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1.
Ir J Med Sci ; 190(3): 1165-1172, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33866519

RESUMO

BACKGROUND: Postauricular steroid administration has been popular for treating sudden sensorineural hearing loss. However, there are few reports on its use in patients with refractory sudden sensorineural hearing loss (RSSNHL). AIMS: The objective of this study was to investigate the therapeutic efficacy of postauricular steroid injection as a salvage treatment for RSSNHL patients. METHODS: This retrospective study enrolled 63 RSSNHL patients between January 2016 and January 2019. Thirty-three patients of them who have been divided into the treatment group received postauricular methylprednisolone sodium succinate injection. The remaining 30 patients who formed the control group did not receive any steroid as a salvage therapy. Improvements in hearing were evaluated between pre-salvage therapy and 3 months follow-up after salvage therapy. RESULTS: The median hearing gain in PTA was 9.88 dB HL (quartile range 7.58, 18.65) in the treatment group and 0.90 dB HL (quartile range 0.00, 4.90) in the control group (P<0.01). According to the criteria of Furuhashi, the total percentage for effective prognosis was 48.48% (16/33) in the treatment group and 10.00% (3/30) in the control group (P<0.01). The time interval from onset to study entry was significantly and independently associated with the prognosis for RSSNHL patients (P< 0.01). CONCLUSIONS: The present findings suggest that postauricular corticosteroid administration as a salvage treatment demonstrated better results than no treatment for RSSNHL patients. The time interval from onset to study entry was mainly the prognostic factor for RSSNHL patients. It is therefore considered that postauricular corticosteroid administration may be used as a salvage therapy for RSSNHL patients.


Assuntos
Perda Auditiva Neurossensorial , Hemissuccinato de Metilprednisolona , Dexametasona , Glucocorticoides/uso terapêutico , Perda Auditiva Neurossensorial/tratamento farmacológico , Humanos , Metilprednisolona/uso terapêutico , Hemissuccinato de Metilprednisolona/uso terapêutico , Estudos Retrospectivos , Terapia de Salvação , Resultado do Tratamento
2.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(1): 32-36, 2021 Feb 28.
Artigo em Chinês | MEDLINE | ID: mdl-33663659

RESUMO

Objective To evaluate the effect of methylprednisolone sodium succinate combined with tropisetron on postoperative nausea and vomiting(PONV)under microvascular decompression of hemifacial spasm.Methods From January to June 2019,485 patients undergoing microvascular decompression for facial spasm at Department of Neurosurgery,Peking University People's Hospital were randomly assigned into two groups with random number table method.For group A(n=242),2 ml saline was administrated by intravenous drip before induction and 5 mg tropisetron after operation.For group B(n=243),40 mg methylprednisolone sodium succinate was administrated by intravenous drip before induction and 5 mg tropisetron after operation.The anesthesia time,operation time,and incidence of PONV in 0-24 h and 24-48 h were recorded for the comparison of the remedial treatment rate of nausea and vomiting between the two groups.Results There was no significant difference in age,gender,smoking history,body mass index value,American Society of Anesthesiologists score,medical history,surgical side,PONV history,operation time or anesthesia time between the two groups(all P > 0.05).The incidence of PONV in group A was 35.5% and 18.2% during 0-24 h and 24-48 h,respectively,which was significantly higher than that(18.5%,χ 2=7.331,P=0.007;8.2%,χ 2=4.364,P=0.037)in group B.The application rate of antiemetic drugs in group A was 15.2% and 8.7% during 0-24 h and 24-48 h,respectively,which was significantly higher than that(5.3%,χ 2=5.327,P=0.021;2.0%,χ 2=4.432,P=0.035)in group B.Conclusion The combination of methylprednisolone sodium succinate and tropisetron can effectively prevent PONV under microvascular decompression of hemifacial spasm,with the performance superior to single drug treatment.


Assuntos
Antieméticos , Espasmo Hemifacial , Cirurgia de Descompressão Microvascular , Método Duplo-Cego , Espasmo Hemifacial/tratamento farmacológico , Espasmo Hemifacial/cirurgia , Humanos , Indóis , Hemissuccinato de Metilprednisolona/uso terapêutico , Tropizetrona
3.
BMJ Case Rep ; 14(3)2021 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-33737283

RESUMO

COVID-19 and granulomatosis with polyangiitis share many clinical and radiological features, making it challenging for clinicians to distinguish between the two. In this case report, we describe a patient who was diagnosed with COVID-19 in October 2020. One month later, she presented with persistent fatigue, shortness of breath and anaemia with worsening renal functions, found to have elevated antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies, and diagnosed with granulomatosis with polyangiitis.


