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1.
Rev. cuba. estomatol ; 58(1): e2949, ene.-mar. 2021. graf
Article in English | LILACS, CUMED | ID: biblio-1156423

ABSTRACT

Introduction: Facial injuries are a common occurrence at the emergency room. Treatment for this type of trauma is complex in terms of re-establishing good oral and facial function, plus aesthetics. Objective: This paper aims to report a clinical case of aesthetic and functional rehabilitation using triamcinolone in a patient affected on the face by a fireworks explosion. Case report: A 26-year-old man was admitted to the oral and maxillofacial surgery service of the Sergipe Urgency Hospital presenting trauma after the explosion of a "Firework rocket" in his face. The patient had extensive soft tissue injury in gingival mucosa, right labial commissure, and tongue. There was also inferior incisive avulsion and dentoalveolar fracture. His clinical and tomographic evaluation presented comminuted mandibular fracture. After eighteen days he was discharged and sent to the dentistry service of the Federal University of Sergipe for aesthetic and functional rehabilitation of his facial damages. Two months later, the patient attended a University dental service to begin aesthetic and postoperative functional rehabilitation. First, the necrotic bone was removed, following intralesional infiltration of hexacetonide triamcinolone 20mg/mL into the scar of the labial region and the commissure of the lips was performed. Each application was performed after twenty days of interval. Later, lingual frenectomy and glossosplasty were done for improving his lingual mobility and then hexacetonide triamcinolone 20mg/mL infiltrations were also done in the tongue base in the following sessions. Conclusions: After five infiltrations, it was observed an improvement in the scar appearance and texture, which also had a lower contracture, as well as a lingual motricity improvement(AU)


Introducción: Las lesiones faciales son frecuentes en el servicio de emergencia. El tratamiento para este tipo de trauma es complejo en términos de restablecer una buena función bucal y facial, además de la estética. Objetivo: Reportar un caso clínico de rehabilitación estética y funcional a través del uso de hexacetónido de triamcinolona en un paciente afectado por una explosión de fuegos artificiales en su rostro. Caso clínico: Hombre de 26 años ingresado en el servicio de cirugía oral y maxilofacial del Hospital de Urgencia de Sergipe por presentar un traumatismo después de la explosión contra su rostro de un cohete de fuegos artificiales. El paciente tenía una lesión extensa de partes blandas en la mucosa gingival, comisura labial derecha y lengua. También hubo avulsión incisiva inferior y fractura dentoalveolar. A través de la evaluación clínica y de tomografía, fue posible observar fragmentación múltiple ósea en el sitio de la fractura, compatible con fractura mandibular conminuta. Después de dieciocho días fue dado de alta y enviado al servicio de odontología de la Universidad Federal de Sergipe para la rehabilitación estética y funcional de sus daños faciales. Dos meses después, el paciente asistió al servicio dental de la universidad para comenzar la rehabilitación funcional estética y posoperatoria. Primero, se retiró el hueso necrótico, luego se realizó la infiltración intralesional de hexacetónido de triamcinolona 20 mg/mL en la cicatriz de la región labial y se realizó la comisura de los labios; con un intervalo de 20 días entre cada aplicación. Posteriormente, se realizaron frenectomía lingual y glososplastia, para mejorar su movilidad lingual, y luego se realizaron infiltraciones de 20 mg/mL de hexacetónido de triamcinolona en la base de la lengua en las sesiones siguientes. Comentarios principales: Después de cinco infiltraciones se observó una mejora en el aspecto y la textura de la cicatriz, que también tenía una contractura más baja, así como una mejora de la motricidad lingual(AU)


Subject(s)
Humans , Male , Adult , Triamcinolone/therapeutic use , Explosions/prevention & control , Facial Injuries/diagnosis , Mandibular Fractures/therapy , Reconstructive Surgical Procedures/rehabilitation , Emergency Service, Hospital
2.
Rev. bras. ortop ; 55(5): 551-556, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1144208

ABSTRACT

Abstract Objectives This study aimed to analyze the efficacy of platelet-rich plasma obtained from the peripheral, autologous blood of the patients in pain complaints reduction and functional improvement of knee osteoarthritis compared with the standard treatment with injectable corticosteroid, such as triamcinolone. Methods The patients were followed-up clinically at the preinfiltrative visit, with quantitative evaluation using the Knee Society Score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and the Kellgren and Lawrence scales. In addition, they were reevaluated with the same scales after 1 month and 6 months of intervention with 2.5 mL of triamcinolone acetate or 5 mL of platelet-rich plasma. The study was performed on 50 patients with knee osteoarthritis treated at the Medical Specialty Center and randomly divided into equivalent samples for each therapy. Results The present study verified the reduction of pain scores, such as the WOMAC score, and elevations of functional scales, such as the KSS, evidenced in 180 days when using platelet-rich plasma, a therapy that uses the autologous blood of the patient and has fewer side effects. Conclusion Although both platelet-rich plasma and corticosteroid therapies have been shown to be effective in the reduction pain complaints and functional recovery, there was a statistically significant difference between them at 180 days. According to the results obtained, platelet-rich plasma presented longer-lasting effects within 180 days in the treatment of knee osteoarthritis.


