone levels but differed significantly depending on and when GAHT was stopped. STRENGTHS & LIMITATIONS: This is the first study examining the steroid hormone profiles of transgender persons on the day of GAS in a multi-center setting. Additional studies (including follow ups before and after GAS and stress questionnaires) will be necessary to assess these conflicting results about the possible psychological impact on persons undergoing GAS to improve care. CONCLUSION: Concerning feminized blood serum levels, continued GAHT seems the better alternative, however stopping treatment 4-6 weeks prior to surgery was associated with reduced cortisone levels. Schneider F, Wistuba J, Holterhus P-M, et al. New Insights Into Extended Steroid Hormone Profiles in Transwomen in a Multi-Center Setting in Germany. J Sex Med 2021;18:1807-1817.


Assuntos
Espectrometria de Massas em Tandem , Pessoas Transgênero , Cromatografia Líquida , Alemanha , Hormônios , Humanos , Masculino , Esteroides
13.
Agri ; 33(4): 223-231, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34671961

RESUMO

OBJECTIVES: We aimed to compare the treatment response with simultaneous application of transforaminal epidural steroid injection (TESI) and pulsed radiofrequency (PRF) to the lumbar dorsal root ganglion (DRG) with TESI in patients with chronic lumbar radicular pain. METHODS: A total of 129 patients were enrolled. TESI was performed to 67 patients and TESI+DRG-PRF was performed to 62 patients. Demographic data, surgical records, and medications, side, and level of the procedure were recorded. Patients were evaluated on the pre-operative and post-operative 10th day, 1st and 3rd month follow-up visits, and visual analog scale (VAS, 0-10) scores, and patients' satisfaction assessment on the 3rd month follow-up were collected. A successful therapeutic response was defined as a 50% or more reduction in VAS scores. RESULTS: In both groups, post-operative VAS scores were significantly lower than the pre-operative levels (p<0.001). VAS scores in the TESI+DRG-PRF group were significantly lower than the TESI group at all follow-up periods (p˂0.001). Reduction ratios in VAS scores were significantly higher in the TESI+DRG-PRF group in all follow-up visits (p˂-0.001). Satisfaction levels were significantly higher in the TESI+DRG-PRF group (p˂0.01). CONCLUSION: According to our study, TESI provides short-moderate pain relief in patients with chronic lumbar radicular pain. A simultaneous application of PRF in the same session with TESI should be considered as an option to improve the treatment response.


Assuntos
Dor Lombar , Tratamento por Radiofrequência Pulsada , Gânglios Espinais , Humanos , Dor Lombar/terapia , Esteroides , Resultado do Tratamento
14.
Medicine (Baltimore) ; 100(39): e27391, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34596164

RESUMO

RATIONALE: Several reports have described retinal pigment epithelial (RPE) tears in central serous chorioretinopathy (CSC). However, there have been no reports of spontaneously large RPE tears in acute CSC without bullous retinal detachment (RD). Herein, we report and provide sequential images of a case of bilateral spontaneous large RPE tears in patient with acute CSC without bullous RD. PATIENT CONCERNS: An 88-year-old female patient was admitted with impaired vision in both eyes, which began 10 days prior. The visual acuity was 0.4 and 0.5 in the right and left eye, respectively. She had started taking oral steroids 2 weeks prior for polymyalgia. DIAGNOSIS: Ophthalmologic examinations, including fundus photography, optical coherence tomography, and fluorescence angiography, were performed, and she was diagnosed with steroid-induced acute CSC in both eyes with large pigment epithelial detachment (PED) of approximately 4-disc diameter. Discontinuation of steroids and follow-up ophthalmic examinations were performed. However, a spontaneous large RPE tear occurred in the right eye. INTERVENTIONS: We performed follow-ups more frequently and CSC treatment such as laser photocoagulation, photodynamic therapy, and anti-vascular endothelial growth factor injections were not performed. OUTCOMES: Nine months later, a spontaneous large RPE tear occurred sequentially in the left eye. Her final visual acuity was 0.3 and 0.15 in the right and left eye, respectively. LESSONS: Patients may spontaneously develop large RPE tears in both eyes, despite no treatment for acute CSC with non-bullous RD. Large PED and old age may affect this. Therefore, for a CSC patient with a large PED and advanced age, attention must be paid when determining treatment.