Assuntos
COVID-19/complicações , Granulomatose com Poliangiite/diagnóstico , Granulomatose com Poliangiite/etiologia , Anti-Inflamatórios/uso terapêutico , Biópsia , Diagnóstico Diferencial , Feminino , Granulomatose com Poliangiite/tratamento farmacológico , Humanos , Fatores Imunológicos/uso terapêutico , Rim/patologia , Hemissuccinato de Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Rituximab/uso terapêutico , SARS-CoV-2
4.
Exp Brain Res ; 239(2): 627-638, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33388811

RESUMO

Localized carrier-mediated administration of drugs is a promising approach to treatment of acute phase of spinal cord injury (SCI) as it allows enhanced and/or sustained drug delivery to damaged tissues along with minimization of systemic side effects. We studied the effect of locally applied self-assembling micellar formulation of methylprednisolone succinate (MPS) with trifunctional block copolymer of ethylene oxide and propylene oxide (TBC) on functional recovery and tissue drug content after SCI in rats in comparison with local and systemic administration of MPS alone. Variations in the amplitude of motor evoked responses in the hindlimb muscles induced by epidural stimulation during acute phase of SCI and restoration of movements during chronic period after local vs. systemic application of MPS were evaluated in this study. Results demonstrate that local delivery of MPS in combination with TBC facilitates spinal cord sensorimotor circuitry, increasing the excitability. In addition, this formulation was found to be more effective in improvement of locomotion after SCI compared to systemic administration. LC-MS/MS data shows that the use of TBC carrier increases the glucocorticoid content in treated spinal cord by more than four times over other modes of treatment. The results of this study demonstrate that the local treatment of acute SCI with MPS in the form of mixed micelles with TBC can provide improved therapeutic outcome by promoting drug accumulation and functional restoration of the spinal cord.


Assuntos
Hemissuccinato de Metilprednisolona , Traumatismos da Medula Espinal , Animais , Cromatografia Líquida , Ratos , Medula Espinal , Traumatismos da Medula Espinal/tratamento farmacológico , Espectrometria de Massas em Tandem
5.
Retin Cases Brief Rep ; 15(3): 302-305, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30074567

RESUMO

PURPOSE: To describe a novel case of intraocular tuberculosis (TB) arising in a patient undergoing treatment for Vogt-Koyanagi-Harada disease, and to highlight the use of spectral domain optical coherence tomography for helping confirm the diagnosis and monitor treatment response. METHODS: Case report of a patient with Vogt-Koyanagi-Harada disease on prednisone, with acute clinical changes suspicious for bilateral tuberculous choroiditis. Spectral optical coherence tomography, fundus photography, and B-scan ultrasonography were all used to capture the acute lesions, and to monitor their responses after initiation of anti-TB therapy. RESULTS: New subretinal lesions arose bilaterally, as characterized by spectral domain optical coherence tomography, and appeared to regress after a first round of anti-TB therapy, thereby helping confirm the presumed diagnosis of intraocular TB. A new peripheral choroidal lesion arose shortly after temporary cessation of antimicrobial treatment, and again regressed once four-drug therapy was instituted, with no recurrent lesions thereafter. CONCLUSION: The use of multimodal imaging was instrumental in the management of a rare case of intraocular TB arising in the setting of underlying Vogt-Koyanagi-Harada disease.