Resumo Objetivo Analisar a eficácia do uso de plasma rico em plaquetas, obtido do sangue periférico e autólogo dos pacientes, na redução das queixas álgicas e melhoria funcional dos pacientes portadores de osteoartrite de joelhos, em comparação com o tratamento padrão com injeção de corticosteroides de depósito, como a triancilonola. Métodos Os pacientes foram acompanhados clinicamente na consulta pré-infiltrativa, com avaliação quantitativa através das escalas Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), e Kellgren and Lawrence. Além disso, os pacientes foram reavaliados com as mesmas escalas após 1 mês e 6 meses de intervenção com 2,5 mL de acetato de triancinolona ou 5 mL de plasma rico em plaquetas. O estudo foi feito em 50 pacientes portadores de osteoartrite de joelhos atendidos no Centro de Especialidades Médicas, divididos em amostras equivalentes randomizadas para cada terapia. Resultados No presente estudo, verificaram-se redução dos valores em escalas álgicas, como a WOMAC, e elevação das pontuações em escalas funcionais, como a KSS, evidenciadas em 180 dias após o uso de plasma rico em plaquetas, uma terapia feita a partir do sangue autólogo do paciente e com menos efeitos colaterais. Conclusão Embora ambas as terapias com plasma rico em plaquetas e corticosteroides tenham se mostrado eficazes na redução das queixas álgicas e na recuperação funcional, houve diferença significativa entre as terapias aos 180 dias. De acordo com os resultados obtidos, no tratamento da osteoartrite do joelho, o plasma rico em plaquetas demonstrou efeitos mais duradouros em 180 dias.


Subject(s)
Humans , Osteoarthritis , Blood , Triamcinolone , Efficacy , Adrenal Cortex Hormones , Osteoarthritis, Knee , Platelet-Rich Plasma , Recycling , Injections
3.
Rev. cuba. oftalmol ; 33(3): e878, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139101

ABSTRACT

RESUMEN El origen del pseudotumor orbitario no es del todo conocido. Se admite su naturaleza inflamatoria granulomatosa e inespecífica en diferentes localizaciones. El pseudotumor orbitario se define como una respuesta inflamatoria celular pleomórfica, que está usualmente confinado a estructuras de la órbita y tiene una evolución limitada. En este trabajo se presenta una paciente femenina de 16 años, con diagnóstico de pseudotumor orbitario corroborado por biopsia y tomografía axial computarizada, refractaria al tratamiento con esteroides sistémicos, por lo que se decide iniciar con la aplicación de hialuronidasa y triamcinolona en el espacio peribulbar. Los casos agudos casi siempre responden rápidamente al tratamiento con cortocoesteroides, como prednisona, pero debemos tener en cuenta que existen pacientes que son refractarios al tratamiento, por lo que es necesario buscar procedimientos alternativos. Una opción es el uso de hialuronidasa para destruir las uniones extracelulares, y difundir un esteroide de manera local, como la triamcinolona, más efectiva dentro del tejido inflamatorio para provocar un efecto localizado de este. A los tres meses del tratamiento hubo una regresión total del cuadro en esta paciente(AU)


ABSTRACT The exact etiology of orbital pseudotumor is unknown, but its granulomatous unspecific inflammatory nature at various locations has been recognized. Orbital pseudotumor is defined as a cellular pleomorphic inflammatory response of limited evolution often confined to orbital structures. A case is presented of a female 16-year-old patient diagnosed with orbital pseudotumor confirmed by biopsy and computerized axial tomography, refractory to treatment with systemic steroids, due to which it is decided to start treatment with hyaluronidase and triamcinolone in the peribulbar space. Acute cases often respond fast to treatment with corticosteroids such as prednisone. It should be borne in mind that there are patients who are refractory to treatment for whom alternative treatments should be sought. An option is the use of hyaluronidase to destroy extracellular junctions and locally spread a steroid such as triamcinolone, most effectively within the inflammatory tissue to ensure its localized effect. Total regression of the patient's status was observed at three months of treatment(AU)


Subject(s)
Humans , Female , Adolescent , Triamcinolone/therapeutic use , Orbital Pseudotumor/diagnosis , Hyaluronoglucosaminidase/therapeutic use
4.
Rev. cuba. med. mil ; 49(1): e374, ene.-mar. 2020. fig
Article in Spanish | LILACS, CUMED | ID: biblio-1126690