Assuntos
Coriorretinopatia Serosa Central/complicações , Perfurações Retinianas/etiologia , Idoso de 80 Anos ou mais , Coriorretinopatia Serosa Central/induzido quimicamente , Coriorretinopatia Serosa Central/diagnóstico , Feminino , Angiofluoresceinografia , Humanos , Descolamento Retiniano/etiologia , Perfurações Retinianas/diagnóstico por imagem , Perfurações Retinianas/patologia , Esteroides/administração & dosagem , Esteroides/efeitos adversos , Tomografia de Coerência Óptica , Acuidade Visual
15.
Khirurgiia (Mosk) ; (10): 105-109, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34608788

RESUMO

The authors report a rare case of combination of chromophobe renal cell carcinoma Grade 2 pT2aN0 with multiple hepatocellular adenomas in a 31-year-old bodybuilder who received anabolic androgenic steroids at high doses for 8 years. According to MRI data, over 15 liver adenomas and tumor in the lower segment of the right kidney were detected. The patients underwent laparascopic resection of the right kidney and liver segments 2, 3 and 4 with large adenomas. Histological study and immunohistochemistry revealed no malignancy signs in hepatocellular adenomas. Nuclear ß-catenin expression was absent. Kidney tumor had a structure of chromophobe renal cell carcinoma. The patient is currently being followed-up due to residual small liver adenomas. In our opinion, liver adenomatosis and renal cancer have the same cause in this case (chronic toxic effect of androgens).


Assuntos
Adenoma de Células Hepáticas , Anabolizantes , Carcinoma Hepatocelular , Carcinoma de Células Renais , Neoplasias Renais , Neoplasias Hepáticas , Adulto , Anabolizantes/efeitos adversos , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/cirurgia , Humanos , Neoplasias Renais/induzido quimicamente , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Neoplasias Hepáticas/diagnóstico , Esteroides
16.
Molecules ; 26(19)2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34641331

RESUMO

BACKGROUND: Immune-related adverse events (irAEs) are inflammatory side effects, which can occur during immune-checkpoint(s) inhibitors (ICIs) therapy. Steroids are the first-line agents to manage irAEs because of their immunosuppressive properties. However, it is still debated whether or when steroids can be administered without abrogating the therapeutic efforts of immunotherapy. METHODS: We retrospectively evaluated 146 patients with metastatic non-small cell lung cancer (NSCLC), melanoma and renal cell carcinoma (RCC) treated with ICIs. We assessed the progression-free survival (PFS) of patients treated with steroids due to an irAE compared to a no-steroid group. RESULTS: The early treatment with steroid (within the first 30 days from the beginning of immunotherapy) was not related to a shorter PFS (p = 0.077). Interestingly, patients who were treated with steroids after 30 days from the start of immunotherapy had significantly longer PFS (p = 0.017). In a multivariate analysis, treatment with steroids after 30 days was an independent prognostic factor for PFS (HR: 0.59 [95% CI 0.36-0.97], p = 0.037). CONCLUSIONS: This retrospective study points out that early systemic steroids administration to manage irAEs might not have a detrimental effect on patient clinical outcome in NSCLC, melanoma and RCC patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma de Células Renais/tratamento farmacológico , Inibidores de Checkpoint Imunológico/uso terapêutico , Neoplasias Renais/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Melanoma/tratamento farmacológico , Esteroides/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Inibidores de Checkpoint Imunológico/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
17.
Molecules ; 26(20)2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34684799