Assuntos
Corioidite/complicações , Tuberculose Ocular/complicações , Síndrome Uveomeningoencefálica/complicações , Adulto , Antituberculosos/uso terapêutico , Corioidite/diagnóstico , Corioidite/tratamento farmacológico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Testes de Liberação de Interferon-gama , Isoniazida/uso terapêutico , Hemissuccinato de Metilprednisolona/uso terapêutico , Prednisona/uso terapêutico , Teste Tuberculínico , Tuberculose Ocular/diagnóstico , Tuberculose Ocular/tratamento farmacológico , Síndrome Uveomeningoencefálica/diagnóstico , Síndrome Uveomeningoencefálica/tratamento farmacológico , Acuidade Visual
6.
J Pak Med Assoc ; 70(10): 1679-1683, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33159732

RESUMO

OBJECTIVE: To determine the curative effect of gamma globulin combined with methylprednisolone sodium succinate on paediatric patients with severe hand-foot-mouth disease and analyse its influence on cardio-pulmonary functions. Methodology: Eighty paediatric patients with severe hand-foot-mouth diseases (HFMD) treated in Baoding Children's Hospital, Key Laboratory of Clinical Research on Respiratory Digestive Disease from January 2015 to January 2017 were selected. This study was designed as a case control study with equally dividing patients into test and control groups through random digital method. Patients in the control group accepted methylprednisolone sodium succinate treatment based on conventional therapy. Those in the test group accepted gamma globulin combined with methylprednisolone sodium succinate. The efficacy of the two groups were observed and compared and the improvement of cardiac function index was detected after 3 days of treatment. RESULTS: The time for symptom remission and hospitalisation of children in the test group were significantly shorter than those in the control group (P<0.05). The differences between the two groups had no statistical significance in terms of PaO2, PaCO2, OI, HR, EF% and CO before treatment. After the treatment, patients in the test group had significant improvement compared with the control group (P<0.05). CONCLUSIONS: Curative effect of gamma globulin combined with methylprednisolone sodium succinate on paediatric patients showed significance and this treatment could be effectively improve clinical symptoms and cardio-pulmonary functions of paediatric patients.


Assuntos
Doença de Mão, Pé e Boca , Doenças da Boca , gama-Globulinas , Estudos de Casos e Controles , Criança , China , Doença de Mão, Pé e Boca/tratamento farmacológico , Hospitais , Humanos , Metilprednisolona/uso terapêutico , Hemissuccinato de Metilprednisolona/uso terapêutico , gama-Globulinas/uso terapêutico
7.
BMJ Case Rep ; 13(11)2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33051251

RESUMO

Sudden onset sensorineural hearing loss (SSNHL) is frequently seen by otolaryngologists. The exact pathophysiology of the disease is still unknown, with the most likely causative factor being following a viral infection. Immediate steroids are the best treatment to improve prognosis. Despite a plethora of papers in the literature describing SSNHL, there are only a few reported cases of hearing loss following COVID-19, none of which have been reported in the UK. This paper presents the first UK case of SSNHL following COVID-19. Physical examination and imaging excluded any other cause of hearing loss. A literature review showed that four other cases have been previously described. Hearing loss can be a significant cause of morbidity and can easily be missed in the intensive care setting. Being aware and screening for SSNHL following COVID-19 enables an early course of steroids, which offers the best chance of recovering hearing.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Perda Auditiva Súbita/complicações , Perda Auditiva Súbita/tratamento farmacológico , Hemissuccinato de Metilprednisolona/uso terapêutico , Pneumonia Viral/complicações , Prednisolona/uso terapêutico , Administração Oral , COVID-19 , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Perda Auditiva Súbita/diagnóstico , Humanos , Injeções , Masculino , Hemissuccinato de Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Pandemias , Prednisolona/administração & dosagem , SARS-CoV-2
8.
J Investig Med High Impact Case Rep ; 8: 2324709620947608, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32762386

RESUMO

Leukocytoclastic vasculitis (LCV) is a rare vascular inflammatory condition that affects post-capillary venules. Its incidence in the pediatric population is unknown. However, its incidence has been shown to increase with age. The causes of LCV can be varied, ranging from drugs to infections to systemic disease. LCV as a presenting symptom of inflammatory bowel disease (IBD) is rare, especially in the pediatric population. A 15-year-old female with a family history of systemic lupus erythematosus was transferred to our hospital with a month-long history of rash, joint swelling and tenderness, periorbital edema, weight loss, and diarrhea. She presented with the objective findings of a biopsy showing LCV and a computed tomography scan read that was concerning for IBD versus infectious colitis. She had a thorough workup, involving both the rheumatology and gastroenterology services, and was ultimately found to have Crohn's disease. This case reveals the importance of recognition of a constellation of symptoms in IBD even when they are not classical in nature at initial presentation.