ABSTRACT

Introducción: La cicatriz queloide forma parte de las cicatrices patológicas por exceso; es una afección que se caracteriza por el depósito excesivo de colágeno en la dermis y tejido celular subcutáneo. El proceso por el cual se desarrolla no es del todo conocido, es más frecuente en la raza negra y afecta en igual proporción a hombres que mujeres. Objetivo: Informar a la comunidad médica sobre experiencia en el manejo y tratamiento con dos pacientes portadores de lesiones queloides de gran tamaño. Caso clínico: Se presentan dos pacientes con cicatriz queloide gigante a partir de ambos lóbulos auriculares y cuello anterior; se expone la conducta terapéutica basada en la combinación de tres modalidades de tratamiento: cirugía; infiltración con acetónido de triamcinolona, 1 ml (40 mg) desde el día del acto quirúrgico, se repitió cada 15 días; junto a presoterapia con crema esteroidea. Conclusiones: Aunque no existe un tratamiento ideal, se debe tener en cuenta al tratar esta enfermedad si se está ante una lesión recidivante, el tiempo de aparición de la tumoración, sus características clínicas; de seleccionarse el tratamiento quirúrgico como opción terapéutica, debe acompañarse de otras modalidades de tratamiento(AU)


Introduction: The keloid scar is part of the pathological scars by excess, is a condition characterized by the excessive deposit of collagen in the dermis and subcutaneous cell tissue, the process by which it develops is not entirely known, it is more frequent in the black race, affects in equal proportion men than women. Objective: To inform the medical community of the experience in handling and treating two patients with large keloid lesions. Clinical case: Two patients with giant keloid scars are presented from both earlobes and anterior neck where therapeutic behavior based on the combination of three treatment modalities is exposed: surgery, triamcinolone acetonide 1 ml (40mg) infiltration beginning on the first day after surgery, repeated every 15 days and pressotherapy with steroid cream. Conclusions: Although there is no ideal treatment, it should be taken into account when treating this disease if we are facing a recurrent injury, the time of onset of the tumor, its clinical characteristics, surgical treatment should be selected as a therapeutic option, accompanied by other forms of treatment(AU)


Subject(s)
Humans , Male , Adult , General Surgery/organization & administration , Triamcinolone , Triamcinolone Acetonide , Cicatrix/epidemiology , Keloid
5.
Article in Korean | WPRIM | ID: wpr-811326

ABSTRACT

PURPOSE: To compare the intraocular pressure (IOP) in diabetic macular edema (DME) patients and macular edema associated with branch retinal vein occlusion (BRVO) patients after intravitreal preservative-free Triamcinolone injection.METHODS: This study included 36 patients diagnosed with DME and 44 patients diagnosed with BRVO with macular edema. Both groups were treated with intravitreal preservative-free Triamcinolone (Maqaid®, Wakamoto Pharmaceutical Co., Ltd., Tokyo, Japan) injection, and we compared the IOPs of the two groups determined before injection and at 1, 2, 3, and 6 months after injection. We also compared the IOP elevation ratios and durations, and central foveal thickness (CFT) changes using optical coherence tomography.RESULTS: In both groups, there was no statistical significance in the IOP before injection and at 1, 2, 3, and 6 months after injection. However, the IOP elevation ratio in the DME patients (38.9%) was significantly higher than that in the BRVO patients (15.9%) (p = 0.02). The duration of IOP elevation in the DME patients (1.14 ± 1.85 months) was significantly longer than that in the BRVO patients (0.30 ± 1.20 months) (p = 0.03). When the IOP was not controlled, we used IOP-lowering agents, and two patients in the DME were treated with glaucoma surgery. There was no statistical significance in the CFT before injection and at 1, 2, or 3 months after injection between the two groups (p = 0.72, p = 0.26, p = 0.66, p = 0.34, respectively). However, the CFT after 6 months was 328 ± 103 µm in the DME group and 434 ± 189 µm in the BRVO; this difference was significant (p < 0.01).CONCLUSIONS: Intravitreal injection of preservative-free Triamcinolone was effective in the treatment of both DME patients and macular edema patients associated with BRVO. Furthermore, Triamcinolone was more safely injected in macular edema associated with BRVO patients than in DME patients.


Subject(s)
Glaucoma , Humans , Intraocular Pressure , Intravitreal Injections , Macular Edema , Retinal Vein Occlusion , Retinal Vein , Retinaldehyde , Tomography, Optical Coherence , Triamcinolone
7.
Article in Korean | WPRIM | ID: wpr-759766

ABSTRACT

A 61-year-old man presented with a 3-year history of erythematous firm nodules on the hands and feet. Histopathological findings of the lesional skin revealed perivascular and diffuse neutrophilic infiltrations on the upper and mid-dermis. Increased and dilated blood vessels were observed in the upper dermis. Fibrinoid necrosis of the vessel walls was unremarkable, but endothelial swelling and scant red blood cell (RBC) extravasation were noted. Fibrosis and sclerosis of collagen fibers were noted on the deep dermis. Results of laboratory examinations, including complete blood count (CBC), routine chemistry, c-reactive protein (CRP), syphilis and human immunodeficiency virus (HIV) tests, and serum immunoglobulin electrophoresis, were all negative or within normal limit. A diagnosis of erythema elevatum diutinum was made based on the clinical and histological findings. The patient was treated with prednisolone, dapsone, colchicine, and intralesional injection of triamcinolone and showed slight improvement after treatment for 8 months.


