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1.
Article in Chinese | WPRIM | ID: wpr-879456

ABSTRACT

OBJECTIVE@#To compare clinical effects of compound betamethasone and compound betamethasone with hyaluronic acid in treating moderate-severe knee osteoarthritis (KOA).@*METHODS@#A prospective randomized controlled study was conducted in 116 patients with unilateral moderate-severe KOA patients from February 2017 to November 2017 and divided into observation group and control group, 58 patients in each group. In observation group, there were 15 males and 43 females aged from 45 to 80 years old with an average of (66.45±6.31) years old;according to Kellgren-Lawrence(K-L) classification, 42 patients were type Ⅲ and 16 patients were type Ⅳ;the courses of disease ranged from 4 to 8 years with an average of (5.25±2.21) years;the patients were treated by injecting 1 ml compound betamethasone into knee joint. In control group, there were 13 males and 45 females aged from 45 to 80 years old with an average of (64.89±6.41) years old;according to K-L classification, 43 patients were type Ⅲ and 15 patients were type Ⅳ;the courses of disease ranged from 4 to 10 years with an average of (5.41±2.35) years;the patients were treated by knee joint injection of 4 ml hyaluronic acid and 1 ml compound betamethasone. Visual analog scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to evaluate clinical effects before treatment and 1 week, 1, month, 3 and 6 months after treatment.@*RESULTS@#Totally 55 patients in observation group were followed up for 6 months, and 3 patients were quit at 3 months after treatment for poor efficacy. Totally 56 patients in control group were followed up for 6 months, and 2 patients were withdrew from the follow-up on the first and third month respectively for poor efficacy. There were no statistical difference in VAS and WOMAC between two groups before treatment and different time points after treatment (@*CONCLUSION@#For patients with moderate-severe KOA, there is no significant difference in therapeutic effect between compound betamethasone injection and compound betamethasone combined with hyaluronic acid injection, and long-term effect of two methods is not good.


Subject(s)
Betamethasone , Child , Child, Preschool , Female , Humans , Hyaluronic Acid , Injections, Intra-Articular , Male , Osteoarthritis, Knee/drug therapy , Prospective Studies , Treatment Outcome
2.
Medicentro (Villa Clara) ; 24(4): 721-734, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1143241

ABSTRACT

RESUMEN Introducción: el empleo de corticoesteroides es una estrategia eficaz para reducir el dolor postoperatorio. Objetivo: determinar la utilidad de la betametasona en la prevención del dolor postoperatorio en pacientes intervenidos por hernia discal lumbar. Métodos: se realizó un estudio cuasi-experimental en 100 pacientes intervenidos por hernia discal lumbar en el Hospital Universitario Clínico-Quirúrgico «Arnaldo Milián Castro¼, de la provincia de Villa Clara, durante el período de abril de 2013 a diciembre de 2015. Se dividieron en un grupo control y en un grupo estudio; previo a la incisión quirúrgica, se les administró diclofenaco 75 mg endovenoso y 8 mg de betametasona (solo en el grupo estudio). Resultados: el 70 % de los pacientes eran masculinos, y la edad media fue 45,99 años. En el grupo estudio el tiempo de aparición del dolor () y su intensidad, a las 4, 8 y 24 horas, fue significativamente menor que en el grupo control (pα< 0,010, pα< 0,001 y <0,001); el 48 % de los pacientes pudieron levantarse sin dolor, 32 % menos requirieron analgesia de rescate, y el grado de satisfacción fue significativamente mejor. Conclusiones: la administración de betametasona antes de la incisión quirúrgica resultó muy útil en la prevención del dolor postoperatorio en los pacientes intervenidos de hernia discal lumbar.


ABSTRACT Introduction: use of corticosteroids is an effective strategy to reduce postoperative pain. Objective: to determine usefulness of betamethasone in the prevention of postoperative pain in patients operated for lumbar disc herniation. Methods: a quasi-experimental study was carried out in 100 patients operated for lumbar disc herniation at "Arnaldo Milián Castro" Clinico-Surgical University Hospital, in Villa Clara province from April 2013 to December 2015. They were divided into a control group and a study one; prior to surgical incision, intravenous diclofenac 75mg and betamethasone 8mg were administered (only in the study group). Results: 70% of the patients were male, and the mean age was 45.99 years. In the study group, the time of onset of pain () and its intensity, at 4, 8 and 24 hours, was significantly lower than in the control group (pα <0.010, pα <0.001 and <0.001); 48% of the patients were able to get up without pain, 32 % less required rescue analgesia, and the degree of satisfaction was significantly better. Conclusions: administration of betamethasone before surgical incision was very useful in the prevention of postoperative pain in patients operated for lumbar disc herniation.