Assuntos
Doença de Crohn/complicações , Doença de Crohn/diagnóstico , Vasculite Leucocitoclástica Cutânea/diagnóstico , Vasculite Leucocitoclástica Cutânea/etiologia , Adolescente , Doença de Crohn/tratamento farmacológico , Doença de Crohn/patologia , Feminino , Humanos , Hemissuccinato de Metilprednisolona , Vasculite Leucocitoclástica Cutânea/tratamento farmacológico , Vasculite Leucocitoclástica Cutânea/patologia
9.
Medicine (Baltimore) ; 99(26): e20828, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590770

RESUMO

RATIONALE: Pulmonary amyloidosis is a rare respiratory disease characterized by amyloid deposition in the lungs. The clinical manifestations of pulmonary amyloidosis are variable and without specific symptoms. PATIENT CONCERNS: We report a rare case of tracheobronchial amyloidosis to improve our understanding of the disease. DIAGNOSES: The diagnosis of tracheobronchial amyloidosis was finally established by transbronchoscopic lung biopsy and histological examination. INTERVENTIONS: The patient significantly improved with methylprednisolone sodium succinate for injection (40 mg/day) for 5 days and low-dose oral prednisone for 10 days. OUTCOMES: After treatment, discomfort, such as cough, stridor, dyspnea, and chest tightness, disappeared, and he was discharged. The patient was in good clinical condition after 8 months of follow-up. CONCLUSION: This case clearly shows that it is difficult to distinguish tracheobronchial amyloidosis from other diseases with manifestations of cough, dyspnea and chest tightness because of their similar symptoms and imaging findings. Thus, the role of transbronchoscopic lung biopsy and histological examination in the diagnosis of tracheobronchial amyloidosis is very important.


Assuntos
Amiloidose/diagnóstico , Amiloidose/tratamento farmacológico , Biópsia/métodos , China , Tosse/etiologia , Dispneia/etiologia , Glucocorticoides/uso terapêutico , Humanos , Pneumopatias/diagnóstico , Pneumopatias/tratamento farmacológico , Masculino , Hemissuccinato de Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos
10.
Eur J Hosp Pharm ; 27(e1): e58-e62, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32296507

RESUMO

Background: A combination of methylprednisolone sodium succinate and tropisetron hydrochloride is commonly used to treat the nausea and vomiting associated with antineoplastic therapy. The objective of this study was to investigate the stability of tropisetron hydrochloride and methylprednisolone sodium succinate in 0.9% sodium chloride injection for up to 48 hours. Methods: Commercial solutions of methylprednisolone sodium succinate and tropisetron hydrochloride were obtained and further diluted with 0.9% sodium chloride injection to final concentrations of either 0.4 or 0.8 mg/mL (methylprednisolone sodium succinate) and 0.05 mg/mL (tropisetron). The admixtures were assessed for periods of up to 48 hours after storage at 4°C with protection from light and at 25°C without protection from light. Physical compatibility was determined visually, and the chemical compatibility was measured with high-performance liquid chromatography (HPLC) and by measurement of pH values. Results: HPLC analysis demonstrated that methylprednisolone sodium succinate and tropisetron hydrochloride in the various solutions were maintained at 97% of the initial concentrations or higher during the testing period. There were no changes observed by physical precipitation or pH in any of the prepared solutions. Conclusions: Tropisetron hydrochloride injection and methylprednisolone sodium succinate injection in 0.9% sodium chloride injection are stable for up to 48 hours at 4°C and 25°C.


Assuntos
Anti-Inflamatórios/química , Antieméticos/química , Incompatibilidade de Medicamentos , Hemissuccinato de Metilprednisolona/química , Solução Salina/química , Tropizetrona/química , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/análise , Antieméticos/administração & dosagem , Antieméticos/análise , Cromatografia Líquida de Alta Pressão/métodos , Estabilidade de Medicamentos , Humanos , Injeções , Hemissuccinato de Metilprednisolona/administração & dosagem , Hemissuccinato de Metilprednisolona/análise , Solução Salina/administração & dosagem , Solução Salina/análise , Tropizetrona/administração & dosagem , Tropizetrona/análise
11.
Emerg Infect Dis ; 26(8): 1941-1943, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32348233