Subject(s)
Blood Cell Count , Blood Vessels , C-Reactive Protein , Chemistry , Colchicine , Collagen , Dapsone , Dermis , Diagnosis , Electrophoresis , Erythema , Erythrocytes , Fibrosis , Foot , Hand , HIV , Humans , Immunoglobulins , Injections, Intralesional , Middle Aged , Necrosis , Neutrophils , Prednisolone , Sclerosis , Skin , Syphilis , Triamcinolone
8.
Article in English | WPRIM | ID: wpr-759708

ABSTRACT

Cheilitis granulomatosa (CG) is a subset of orofacial granulomatosis (OFG) and considered to be a monosymptomatic form of Melkersson-Rosenthal syndrome (MRS), which is characterized by the triad of chronic lip swelling, facial paralysis, and fissured tongue. The labial swelling is thought to be associated with an orofacial swelling, which affects the chin, cheeks, and oral mucosa. Histologically, it is distinguished by noncaseating granulomas consisting of lymphohistiocytes and giant cells. Although systemic steroids with or without intralesional triamcinolone injections are the mainstay of treatment, and various agents have been proposed for this rare disease, no successful treatment modality has been reported in the literature yet. Herein, we present our experience with three different CG cases, which showed a varied level of positive response to the combination therapy.


Subject(s)
Cheek , Cheilitis , Chin , Facial Paralysis , Giant Cells , Granuloma , Granulomatosis, Orofacial , Lip , Melkersson-Rosenthal Syndrome , Mouth Mucosa , Rare Diseases , Steroids , Tongue, Fissured , Triamcinolone
9.
Article in English | WPRIM | ID: wpr-763622

ABSTRACT

BACKGROUND: Increased oxidative stress and inflammation play a critical role in the etiopathogenesis of chronic tendinopathy. Melatonin is an endogenous molecule that exhibits antioxidant and anti-inflammatory activity. The aim of this study was to evaluate the biochemical and histopathological effects of exogenous melatonin administrations in supraspinatus overuse tendinopathy. METHODS: Fifty rats were divided into the following four groups: cage activity, melatonin treatment, corticosteriod therapy, and control. Melatonin (10 mg/kg, intraperitoneal; twice a day) and triamcinolone (0.3 mg/kg, subacromial; weekly) were administered to the treatment groups after the overuse period. Biochemical and histopathological evaluations were performed on serum samples and biopsies obtained from rats. Plasma inducible nitric oxide synthase (iNOS), vascular endothelial growth factor (VEGF), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) levels were evaluated biochemically. RESULTS: The TAS, TOS, OSI, iNOS, and VEGF values were significantly lower than the pre-treatment levels in rats receiving exogenous melatonin treatment (3 or 6 weeks) (p<0.05). TOS, iNOS, VEGF, and OSI values after 3 weeks of triamcinolone administration, and TOS, VEGF, and OSI levels after 6 weeks of triamcinolone application, were significantly lower than the pre-treatment levels (p<0.05). CONCLUSIONS: Exogenous melatonin application in overuse tendinopathy reduces oxidative stress and inflammation. Melatonin might be an alternative potential molecule to corticosteroids in the treatment of chronic tendinopathy.


Subject(s)
Adrenal Cortex Hormones , Animals , Biopsy , Inflammation , Melatonin , Models, Animal , Nitric Oxide Synthase Type II , Oxidative Stress , Plasma , Rats , Rotator Cuff , Shoulder , Tendinopathy , Triamcinolone , Vascular Endothelial Growth Factor A
10.
Article in Korean | WPRIM | ID: wpr-766849

ABSTRACT

PURPOSE: To report the short-term effects of intravitreal bevacizumab alone, low-dose bevacizumab combined with low-dose triamcinolone injection, and intravitreal dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) injection in patients with macular edema following central retinal vein occlusion (CRVO). METHODS: The medical records of 70 patients (70 eyes) with macular edema secondary to CRVO were reviewed retrospectively. Of these, 25 eyes (IVB group) were injected with intravitreal bevacizumab, 23 eyes (intravitreal low-dose bevacizumab and triamcinolone injection [IVB+IVTA] group) were injected with low-dose bevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL), and 20 eyes (intravitreal dexamethasone implant [IVD] group) were injected with an intravitreal dexamethasone implant. The best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) of treated eyes were measured before injection and at 1 month and 3 months after injection. RESULTS: Groups were similar in age and gender distribution. At 1 month, the CMT of all groups was significantly lower, and the BCVA of all groups had increased significantly in patients with CRVO; there were no significant differences among the three groups (p = 0.246, p = 0.974). At 3 months, the CMT and BCVA had improved significantly only in the IVD and IVB+IVTA groups; the short-term effect was comparable to the IVD group. IOP showed no significant change at 3 months after injection for all groups. CONCLUSIONS: Considering various clinical variables in the treatment of macular edema associated with CRVO, intravitreal injection of bevacizumab, low-dose bevacizumab combined with triamcinolone, and dexamethasone implants may be used selectively.