Subject(s)
Pain, Postoperative , Betamethasone , Hernia , Lumbar Vertebrae
4.
Buenos Aires; s.n; 16 jun. 2020.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-1116497

ABSTRACT

CONTEXTO CLÍNICO: La Enfermedad por el Coronavirus 2019 (COVID­19, por su sigla en inglés Coronavirus Disease 2019) es una enfermedad respiratoria de humanos producida por un nuevo coronavirus identificado con la sigla SARS-CoV-2. El 11 de marzo de 2020 la Organización Mundial de la Salud (OMS) declaro la COVID-19 como una pandemia. Desde ese momento hasta el 15 de junio su circulación se ha reportado en 205 países reportándose más de 7.800.000 casos y la muerte 430.000 personas. El período de incubación de la infección es de 2 a 14 días. La mayor parte de los contagios se producen persona a persona, siendo altamente transmisible.(3) La clínica varía desde casos asintomáticos a cuadros febriles con tos y dificultad respiratoria, neumonía y distrés respiratorio. También puede acompañarse de alteraciones gastrointestinales. En los casos con mal pronóstico, el paciente presenta un importante deterioro respiratorio en 4-8 días. Las imágenes radiológicas muestran generalmente neumonía focal o generalizada semejante al síndrome de distress respiratorio agudo. (3) La mayoría de los casos graves requieren ingreso hospitalario, siendo mayoritariamente casos primarios en pacientes de edad avanzada y con comorbilidades (diabetes, enfermedad crónica renal, hipertensión, enfermedad cardiaca y enfermedad pulmonar crónica). La tasa media de letalidad de los pacientes ingresados a UTI es cercana al 49%, siendo los valores más elevados en pacientes masculinos de más de 50 años con comorbilidades múltiples. Actualmente el tratamiento de la COVID­19 es sintomático y de sostén no existiendo hasta el momento tratamiento farmacológico específico curativo. Debido a la evidencia que sugiere que el daño pulmonar agudo observado en la infección por SARS-CoV-2 estaría asociada a la activación de las células inmunes circulantes, incluyendo células T y las citoquinas que conducen a un síndrome de liberación de citoquinas (similar al síndrome de activación macrofágica y hemofagocítico) por lo que se plantea que el uso de corticoides sistémicos podría disminuir la mortalidad y/o necesidad de soporte ventilatorio invasivo. TECNOLOGÍA: Los glucocorticoides (GCS) son una familia de medicamentos antiinflamatorios e inmunomoduladores que se utilizan en el tratamiento de diversas patologías cuyo principal componente etiopatogénico es la inflamación. Dentro de los mecanismos de acción propuestos se encuentran: inhibición de citoquinas inflamatorias (IL-1 y IL-2), inhibición de la migración de leucocitaria, inhibición de la desgranulación de mastocitos, depleción linfocitaria (principalmente linfocitos T), incremento de citoquinas anti-inflamatorias (IL-10). Dentro de las alternativas para la administración sistémica se pueden mencionar a la hidrocortisona, dexametasona, betametasona, prednisona, prednisolona, metilprednisolona y deflazacort. Todos ellos difieren principalmente en el grado de actividad mineralocorticorticoide y vida media. OBJETIVO: El objetivo del presente informe es evaluar la evidencia disponible acerca de la eficacia, seguridad y aspectos relacionados a las políticas de cobertura del uso de corticoides sistémicos en COVID­19. MÉTODOS: Se realizó una búsqueda en las principales bases de datos bibliográficas, en buscadores genéricos de internet, y financiadores de salud. Se priorizó la inclusión de revisiones sistemáticas (RS), ensayos clínicos controlados aleatorizados (ECAs), evaluaciones de tecnologías sanitarias (ETS), evaluaciones económicas, guías de práctica clínica (GPC) y recomendaciones de diferentes organizaciones de salud. RESULTADOS: Se incluyeron un ECA, una RS, dos estudios observacionales, un documento de evaluación de tecnología sanitaria, 12 guías de práctica clínica, recomendaciones de organismos gubernamentales o sociedades científicas acerca del uso de corticoides sistémicos en pacientes con diagnóstico de COVID­19. CONCLUSIONES: Evidencia de alta calidad proveniente de los resultados de un ensayo clínico aleatorizado aún no publicado sugiere que el uso de corticoides sistémicos se asocia a una disminución en el riesgo de mortalidad principalmente en pacientes con requerimientos de oxigeno suplementario o asistencia mecánica invasiva. Evidencia de muy baja calidad también sugiere que podría tener el mismo beneficio en aquellos pacientes con COVID-19 que presentan síndrome de distrés respiratorio agudo. Múltiples ensayos clínicos aleatorizados en pacientes con cuadros moderados o severos se encuentran en curso. Las guías de práctica clínica de diferentes sociedades internacionales y organismos gubernamentales que lo recomiendan indican su utilización para el tratamiento de pacientes con criterios de síndrome de distrés respiratorio agudo. Si bien no se encontraron estudios de costo-efectividad en Latinoamérica, el costo total del tratamiento al igual que su impacto presupuestario sería muy bajo.