RESUMO

We report 3 patients with coronavirus disease who had a decline in respiratory status during their hospital course that responded well to intravenous steroids and interleukin-6 receptor antagonist therapy. These patients later showed development of persistent hypoxia with increased levels of d-dimer levels and were given a diagnosis of pulmonary embolisms.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/complicações , Síndrome da Liberação de Citocina/complicações , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Hipóxia/complicações , Pneumonia Viral/complicações , Embolia Pulmonar/complicações , Doença Aguda , Idoso , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticoagulantes/uso terapêutico , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/fisiologia , Biomarcadores/sangue , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/virologia , Síndrome da Liberação de Citocina/diagnóstico , Síndrome da Liberação de Citocina/tratamento farmacológico , Síndrome da Liberação de Citocina/virologia , Enoxaparina/uso terapêutico , Feminino , Humanos , Hipóxia/diagnóstico , Hipóxia/tratamento farmacológico , Hipóxia/virologia , Masculino , Hemissuccinato de Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/tratamento farmacológico , Embolia Pulmonar/virologia , Rivaroxabana/uso terapêutico , SARS-CoV-2 , Tomografia Computadorizada por Raios X , Resultado do Tratamento
13.
Carbohydr Polym ; 233: 115856, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32059907

RESUMO

A water-soluble polysaccharide (SPAW) was purified from Safflower and it was identified to be (1→3)-linked ß-d-Glucan. The therapeutic effect and underlying mechanism of SPAW on steroid-induced avascular necrosis of the femoral head (SANFH) in a rabbit model was performed here. The abnormal histopathologic changes and apoptosis of femoral head in model group were significantly reverted after SPAW (25, 100 and 200 mg/kg) administration for 60 days, as evidenced by the a decline of empty lacunae rate, the average bone marrow fat cell size and the proportion of apoptotic cells. Furthermore, administration of SPAW significantly decreased the Bax and caspase-3 protein expression, but increased the protein expression of Bcl-2 when compared these in model rabbits. Meanwhile, increased hydroxyproline (HOP) and decreased serum hexosamine (HOM) concentration in rabbit serum were turned to the opposite way. The present study suggested that SPAW may provide an alternative treatment for the treatment of SANFH.


Assuntos
Carthamus tinctorius/química , Necrose da Cabeça do Fêmur/tratamento farmacológico , Glucanos/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Caspase 3/metabolismo , Feminino , Cabeça do Fêmur/patologia , Necrose da Cabeça do Fêmur/induzido quimicamente , Glucanos/química , Glucanos/isolamento & purificação , Hexosaminas/metabolismo , Cavalos , Hidroxiprolina/metabolismo , Masculino , Hemissuccinato de Metilprednisolona , Peso Molecular , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Coelhos , Ratos , Proteína X Associada a bcl-2/metabolismo
14.
Molecules ; 25(3)2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-32012928

RESUMO

PEGylated nanomedicines are known to induce infusion reactions (IRs) that in some cases can be life-threatening. Herein, we report a case study in which a patient with rare mediastinal and intracardiac IgG4-related sclerosing disease received 8 treatments of intravenously administered PEGylated liposomal methylprednisolone-succinate (NSSL-MPS). Due to the ethical requirements to reduce IRs, the patient received a cocktail of premedication including low dose of steroids, acetaminophen and H2 blockers before each infusion. The treatment was well-tolerated in that IRs, complement activation, anti-PEG antibodies and accelerated blood clearance of the PEGylated drug were not detected. Prior to the clinical study, an in vitro panel of assays utilizing blood of healthy donors was used to determine the potential of a PEGylated drug to activate complement system, elicit pro-inflammatory cytokines, damage erythrocytes and affect various components of the blood coagulation system. The overall findings of the in vitro panel were negative and correlated with the results observed in the clinical phase.