Subject(s)
Bevacizumab , Dexamethasone , Humans , Intraocular Pressure , Intravitreal Injections , Macular Edema , Medical Records , Retinal Vein Occlusion , Retinal Vein , Retrospective Studies , Triamcinolone , Visual Acuity
11.
Article in English | WPRIM | ID: wpr-758954

ABSTRACT

The intra-articular use of hyaluronic acid (HA) for the treatment of synovitis and osteoarthritis is still controversial. As a consequence, corticosteroids remain the most frequently employed therapeutic agents, despite their potential systemic and local deleterious effects. This study examined the anti-inflammatory, antioxidant, and chondroprotective activities of low and high molecular weight hyaluronic acid (LMW-HA and HMW-HA) on lipopolysaccharide (LPS)-induced synovitis in horses compared to triamcinolone acetonide (TA). LPS was injected in the metacarpophalangeal joints, which were treated intra-articularly with either TA (as control) or LMW-HA or HMW-HA. Joint clinical evaluation and synovial fluid (SF) analysis were performed at 0, 8, 24, and 48 h. The white blood cell counts (WBC), prostaglandin E2 (PGE2), interleukin (IL)-1, IL-6, IL-10, tumor necrosis factor-α, chondroitin sulfate (CS) and HA concentrations, oxidative burst, and HA molecular weights were measured. TA reduced the lameness, swelling, and PGE2 release but increased the SF CS concentrations enormously at 24h and 48h, and decreased the SF HA modal molecular weight. These results indicate the breakdown of articular cartilage aggrecan and SF HA. In contrast, LMW-HA and HMW-HA were less effective in reducing the inflammation symptoms, but preserved the joints because only a modest increase in CS occurred at 24 h, decreasing at 48 h, and the SF HA was maintained. The HA-treatment also had anti-inflammatory actions, and LMW-HA was the most effective in reducing the release of cytokine. In summary, the HA treatment inhibited efficiently the digestion of cartilage proteoglycans and SF HA breakdown.


Subject(s)
Adrenal Cortex Hormones , Aggrecans , Cartilage , Cartilage, Articular , Chondroitin Sulfates , Digestion , Dinoprostone , Horses , Hyaluronic Acid , Inflammation , Interleukin-10 , Interleukin-6 , Interleukins , Joints , Leukocyte Count , Metacarpophalangeal Joint , Molecular Weight , Necrosis , Osteoarthritis , Proteoglycans , Respiratory Burst , Synovial Fluid , Synovitis , Triamcinolone , Triamcinolone Acetonide
12.
Braz. dent. sci ; 22(4): 554-560, 2019. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1024923

ABSTRACT

Objective: Recurrent aphthous stomatitis (RAS) is characterized by recurring ulcers, with well-defined margins. The lesions are confined to the oral mucosa (usually seen in non-keratinized mucosa). The disease manifests in the form of outbreaks, with a chronic and self-limiting course in most cases. Since the cause of the disease is unknown, many drugs have been studied to palliate the symptoms. Treatment used is multifocal and varies according to the predisposing factors. The aim of this study was to investigate the effect of recombinant Nano-based triamcinolone acetonide gel and compare it with conventional triamcinolone gel on RAS. Material and methods: In this triple-blind randomized clinical trial study, sixty patients with minor aphthous lesions were divided into two groups receiving conventional triamcinolone (CT) and Nano-based triamcinolone (NT). The patients were requested to apply drug four times a day for a week. The severity of pain (through VAS) and the size of the lesions (mean of the largest diameter of the lesions) were evaluated on starting day and days 2, 4, 6 after the intervention. Statistical analysis was performed using chi square and independent t-test. Findings were significant with P < 0.05. Results: Of the 60 patients enrolled in the study, 5 patients did not continue; 21 (38.2%) cases were female and 34 (61.8%) cases were male (P=0.6). The severity of pain in NT group before and after the study was 1.4 ± 5.2 and 1.8 ± 1.3 cm, respectively and in CT group was 48.1 ± 1 and 1.8 ± 1.3 cm. The size of the lesions in NT group before and at the end of the study was 0.96 ± 0.1 and 0.18 ± 0.1 cm, respectively and in CT group was 0.93 ± 0.1 and 0.19 ± 0.1 cm. Among the mentioned variables, only size of lesions on the 2nd and 4th days had a significant reduction in NT group in comparison with CT group. Conclusion: The size of lesions showed a significant reduction on the 2nd and 4th days in NT group in comparison with CT group, therefore NT has a better impact on RAS in comparison with CT. (AU)