Subject(s)
Humans , Pneumonia, Viral/drug therapy , Betamethasone/therapeutic use , Dexamethasone/therapeutic use , Hydrocortisone/therapeutic use , Methylprednisolone/therapeutic use , Prednisolone/therapeutic use , Prednisone/therapeutic use , Coronavirus Infections/drug therapy , Betacoronavirus/drug effects , Technology Assessment, Biomedical , Health Evaluation , Cost-Benefit Analysis
5.
Rev. cuba. estomatol ; 56(4): e2010, oct.-dez. 2019. graf
Article in Portuguese | LILACS | ID: biblio-1093257

ABSTRACT

RESUMO Introdução: a psoríase é uma doença inflamatória crônica e recorrente da pele que raramente ocorre apenas e primariamente na mucosa bucal. Objetivo: A descrever um caso de psoríase primária na mucosa bucal. Apresentação do caso: Um paciente de 16 anos de idade relatou uma "mancha que fez com que se sentisse desconfortável". O paciente apresentava uma placa leucoplásica, exofítica e uma úlcera. Na histopatologia e com as características clínicas, a suspeita de mucosite psoriasiforme foi confirmada. O tratamento escolhido para as lesões da psoríase foi a aplicação tópica de valerato de betametasona 1 mg/g por três semanas. Após duas semanas de tratamento, o paciente retornou para reavaliação clínica e foi observado sucesso na terapêutica. Conclusões: A presença de psoríase exclusiva na cavidade bucal é uma entidade rara. A apresentação clínica variada e a ausência de alterações locais ou sistêmicas associadas foram elementos-chave na suspeição diagnóstica. A abordagem por meio de cirurgia para remoção da lesão exofítica e o uso de betametasona tópica permitiram o controle locorregional(AU)


RESUMEN Introducción: La psoriasis es una enfermedad inflamatoria crónica y recurrente de la piel y que en rara ocasión ocurre única y por primaria vez en mucosa bucal. Objetivo: Describir un caso de psoriasis primaria en mucosa bucal. Presentación de caso: Paciente de 16 años de edad consultada que refirió una "mancha que incomodaba al comer". La paciente presentaba una placa leucoplásica, exofítica y una úlcera. En la histopatología y con las características clínicas, se confirmó la sospechosa de mucositis psoriasiforme. El tratamiento elegido para las lesiones de psoriasis fue la aplicación tópica de valerato de betametasona 1 mg/g durante tres semanas. Después de dos semanas de tratamiento la paciente retornó para reevaluación clínica y se constató éxito en la terapéutica escogida. Conclusiones: la presencia de psoriasis exclusiva en la cavidad bucal es una entidad poco frecuente. La presentación clínica variada y la ausencia de alteraciones locales o sistémicas asociadas fueron elementos clave en la sospecha diagnóstica. El abordaje por medio de cirugía para remoción de la lesión exofítica y utilización de betametasona tópica posibilitó el control locorregional(AU)


ABSTRACT Introduction: Psoriasis is a chronic inflammatory and recurrent skin disease that rarely occurs solely and primarily in the oral mucosa. Objective: Describe a case of primary psoriasis of the oral mucosa. Case presentation: A 16-year-old female patient attends consultation and reports "a spot that hurts when eating." Clinical observation revealed the presence of leukoplastic, exophytic plaque and an ulcer. Histopathological examination confirmed the suspicion of psoriasiform mucositis. The treatment chosen for the psoriatic lesions was topical application of betamethasone valerate 1 mg/g for three weeks. After two weeks of treatment, the patient returned for clinical reassessment and the treatment applied was found to have been successful. Conclusions: Exclusively oral psoriasis is an uncommon condition. Multi-faceted clinical presentation and the absence of local or systemic associated alterations were key elements in the diagnostic suspicion. Surgical removal of the exophytic lesion and application of topical betamethasone led to locoregional control(AU)


Subject(s)
Humans , Female , Adolescent , Psoriasis/drug therapy , Stomatitis/diagnosis , Betamethasone/therapeutic use , Mouth/injuries
6.
Rev. chil. obstet. ginecol. (En línea) ; 84(1): 41-48, feb. 2019. tab
Article in Spanish | LILACS | ID: biblio-1003721