RESUMO

The quantification of steroid hormones of individual zebrafish (Danio rerio) provides perspective to understand endogenous hormone function. A UPLC-TOF-MS method was developed to provide a reproducible, sensitive, and efficient assay to determine the concentration of steroid hormones, including cortisol, testosterone, androstenedione, 11-deoxycortisol, 11-deoxycorticosterone, and 17-hydroxyprogesterone in whole-body homogenates of each zebrafish. Solid-phase extraction was used to sample matrix clean-up and acquired a recovery from 89.7% to 107.9%. The analytes were separated on an Aquity BEH C18 column using gradient elution. Mass spectrometric analysis was performed by single reaction monitoring (SRM) using positive electrospray ionization mode. The total running time was 6 min, which was greatly shortened compared with a previously reported method. The developed method exhibited excellent linearity for all the analytes, with regression coefficients higher than 0.99. The limit of detection varied between 0.1 and 0.5 ng/L and the limit of quantification was 0.5-1.7 ng/L for all analytes. The precision of the method was assessed on replicate measurements and was found to be in the ranges of 1.9 % to 6.6% and 4.3% to 8.6%, for intra- and inter-day analysis, respectively. This method was validated according to FDA guidance and applied to determine steroid hormone levels in the tissue homogenate of zebrafish acutely treated with caffeine and ethanol.


Assuntos
Esteroides/análise , Peixe-Zebra/metabolismo , Animais , Vias Biossintéticas , Cafeína/administração & dosagem , Cromatografia Líquida/métodos , Cromatografia Líquida/estatística & dados numéricos , Etanol/administração & dosagem , Feminino , Masculino , Modelos Animais , Extração em Fase Sólida/métodos , Extração em Fase Sólida/estatística & dados numéricos , Esteroides/biossíntese , Estresse Fisiológico/efeitos dos fármacos , Espectrometria de Massas em Tandem/métodos , Espectrometria de Massas em Tandem/estatística & dados numéricos
18.
PLoS One ; 16(10): e0259153, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34705851

RESUMO

PURPOSE: To determine the effects of statins and steroids on the risk of coronary artery disease (CAD) and stroke in patients with interstitial lung disease and pulmonary fibrosis (ILD-PF). METHODS: We retrospectively enrolled patients with ILD-PF who were using statins (statin cohort, N = 11,567) and not using statins (nonstatin cohort, N = 26,159). Cox proportional regression was performed to analyze the cumulative incidence of CAD and stroke. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of CAD and stroke were determined after sex, age, and comorbidities, as well as the use of inhaler corticosteroids (ICSs), oral steroids (OSs), and statins, were controlled for. RESULTS: Compared with those of patients without statin use, the aHRs (95% CIs) of patients with statin use for CAD and ischemic stroke were 0.72 (0.65-0.79) and 0.52 (0.38-0.72), respectively. For patients taking single-use statins but not ICSs/OSs, the aHRs (95% CIs) for CAD and ischemic stroke were 0.72 (0.65-0.79)/0.69 (0.61-0.79) and 0.54 (0.39-0.74)/0.50 (0.32-0.79), respectively. For patients using ICSs/OSs, the aHRs (95% CIs) for CAD and ischemic stroke were 0.71 (0.42-1.18)/0.74 (0.64-0.85) and 0.23 (0.03-1.59)/0.54 (0.35-0.85), respectively. CONCLUSIONS: The findings demonstrate that statin use, either alone or in combination with OS use, plays an auxiliary role in the management of CAD and ischemic stroke in patients with ILD-PF.


Assuntos
Doença da Artéria Coronariana/epidemiologia , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Doenças Pulmonares Intersticiais/complicações , Fibrose Pulmonar/complicações , Esteroides/uso terapêutico , Acidente Vascular Cerebral/epidemiologia , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/prevenção & controle , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Incidência , Masculino , Pessoa de Meia-Idade , Esteroides/administração & dosagem , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/prevenção & controle
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