Assuntos
Fatores Imunológicos/administração & dosagem , Lipossomos , Hemissuccinato de Metilprednisolona/administração & dosagem , Biomarcadores , Ativação do Complemento/efeitos dos fármacos , Ativação do Complemento/imunologia , Proteínas do Sistema Complemento/imunologia , Suscetibilidade a Doenças , Feminino , Humanos , Inflamação/etiologia , Inflamação/metabolismo , Lipossomos/química , Masculino , Hemissuccinato de Metilprednisolona/farmacocinética , Polietilenoglicóis/química
16.
Undersea Hyperb Med ; 46(5): 665-672, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683366

RESUMO

We compared the efficacy of hyperbaric oxygen (HBO2) therapy used in the treatment of sudden sensorineural hearing loss (SSNHL) as a supplementary therapy to the first-line medical treatment according to the different applied pressures used in HBO2 treatment while maintaining the same number of sessions, periodicity and exposure times. We evaluated data from 115 patients suffering from SSNHL within seven days of hearing loss: 35 patients received the standard treatment protocol (control group), and 80 individuals were treated with additional application of HBO2 therapy pressured to 2.0 ATA (H2.0; n=49) or 2.5 ATA (H2.5; n=31), respectively. Treatment success was assessed using pre- and post-treatment audiograms. We found significant differences in both HBO2 groups compared to the control group. In low frequencies the most significant differences can be seen in both H2.0 and H2.5. In spoken speech frequencies only the H2.0 group was statistically significant. In high frequencies the therapeutic benefits were the lowest. Furthermore, we found a notable difference in the therapeutic effect of HBO2 therapy according to the different applied pressure. At low frequencies, the use of 2.5 ATA pressure was more efficient. However, in the higher frequency ranges, the better hearing gains were obtained at the 2.0 ATA pressure. Our results support the possibility of optimizing treatments individually, depending on the type and frequency range of hearing impairment (shape of the audiogram) in favor of using the 2.0 ATA. This is important in terms of an individual approach to each patient as well as to minimize the burden of a patient in order to obtain the maximum therapeutic effect.


Assuntos
Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/terapia , Oxigenação Hiperbárica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Atmosférica , Estudos de Casos e Controles , Feminino , Glucocorticoides/administração & dosagem , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Súbita/tratamento farmacológico , Humanos , Masculino , Hemissuccinato de Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Estudos Prospectivos , Adulto Jovem
17.
Undersea Hyperb Med ; 46(5): 709-712, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683371

RESUMO

We describe the emergency management of a man who experienced acute vision loss diagnosed as direct traumatic optic neuropathy (TON) in his right eye (no light perception) after falling from a height. TON is caused by a high-impact mechanism of injury. Clinical findings include acute vision loss, which is typically immediate, afferent pupillary defect, decreased color vision, and visual field defects. Treatment is controversial because of the lack of strong evidence supporting intervention over observation. In this case report, our treatment strategy comprised immediate hyperbaric oxygen (HBO2) and daily high doses of a steroid. On the second day, minocycline was added to the treatment regimen for its neuroprotective effects. The patient was discharged after receiving six HBO2 treatments and six days of intravenous solumedrol transitioned to oral prednisone. After the third HBO2 treatment, his vision improved to 20/100; after the fourth treatment, it was 20/40 and plateaued. At the time of discharge, it was 20/40. At two-month follow-up, his corrected visual acuity was 20/60+2 in the affected eye. Immediate HBO2 for ischemic and mechanical injury to the optic nerve following trauma is a therapeutic option.


Assuntos
Cegueira/terapia , Glucocorticoides/administração & dosagem , Hemissuccinato de Metilprednisolona/administração & dosagem , Minociclina/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Traumatismos do Nervo Óptico/terapia , Acidentes por Quedas , Doença Aguda , Adulto , Cegueira/etiologia , Terapia Combinada/métodos , Tratamento de Emergência/métodos , Humanos , Masculino , Traumatismos do Nervo Óptico/complicações , Prednisona/administração & dosagem , Recuperação de Função Fisiológica
18.
Otol Neurotol ; 40(10): 1386-1391, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31592822