ABSTRACT

RESUMEN Introducción: El estándar para inducción de madurez pulmonar en fetos con riesgo de nacer prematuramente es la administración de 12 mg de betametasona acetato/fosfato por dos veces espaciada cada 24 horas. El uso establecido en algunos hospitales públicos en Chile es con dos dosis de 12 mg betametasona fosfato aunque no existen estudios publicados sólo con betametasona fosfato sobre la incidencia de Síndrome de Distress Respiratorio (SDR). Objetivo: Evaluar efecto de betametasona en su forma fosfato como tratamiento antenatal para inducción de madurez fetal pulmonar en la incidencia SDR debido a membrana hialina en prematuros menores de 34 semanas de edad gestacional. Comparar el efecto de betametasona fosfato con el efecto publicado de betametasona acetato/fosfato. Material y método: Análisis de incidencia de SDR en prematuros nacidos en Hospital Padre Hurtado entre 24+0 y 34+0 semanas que recibieron betametasona fosfato para madurez pulmonar y aquellos que no la recibieron. Resultados: De 1.265 neonatos estudiados, 722 completaron dos dosis (57,5%); 436 sólo una dosis (34,5%) y 107 (8,5%) no recibieron corticoides antenatales. La incidencia de SDR debido a membrana hialina en el grupo con dos dosis fue 8,7%, una dosis 25,3% y 32,7% en los no tratados (p<0,001). Para SDR severo las incidencias fueron 6,7%, 12,6% y 16,8% respectivamente (p<0,001). Conclusiones: Inducción de madurez fetal pulmonar con betametasona fosfato en dos dosis de 12 mg IM separadas por 24 horas otorga una reducción significativa de incidencia de SDR semejante a la publicada con betametasona acetato/fosfato en iguales dosis.


ABSTRACT The standard for induction of lung maturity in fetuses at risk of being born prematurely is the administration of 12 mg of betamethasone acetate/phosphate two doses separated by 24 hours. The established use in some public hospitals in Chile is with two doses of 12 mg betamethasone phosphate although there are no studies published with betamethasone phosphate alone on the incidence of respiratory distress syndrome (RDS). Objective: To evaluate the effect of betamethasone in its phosphate form as antenatal treatment for the induction of fetal lung maturity in the incidence of RDS due to hyaline membrane in preterm infants less than 34 weeks of gestational age. To compare the effect of betamethasone phosphate with the published effect of betamethasone acetate/phosphate. Material and method: Analysis of the incidence of RDS in preterm infants born at Hospital Padre Hurtado between 24 + 0 and 34 + 0 weeks who received betamethasone phosphate for lung maturity and those who did not receive it. Results: Of 1,265 infants studied, 722 completed two doses (57.5%); 436 only one dose (34.5%) and 107 (8.5%) did not receive antenatal corticosteroids. The incidence of RDS due to hyaline membrane in the group with two doses was 8.7%, one dose 25.3% and 32.7% in the untreated ones (p <0.001). For severe RDS, incidences were 6.7%, 12.6% and 16.8% respectively (p <0.001). Conclusions: Induction of fetal lung maturity with betamethasone phosphate in two doses of 12 mg IM separated by 24 hours gives a significant reduction in the incidence of RDS similar to that published with betamethasone acetate/phosphate in equal doses.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Respiratory Distress Syndrome, Newborn/prevention & control , Betamethasone/analogs & derivatives , Premature Birth , Glucocorticoids/administration & dosage , Prenatal Care/methods , Respiratory Distress Syndrome, Newborn/epidemiology , Betamethasone/administration & dosage , Incidence , Retrospective Studies , Hospitals, Public , Hyaline Membrane Disease/prevention & control , Lung/drug effects
7.
Rev. Soc. Bras. Med. Trop ; 52: e20190055, 2019. graf
Article in English | LILACS | ID: biblio-1013312

ABSTRACT

Abstract Snakebites by aglyphous or opisthoglyphous snakes are common in Brazil. We report a case of snakebite by the opisthoglyphous Erythrolamprus aesculapii. The victim presented with pain, edema, and bleeding at the bite site, along with erythema, similar to a Bothrops envenomation. In this type of snakebite, if the snake is not brought to the hospital, the victim may receive unnecessary serum therapy, with the risk of adverse reactions to the antivenom. The possibility of reducing after-effects with anti-inflammatory drugs and early antibiotic therapy for secondary infection need to be further investigated, preferably in multicenter studies, while observing good clinical practice.


Subject(s)
Humans , Animals , Male , Young Adult , Snake Bites/complications , Snake Venoms/poisoning , Colubridae , Hand Injuries/etiology , Snake Bites/drug therapy , Brazil , Betamethasone/therapeutic use , Accidents, Occupational , Hand Injuries/drug therapy , Histamine Antagonists/therapeutic use
8.
Neonatal Medicine ; : 198-203, 2019.
Article in English | WPRIM | ID: wpr-786441