Objetivos: A estomatite aftosa recorrente (EAR) é caracterizada por úlceras recorrentes, com margens bem definidas. As lesões estão confinadas à mucosa oral (geralmente vista em mucosa não queratinizada). A doença se manifesta na forma de surtos, com um curso crônico e autolimitado na maioria dos casos. Como a causa da doença é desconhecida, muitos medicamentos foram estudados para aliviar os sintomas. O tratamento utilizado é multifocal e varia de acordo com os fatores predisponentes. O objetivo deste estudo foi investigar o efeito do gel acetonido de triancinolona recombinante baseado em Nano e compará-lo com o gel de triancinolona convencional no EAR. Material e métodos: Neste estudo clínico randomizado triplocego, sessenta pacientes com lesões aftosas menores foram divididos em dois grupos que receberam triancinolona convencional (CT) e triancinolona Nano (NT). Os pacientes foram solicitados a aplicar droga quatro vezes ao dia durante uma semana. A gravidade da dor (por meio da EVA) e o tamanho das lesões (média do maior diâmetro das lesões) foram avaliados no dia inicial e nos dias 2, 4 e 6 após a intervenção. A análise estatística foi realizada utilizando teste qui quadrado e teste t independente. Os achados foram significativos com P < 0.05. Resultados: Dos 60 pacientes incluídos no estudo, 5 pacientes não deram continuidade; 21(38,2%) casos foram mulheres e 34 (61,8%) casos foram homens (P=0,6). A gravidade da dor no grupo NT antes e depois do estudo foi de 1,4 ± 5,2 e 1,8 ± 1,3 cm. O tamanho das lesões no grupo NT antes e ao final do estudo foi de 0,96 ± 0,1 e 0,18 ± 0,1 cm, respectivamente, e no grupo de TC foi de 0,93 ± 0,1 e 0,19 ± 0,1 cm. Entre as variáveis mencionadas, somente o tamanho das lesões no segundo e quarto dias tiveram uma redução significativa no grupo NT em comparação com o grupo CT. Conclusão: O tamanho das lesões mostrou uma redução significativa nos 2º e 4º dias no grupo NT em comparação ao grupo CT, portanto o NT tem um impacto melhor no RAS em comparação com o TC. (AU)


Subject(s)
Humans , Stomatitis, Aphthous , Triamcinolone , Nanoparticles
13.
Int. j. morphol ; 37(1): 344-348, 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-990049

ABSTRACT

RESUMEN: El proceso angiogénico se define como el proceso en el que los vasos sanguíneos generan brotes dando como resultado neovascularidad. Un desbalance en el proceso angiogénico contribuye a numerosos desórdenes inflamatorios, infecciosos, isquémicos, inmunológicos y malignos. En el territorio maxilofacial se pueden encontrar patologías neoplásicas benignas de desarrollo local con un marcado componente angiogénico que determinan su crecimiento y agresividad. Sin embargo, existe escasa evidencia de cómo tratarlas en base al control de la angiogénesis. Terry & Jacoway (1994) desarrollaron un protocolo de tratamiento para lesiones neoplásicas benignas con un importante componente vascular que se utiliza actualmente. Este protocolo consiste en la infiltración intralesional de una suspensión de triamcinolona 10 mg/ml más una solución de anestésico local de uso odontológico como la lidocaína al 2 % asociada a epinefrina en una concentración de 1:200.000. Sin embargo, el uso de epinefrina podría disminuir la acción antiangiogénica de la triamcinolona al ser un vasoconstrictor. El objetivo de este estudio es comparar el efecto antiangiogénico, en la membrana alantocoriónica de pollo (MAC), de esta suspensión versus el efecto de la triamcinolona sin asociar a anestésicos locales. Los resultados del efecto antiangiogénico en la MAC de pollo, obtenidos en la investigación concluyeron que la suspensión de triamcinolona asociada a lidocaína con epinefrina es similar al de la suspensión de triamcinolona sin asociar a anestésicos locales. Además, se logró determinar que las suspensiones de triamcinolona sin asociar a anestésicos locales y las asociadas a anestésicos locales con o sin vasoconstrictor poseen un marcado efecto antiangiogénico, en la MAC de pollo, en comparación al grupo control.


SUMMARY: Angiogenesis is defined as the process through which new blood vessels form from previously existing vessels. Several inflammatory, infectious, ischemic, immunological and malignant disorders are caused by the lack of adequate angiogenesis balance. In the maxillofacial area, there are invasive benign neoplastic pathologies with a strong angiogenic component, which determines aggressive behavior and growth. Studies in the literature are scarce regarding treatment of these conditions based on angiogenesis control. Currently, the protocol used to treat these maxillofacial benign neoplastic lesions, was developed in 1994 by Terry & Jacoway and has a strong angiogenic component. Consequently lesions are treated via intra-lesion administration of triamcinolone 10 mg / mL, a solution used in dental local anesthetic, such as lidocaine 2 %, in conjunction with epinephrine at a concentration of 1:200,000. The objective of this study was to compare the antiangiogenic effect of this protocol in chicken chorioallantoic membrane (CAM) without the use of local anesthetic. The results of the antiangiogenic effect in the CAM obtained in this study concluded that the effect of the suspension of triamcinolone associated to lidocaine with epinephrine, is similar to the suspension of triamcinolone without associating local anesthetics. Furthermore, it was determined that suspensions of triamcinolone without local anesthetic, and those associated to local anesthetic with, and without vasoconstrictor have a strong antiangiogenic effect in CAM compared to the control group.