RESUMO

HYPOTHESIS: Commercial quinolone ear drops may promote the development of perforations (TMPs) in intact tympanic membrane (TMs). BACKGROUND: Quinolone ear drops have been associated with TMPs after myringotomy +/- tube placement in a drug-specific manner and potentiation by steroids. METHODS: Rats were randomized to six groups (10/group), with one ear receiving otic instillation of dexamethasone, ofloxacin, ciprofloxacin, ofloxacin + dexamethasone, ciprofloxacin + dexamethasone, or neomycin + polymyxin + hydrocortisone-all commercial formulations and at standard clinical concentrations-and the contralateral ear receiving saline, twice daily for 10 days. TMs were assessed over 42 days. RESULTS: No TMPs were seen in ears treated with saline, dexamethasone, or neomycin. At day 10, TMPs were seen in one of 10 ofloxacin- and three of 10 ciprofloxacin + dexamethasone-treated ears (p = 0.038). At day 14, the ofloxacin TMP healed. In contrast, the three ciprofloxacin + dexamethasone TMPs remained and one new TMP developed in this group. A ciprofloxacin and an ofloxacin + dexamethasone-treated ears also had TMPs (p = 0.023). By day 21, the ofloxacin + dexamethasone TMP and two of four of the ciprofloxacin + dexamethasone TMPs healed but two new TMPs were seen in ciprofloxacin + dexamethasone ears (p = 0.0006). At day 28, 1 of 10 ciprofloxacin and 4 of 10 ciprofloxacin + dexamethasone-treated ears had TMPs (p = 0.0006). By day 35, only one ciprofloxacin + dexamethasone had TMP (p = 0.42). All TMPS were healed at day 42. CONCLUSIONS: Application of commercial quinolone ear drops can cause TMPs in intact TMs. This effect appears to be drug-specific and potentiated by steroids.


Assuntos
Ciprofloxacina/efeitos adversos , Dexametasona/efeitos adversos , Neomicina/efeitos adversos , Ofloxacino/efeitos adversos , Quinolonas/efeitos adversos , Perfuração da Membrana Timpânica/induzido quimicamente , Membrana Timpânica/efeitos dos fármacos , Animais , Ciprofloxacina/administração & dosagem , Dexametasona/administração & dosagem , Feminino , Hidrocortisona/administração & dosagem , Masculino , Hemissuccinato de Metilprednisolona/análogos & derivados , Ventilação da Orelha Média , Neomicina/administração & dosagem , Ofloxacino/administração & dosagem , Próteses e Implantes , Quinolonas/administração & dosagem , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley
19.
Photobiomodul Photomed Laser Surg ; 37(11): 700-705, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31589558

RESUMO

Background and objective: Studies investigating an alternative to corticosteroids in terms of potential side effects after surgical removal of impacted third molars are still ongoing. Accordingly, the present randomized single-blind study aimed to compare the efficacy of photobiomodulation therapy (PBMT) and methylprednisolone on pain, edema, and trismus after surgical removal of impacted third molars. Methods: The study included 30 healthy patients with bilaterally impacted lower third molars. The side (right or left molar) that would be extracted at first and the treatment (PBMT or corticosteroid) that would be applied to this side were decided by tossing a coin. The time interval between two surgical operations was at least 3 weeks. In the laser group, immediately after the surgical procedure, PBMT was applied extraorally to the insertion point of the masseter muscle for 60 sec with an output power of 0.3 W and an energy density of 6 J/cm2 and then repeated on postoperative days 1 and 2. In the corticosteroid group, 40 mg/2 mL methylprednisolone sodium succinate was injected postoperatively into the masseter muscle with the intrabuccal approach. On postoperative day 1, methylprednisolone injection (20 mg/1 mL) was repeated. Pain was evaluated using the visual analog scale on postoperative days 1, 2, and 7. Edema (in mm) and trismus (in mm) were evaluated preoperatively and on postoperative days 2 and 7. Results: There were no significant differences between the PBMT and methylprednisolone administration in terms of postoperative pain, edema, and trismus. Conclusions: Within the limits of the present study, PBMT was considered an alternative and a useful method for controlling inflammatory complications following impacted wisdom tooth surgery as it exhibited similar clinical efficacy to that of methylprednisolone.


Assuntos
Terapia com Luz de Baixa Intensidade , Hemissuccinato de Metilprednisolona/uso terapêutico , Dente Serotino/cirurgia , Dor Pós-Operatória/prevenção & controle , Extração Dentária , Dente Impactado/cirurgia , Adolescente , Adulto , Edema/prevenção & controle , Feminino , Glucocorticoides/uso terapêutico , Humanos , Lasers Semicondutores , Masculino , Complicações Pós-Operatórias/prevenção & controle , Método Simples-Cego , Trismo/prevenção & controle , Escala Visual Analógica , Adulto Jovem
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