ABSTRACT

PURPOSE: Many studies have reported associations of early postnatal growth failure in preterm infants with several morbidities. However, the risk factors for postnatal weight loss (PWL) in late preterm infants have not been identified. We investigated the independentrisk factors for PWL in late preterm infants.METHODS: This was a retrospective cohort study. We enrolled 369 late preterm infants born at 34⁺⁰ to 36⁺⁶ weeks gestational age who were admitted to the Soonchunhyang University Cheonan Hospital between 2015 and 2017. PWL% was calculated as (birth weight–lowest weight)/birth weight×100. The infants were classified into lower (< 5%) and higher (≥10%) PWL% groups by propensity score matching for gestational age, sex, and birth weight. Perinatal risk factors were analyzed using multivariable logistic regression.RESULTS: The lower and higher PWL% groups included 62 and 31 infants, respectively. Antenatal steroids administered within 1 week before birth (odds ratio [OR], 3.26; 95% confidence interval [CI], 1.015 to 10.465; P=0.047), lower total calorie intake during days 1 to 7 (OR, 0.98; 95% CI, 0.977 to 0.999; P=0.027), and phototherapy (OR, 5.28; 95% CI, 1.327 to 21.024; P=0.018) were independent risk factors for the higher PWL%.CONCLUSION: Further studies are needed to identify the risk factors that cause high PWL% according to gestational age and short- and long-term morbidities based on the degree of PWL.


Subject(s)
Betamethasone , Birth Weight , Cohort Studies , Comorbidity , Gestational Age , Humans , Infant , Infant, Newborn , Infant, Premature , Logistic Models , Parturition , Phototherapy , Propensity Score , Retrospective Studies , Risk Factors , Steroids , Weight Loss
9.
Experimental Neurobiology ; : 529-536, 2019.
Article in English | WPRIM | ID: wpr-763775

ABSTRACT

Stress can induce a serious epileptic encephalopathy that occurs during early infancy. Recent studies have revealed that prenatal stress exposure is a risk factor for the development of infantile spasms. Our previous work demonstrates that prenatal stress with betamethasone-induced alterations to the expression of the K⁺/Cl⁻ co-transporter (KCC2) in gamma-aminobutyric acid (GABA) interneurons lowers the seizure threshold in exposed animals. Here, we further investigated the mechanisms involved in this KCC2 dysfunction and explored possible treatment options. We stressed Sprague-Dawley rats prenatally and further treated dams with betamethasone on gestational day 15, which increases seizure susceptibility and NMDA (N-Methyl-D-aspartate)-triggered spasms on postnatal day 15. In this animal model, first, we evaluated baseline calpain activity. Second, we examined the cleavage and dephosphorylation of KCC2. Finally, we checked the effect of a calpain inhibitor on seizure occurrence. The phosphorylated-N-methyl-D-aspartate Receptor 2B (NR2B):non-phosphorylated NR2B ratio was found to be higher in the cortex of the prenatally stressed beta-methasone model. We further found that the betamethasone model exhibited increased phosphorylation of calpain-2 and decreased phosphorylation of KCC2 and Glutamic acid decarboxylase 67 (GAD67). After using a calpain inhibitor in prenatal-stress rats, the seizure frequency decreased, while latency increased. GABAergic depolarization was further normalized in prenatal-stress rats treated with the calpain inhibitor. Our study suggests that calpain-dependent cleavage and dephosphorylation of KCC2 decreased the seizure threshold of rats under prenatal stress. Calpain-2 functions might, thus, be targeted in the future for the development of treatments for epileptic spasms.


Subject(s)
Animals , Betamethasone , Brain Diseases , Calpain , Epilepsy , gamma-Aminobutyric Acid , Glutamate Decarboxylase , Humans , Infant , Infant, Newborn , Interneurons , Models, Animal , N-Methylaspartate , Phosphorylation , Rats , Rats, Sprague-Dawley , Risk Factors , Seizures , Spasm , Spasms, Infantile
11.
Ultrasonography ; : 134-139, 2018.
Article in English | WPRIM | ID: wpr-731153

ABSTRACT

PURPOSE: The aim of this study was to elucidate whether intrasynovial corticosteroid injections for trigger digit reduced the volume of the tendon and pulley on high-resolution ultrasonography. METHODS: Twenty-three digits of 20 patients with trigger digit were included. Each affected finger was graded clinically according to the following classification: grade I for pre-triggering, grade II for active triggering, grade III for passive triggering, and grade IV for presence of contracture. Axial ultrasound examinations were performed before an intrasynovial corticosteroid injection and at an average of 31 days after the injection. The transverse diameter, thickness, and cross-sectional area of the tendon and the thickness of the pulley were measured by two independent, blinded researchers. RESULTS: At least 1 grade of improvement was achieved in this study group by the time of the second examination. The transverse diameter and cross-sectional area of the tendon and the thickness of the pulley significantly decreased (P < 0.05). CONCLUSION: The injection of a single dose of betamethasone improved clinical symptoms by reducing the volume of both the tendon and pulley, which may be related to the fact that tendon and pulley ruptures are delayed by corticosteroid injections.