Subject(s)
Animals , Chick Embryo , Triamcinolone/administration & dosage , Epinephrine/administration & dosage , Angiogenesis Inhibitors/administration & dosage , Chorioallantoic Membrane/drug effects , Lidocaine/administration & dosage , Anesthetics, Local/administration & dosage , Neovascularization, Pathologic
14.
Article in Korean | WPRIM | ID: wpr-738421

ABSTRACT

PURPOSE: This study examined the clinical outcomes and usefulness of triamcinolone acetonide (TA) injections as an option in the conservative treatment of patients with lateral malleolar bursitis of the ankle. MATERIALS AND METHODS: A total of 27 patients (27 ankles), in whom TA injection had been performed between March 2016 and June 2017, were reviewed retrospectively. After the aspiration of fluid in the lateral malleolar bursal sac, 1 mL (40 mg) of TA was injected into the malleolar bursal sac. After the injection, the ankle was compressed with an elastic cohesive bandage for 2 to 4 weeks. The clinical outcomes and side effects were evaluated at the following time points: 2 weeks, 4 weeks, 3 months, 6 months, and 1 year after TA injection therapy. The responses to treatment were assessed according to the degree of fluctuation, shrinkage of the bursal sac, and soft tissue swelling. RESULTS: The mean age was 62.1 years (range, 41~81 years); there were 19 males and 8 females. Complete resolution was observed in 26 patients (96.3%) after the first or second application of a TA injection, and a partial response was observed in 1 patient (3.7%) after the first TA injection. The physical component scores of Medical Outcomes Study 36-item Short-Form Health Survey improved from 71.1 to 76.0 at the last follow-up (p=0.001). Associated complications were 1 patient (3.7%) with skin atrophy and 3 patients (11.1%) with transient hyperglycemia in diabetes mellitus. CONCLUSION: TA injection is a useful and safe procedure for patients not responding to the usual conservative treatment of lateral malleolar bursitis of the ankle.


Subject(s)
Ankle , Atrophy , Bandages , Bursitis , Diabetes Mellitus , Female , Follow-Up Studies , Health Surveys , Humans , Hyperglycemia , Male , Retrospective Studies , Skin , Triamcinolone Acetonide , Triamcinolone
15.
Rev. medica electron ; 40(6): 2083-2096, nov.-dic. 2018. graf
Article in Spanish | LILACS, CUMED | ID: biblio-978719

ABSTRACT

RESUMEN El pénfigo es una enfermedad autoinmune potencialmente mortal, que causa ampollas y erosiones en la piel y en la membrana mucosa. Las lesiones epiteliales son el resultado de autoanticuerpos que reaccionan con las glicoproteínas desmosomales y están presentes en la superficie celular del queratinocito. La reacción autoinmune contra estas glicoproteínas causa una pérdida de adhesión celular, resultando en la formación de ampollas intraepiteliales. Del 80 al 90 % de los pacientes con pénfigo vulgar, desarrollan trastornos cutáneos y en el 60 % de los casos alteraciones en la mucosa que es el primer o único signo. El diagnóstico de las lesiones en cavidad bucal es fundamental, ya que pueden prevenir su afectación a la piel. Si se establece el tratamiento en su etapa inicial, la enfermedad es más fácil de controlar y aumenta la posibilidad de una remisión temprana del trastorno y mejor calidad de vida. Este reporte de caso mostró a una paciente de 35 años, la que comenzó a presentar lesiones ulceradas en toda la orofaringe, con sensación de ardor e incapacidad para la ingestión de alimentos. El diagnóstico fue pénfigo vulgar (AU).


ABSTRACT Pemphigus is a potentially deadly autoimmune disease causing blisters and erosions in the skin and the mucous membrane. The epithelial lesions are the result of antibodies reacting to desmosomal glycoproteins, and are present in the keratinocytes cellular surface. The autoimmune reaction to these glycoproteins causes a cellular adhesion loss resulting in the formation of intraepithelial blisters. From 80 to 90 % of the patients with vulgar pemphigus develop skin disorders, and 60 % of the cases show mucosa changes as the first or unique sign. The diagnosis of the lesions in oral cavity is essential because it could prevent the skin damage. If the treatment begins in an initial stage, it is easier to control the disease and the possibility of the disorder's early remission and a better life quality increases. This is the report of the case of a female patient, aged 35 years, who presented ulcerated lesions in the entire oropharyngeal region, with itching sensation and inability for food consumption. The diagnosis was vulgar pemphigus (AU).