Subject(s)
Adrenal Cortex Hormones , Betamethasone , Classification , Contracture , Fingers , Humans , Rupture , Tendons , Trigger Finger Disorder , Ultrasonography
12.
Braz. j. otorhinolaryngol. (Impr.) ; 83(6): 633-639, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-889315

ABSTRACT

Abstract Introduction: A combination of antihistamines and oral corticosteroids is often used to treat acute symptoms of allergic rhinitis. Objective: To evaluate safety and efficacy of desloratadine plus prednisolone in the treatment of acute symptoms of children (2-12 years) with allergic rhinitis, and to compare it to dexchlorpheniramine plus betamethasone. Methods: Children with moderate/severe persistent allergic rhinitis and symptomatic (nasal symptoms score [0-12] ≥ 6) were allocated in a double-blind, randomized fashion to receive dexchlorpheniramine plus betamethasone (n = 105; three daily doses) or desloratadine plus prednisolone (n = 105; single dose followed by two of placebo) for 7 days. At the beginning and end of the evaluation, the following were obtained: nasal symptoms score, extra nasal symptoms score, peak nasal inspiratory flow, blood biochemistry, and electrocardiogram. Ninety-six children of the dexchlorpheniramine plus betamethasone group and 98 of the desloratadine plus prednisolone group completed the protocol. Results: The two groups were similar regarding initial and final nasal symptoms scores, extra nasal symptoms scores and peak nasal inspiratory flow. A drop of 76.4% and 79.1% for nasal symptoms score, 86.0% and 79.2% for extra nasal symptoms score, as well as an increase of 25.2% and 24.3% for peak nasal inspiratory flow occurred for those treated with desloratadine plus prednisolone and dexchlorpheniramine plus betamethasone, respectively. There were no significant changes in blood chemistry. Sinus tachycardia was the most frequent electrocardiogram change, but with no clinical significance. Drowsiness was reported significantly more often among those of dexchlorpheniramine plus betamethasone group (17.14% × 8.57%, respectively). Conclusion: The desloratadine plus prednisolone combination was able to effectively control acute symptoms of rhinitis in children, improving symptoms and nasal function. Compared to the dexchlorpheniramine plus betamethasone combination, it showed similar clinical action, but with a lower incidence of adverse events and higher dosing convenience.


Resumo Introdução: A associação entre anti-histamínicos e corticosteroides orais é frequentemente empregada no tratamento de sintomas agudos de rinite alérgica. Objetivo: Avaliar a segurança e eficácia da associação desloratadina + prednisolona no tratamento de sintomas agudos de crianças (2-12 anos) com rinite alérgica e compará-las com as da associação dexclorfeniramina + betametasona. Método: Crianças com rinite alérgica persistente moderada/grave e sintomáticas (escore de sintomas nasais [0-12] ≥ 6) foram alocadas de modo duplo-cego e randômico para receber dexclorfeniramina + betametasona (n = 105; três doses diárias) ou desloratadina + prednisolona (n = 105; dose única seguida por duas de placebo) por 7 dias. No início e no fim da avaliação foram obtidos: escore de sintomas nasais, escore de sintomas extranasais, pico de fluxo inspiratório nasal, bioquímica sanguínea e eletrocardiograma. Do total, 96 crianças do grupo dexclorfeniramina + betametasona e 98 do grupo desloratadina + prednisolona concluíram o protocolo. Resultados: Os dois grupos foram iguais com relação ao escore de sintomas nasais, escore de sintomas nasais extranasais e pico de fluxo inspiratório nasal iniciais e finais. Observou-se queda de 76,4% e 79,1% nos escores para escore de sintomas nasais, de 86,0% e 79,2% para escore de sintomas extranasais, assim como incremento de 25,2% e de 24,3% para o pico de fluxo inspiratório nasal para os grupos desloratadina + prednisolona e dexclorfeniramina + betametasona, respectivamente. Não houve alterações significativas da bioquímica sanguínea. Taquicardia sinusal foi a alteração do eletrocardiograma mais encontrada, mas sem significância clínica. Sonolência foi significantemente mais referida entre os tratados com dexclorfeniramina + betametasona do que entre os desloratadina + prednisolona (8,57% × 17,14%, respectivamente). Conclusão: A associação desloratadina + prednisolona foi capaz de controlar efetivamente os sintomas agudos de rinite em crianças, melhorou sintomas e a função nasal. Na comparação com a associação dexclorfeniramina + betametasona, demonstrou ação clínica semelhante, mas com menor incidência de eventos adversos e maior comodidade posológica.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Prednisolone/administration & dosage , Loratadine/analogs & derivatives , Rhinitis, Allergic/drug therapy , Glucocorticoids/administration & dosage , Time Factors , Severity of Illness Index , Betamethasone/administration & dosage , Betamethasone/adverse effects , Prednisolone/adverse effects , Peak Expiratory Flow Rate , Double-Blind Method , Reproducibility of Results , Treatment Outcome , Loratadine/administration & dosage , Loratadine/adverse effects , Statistics, Nonparametric , Histamine H1 Antagonists, Non-Sedating/administration & dosage , Histamine H1 Antagonists, Non-Sedating/adverse effects , Drug Combinations , Glucocorticoids/adverse effects
13.
An. bras. dermatol ; 92(5): 704-706, Sept.-Oct. 2017. graf
Article in English | LILACS | ID: biblio-887026

ABSTRACT

Abstract: Pigmented purpuric dermatoses are chronic vascular inflammatory conditions characterized by the presence of pigmented macules. Among its different presentations, lichen aureus is distinguished by the lichenoid conformation of its plaques and the predilection for lower limb involvement. Its segmented form is rare and difficult to control, especially in cases of symptomatic lesions. We report a rare case of segmental lichen aureus with six years of evolution associated with light itching. We also discuss the main therapeutic approaches to control the disease.


Subject(s)
Humans , Female , Middle Aged , Lichenoid Eruptions/pathology , Sunlight , Betamethasone/therapeutic use , Photosensitizing Agents/therapeutic use , Lichenoid Eruptions/therapy , Glucocorticoids/therapeutic use , Methoxsalen/therapeutic use
15.
Article in English | WPRIM | ID: wpr-330449

ABSTRACT

<p><b>OBJECTIVE</b>To assess the early curative effect of epidural or intravenous administration of steroids during a percutaneous endoscopic lumbar discectomy (PELD).</p><p><b>METHODS</b>28 consecutive patients who underwent PELD due to large lumbar disc herniation between November 2014 and January 2016 were followed up for 6 months. These patients were divided into two groups according to the treatment they received after PELD. 14 patients (Group A) were treated by PELD and epidural steroids, while the other 14 patients (Group B) were treated by PELD and intravenous steroids. We evaluated the effectiveness by the preoperative and postoperative visual analogue scale (VAS) scores for back and leg pain, and the postoperative Oswestry disability index (ODI) at 3 weeks after surgery via the clinical charts and telephone interview. Postoperative hospital stay and time return to work were investigated as well.</p><p><b>RESULTS</b>There is a significant decrease in VAS (back, leg), ODI, and time return to work (p < 0.05). For VAS (back), Group A showed a significant decrease compared with Group B at 1 day and 1 week after surgery (p = 0.011, p = 0.017). As for VAS (leg), Group A showed a significant decrease compared with Group B at 1 day, 1 week, 3 weeks, and 3 months follow-up examinations (p = 0.002, p = 0.006, p < 0.001, p < 0.001). For ODI, Group A showed a notable decrease compared with Group B (p < 0.001). The postoperative hospital stay in two groups was not statistically different (p = 0.636). But the time return to work in Group A was significantly shorter than that in Group B (p = 0.023).</p><p><b>CONCLUSION</b>Patients who underwent PELD with epidural steroid administration for large lumbar disc herniation showed favorable curative effect compared with those who underwent PELD with intravenous steroid administration.</p>


Subject(s)
Adult , Betamethasone , Diskectomy, Percutaneous , Methods , Endoscopy , Female , Glucocorticoids , Humans , Injections, Epidural , Injections, Intravenous , Intervertebral Disc Displacement , General Surgery , Length of Stay , Lumbar Vertebrae , General Surgery , Male , Pain Measurement , Retrospective Studies
16.
Braz. j. oral sci ; 15(3)July-Sept. 2016. ilus
Article in English | LILACS, BBO | ID: biblio-875091

ABSTRACT

Aim: the objective of this study was to evaluate the effect of betamethasone in the control of postoperative pain in patients undergoing endodontic treatment. Methods: patients of both genders (n = 120), after being submitted to emergency endodontic treatment, received a single dose of betamethasone solution (0.05 mg / body weight) or sterile saline solution intramucosally, in the periapical region of the treated tooth. The study evaluated the intensity of pain experienced by the patient and the number of analgesics consumed during periods of 4, 24 and 48 hours after endodontic treatment. To compare the level of pain among the groups and the use of analgesics the Fisher's Exact Test was used, adopting a significance level of 95%. Results: patients who received betamethasone felt less pain in 4 hours (p = 0.0177) and 24 hours (p = 0.0012) compared to those who received the placebo. Conclusions: betamethasone at a dose of 0.05 mg / body weight administered in the periapical region is a advantageous protocol due to its effectiveness, and also because of the comfort it provides to patients in the prevention or control of inflammatory pain in endodontics. (AU)


Subject(s)
Humans , Male , Female , Betamethasone/adverse effects , Betamethasone/therapeutic use , Endodontics , Pain, Postoperative/prevention & control , Pulpitis/prevention & control
17.
An. bras. dermatol ; 91(2): 160-166, Mar.-Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-781364

ABSTRACT

Abstract BACKGROUND: Psoriasis is a common, chronic, recurrent, immune-mediated disorder of the skin and joints. It can have a significant negative impact on the physical, emotional and psychosocial wellbeing of affected patients. OBJECTIVES: To measure improvement in health-related QoL (HRQoL) in Greek patients with psoriasis vulgaris after a month of treatment with calcipotriol-betamethasone dipropionate gel; and evaluate adherence to treatment parameters. METHODS: The study included 394 psoriasis vulgaris patients from 16 private dermatological practices in Greece, all treated with calcipotriol-betamethasone dipropionate gel. They were evaluated at the first visit and after 4 weeks. Moreover, they completed the Dermatology Life Quality Index (DLQI), while other data such as disease severity, subjective symptoms and adherence, were collected. RESULTS: At week 4, the DLQI median was reduced by 3.5 points from the baseline (p<0.001; baseline and week 4 median: 4.5 and 1.0 respectively). Pruritus and sleep disorders also improved (p<0.001). Furthermore, 90.1% of the subjects fully adhered to treatment, with a 97.1% mean level of compliance. CONCLUSIONS: The convincing clinical results, with a distinct improvement in HRQoL, plus the high level of adherence due to its advantageous physical properties, make the calcipotriol-betamethasone dipropionate gel formulation an important, effective and well-tolerated topical therapy to treat psoriasis.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Psoriasis/drug therapy , Quality of Life , Calcitriol/analogs & derivatives , Betamethasone/analogs & derivatives , Dermatologic Agents/therapeutic use , Medication Adherence/statistics & numerical data , Psoriasis/pathology , Time Factors , Severity of Illness Index , Calcitriol/therapeutic use , Betamethasone/therapeutic use , Prospective Studies , Surveys and Questionnaires , Treatment Outcome , Statistics, Nonparametric , Drug Combinations , Medication Adherence/psychology , Gels , Greece
19.
Annals of Dermatology ; : 569-574, 2016.
Article in English | WPRIM | ID: wpr-59033

ABSTRACT

BACKGROUND: Various systemic agents have been assessed for the treatment of alopecia areata (AA); however, there is a paucity of comparative studies. OBJECTIVE: To assess and compare cyclosporine and betamethasone minipulse therapy as treatments for AA with regard to effectiveness and safety. METHODS: Data were collected from 88 patients who received at least 3 months of oral cyclosporine (n=51) or betamethasone minipulse therapy (n=37) for AA. Patients with ≥50% of terminal hair regrowth in the alopecic area were considered responders. RESULTS: The responder of the cyclosporine group was 54.9% and that of the betamethasone minipulse group was 37.8%. In the cyclosporine group, patients with mild AA were found to respond better to the treatment. Based on the patient self-assessments, 70.6% of patients in the cyclosporine group and 43.2% of patients in the betamethasone minipulse group rated their hair regrowth as excellent or good. Side effects were less frequent in the cyclosporine group. CONCLUSION: Oral cyclosporine appeared to be superior to betamethasone minipulse therapy in terms of treatment effectiveness and safety.


Subject(s)
Alopecia Areata , Alopecia , Betamethasone , Cyclosporine , Hair , Humans , Pulse Therapy, Drug , Self-Assessment , Treatment Outcome
20.
Neonatal Medicine ; : 29-34, 2016.
Article in English | WPRIM | ID: wpr-65003

ABSTRACT

PURPOSE: The aim of this study is to prove the association between potential fetal hypoxia and retinopathy of prematurity (ROP) development and absolute nucleated red blood cell (aNRBC) is used to evaluate it in premature infants without any hypoxic or ischemic history. METHODS: Medical records of 43 premature infants with ROP who were admitted to the neonatal intensive care unit at Wonkwang University Hospital from January 2004 to December 2014 were analyzed retrospectively. We excluded 15 infants who had a confounding medical condition that could have increased the aNRBC count. Finally, 28 premature infants affected by ROP were enrolled and compared with 28 pair-matched controls. The aNRBC counts at birth in these infants were compared. Statistical analysis was performed with a paired t-test for continuous data, and a Fisher's exact test for categorical data. P24 hours), prenatal betamethasone, surfactant or respiratory distress syndrome between the ROP and the control infants. In addition, neither group differed in major morbidities such as patent ductus arteriosus, periventricular leukomalacia, intraventricular hemorrhage (> or =Grade 2), or bronchopulmonary dysplasia. Regardless of the severity of ROP, the aNRBC counts at birth in premature infants with ROP were not higher than in the control infants. CONCLUSION: The aNRBC counts at birth may not be related directly to the development of ROP.


Subject(s)
Betamethasone , Birth Weight , Bronchopulmonary Dysplasia , Ductus Arteriosus, Patent , Erythrocyte Count , Erythrocytes , Fetal Hypoxia , Gestational Age , Hemorrhage , Humans , Infant , Infant, Newborn , Infant, Premature , Intensive Care, Neonatal , Leukomalacia, Periventricular , Medical Records , Membranes , Parturition , Retinopathy of Prematurity , Retrospective Studies , Rupture
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