Subject(s)
Humans , Female , Adult , Skin Diseases/etiology , Surgery, Oral , Pemphigus/etiology , Oral Ulcer/diagnosis , Lymphadenopathy/diagnosis , Skin Diseases/diagnosis , Skin Diseases/drug therapy , Triamcinolone/therapeutic use , Pemphigus/diagnosis , Pemphigus/drug therapy , Adrenal Cortex Hormones/therapeutic use , Lymphadenopathy/pathology , Gingivitis/diagnosis
17.
Article in English | WPRIM | ID: wpr-713713

ABSTRACT

Corticosteroids are potent anti-inflammatory and anti-allergic agents used in the treatment of various inflammatory diseases, including allergic disease. They are frequently considered the therapy-of-choice for many skin diseases. However, allergic reactions caused by corticosteroids have been reported. Among these, delayed reactions to topical steroids are more common, whereas immediate reactions to systemic steroids are rare. Herein, we report the case of a 32-year-old woman with triamcinolone-induced immediate hypersensitivity reaction, in which the patient had a positive prick test result with triamcinolone. She has had atopic dermatitis (AD) for three years. She had used systemic steroid, cyclosporine, and antihistamine with topical steroids for AD. In clinic, approximately 10 minutes after intralesional injection of triamcinolone, she complained of erythematous patches with slight elevation and itching on the face, trunk, and both hands. After intravenous injection of dexamethasone, her symptoms got worse. After treatment with epinephrine, all symptoms resolved within two hours. We performed an open test and skin prick test. She had a positive result only from the prick test with triamcinolone; all other steroids showed negative results from the open tests. Dermatologists should be aware of the possibility of anaphylaxis or other allergic hypersensitivity in response to corticosteroids.


Subject(s)
Adrenal Cortex Hormones , Adult , Anaphylaxis , Anti-Allergic Agents , Cyclosporine , Dermatitis, Atopic , Dexamethasone , Epinephrine , Female , Hand , Humans , Hypersensitivity , Hypersensitivity, Immediate , Injections, Intralesional , Injections, Intravenous , Pruritus , Skin , Skin Diseases , Steroids , Triamcinolone
18.
Article in English | WPRIM | ID: wpr-715572

ABSTRACT

Polyacrylamide hydrogel is a widely used filler material in cosmetic procedures performed on the face and breasts. Recently, however, complications including inflammation, deformity, and pain have been reported. The present article addresses unregulated materials/products injected as dermal fillers. The authors report a case involving a 29-year-old woman who developed severe facial pain after undergoing a cosmetic procedure with injectable triamcinolone and hyaluronidase. Two months later, the pain spread to her upper and lower limbs, and abdomen, which eventually led to the the development and diagnosis of complex regional pain syndrome (CRPS) in the upper limbs. The authors hypothesize that CRPS in the upper limbs was responsible for the facial pain through sensitization of third-order neurons and the trigeminal nucleus caudalis extending to the upper cervical segments.


Subject(s)
Abdomen , Adult , Breast , Congenital Abnormalities , Dermal Fillers , Diagnosis , Facial Neuralgia , Facial Pain , Female , Humans , Hyaluronic Acid , Hyaluronoglucosaminidase , Hydrogels , Inflammation , Lower Extremity , Neurons , Triamcinolone , Trigeminal Nuclei , Upper Extremity
19.
Article in English | WPRIM | ID: wpr-715178

ABSTRACT

BACKGROUND: Trap-door deformity is a biophysical phenomenon in which U-, C-, or V-shaped linear scars tend to become depressed and the tissue circumscribed by them tends to bulge. The aim of the present study was to demonstrate the efficacy of triamcinolone acetonide (TCA) injection and subcision as a first-line treatment for post-traumatic acute trap-door deformity. METHODS: In trap-door deformity patients, a subcision was made by cutting the fibrotic band along the scar line in the depression using a 22-gauge needle. TCA was administered. An intralesional injection was made along areas of scarring that were difficult to penetrate with the needle. Scar quality parameters were assessed at each follow-up by a single observer and the patient, using the patient and observer scar assessment scale (POSAS) with an additional question about bulging. RESULTS: The average POSAS score per question on the observer scale improved from 6.6±1.31 to 3.6±1.08, and the average POSAS score per question on the patient scale improved from 5.5±1.57 to 2.5±1.26. The average bulging score on the observer scale decreased from 6.0±0.98 to 3.0±0.83, and that on the patient scale decreased from 5.0±1.67 to 2.0±1.30. The average general opinion score on the observer scale decreased from 5.5±1.12 to 3.5±0.91, and that on the patient scale decreased from 6.0±1.84 to 2.0±0.79. CONCLUSIONS: Better outcomes can be obtained by using both TCA and subcision as the first-line therapy for post-traumatic acute trap-door deformity.


Subject(s)
Biophysical Phenomena , Cicatrix , Congenital Abnormalities , Contracture , Depression , Follow-Up Studies , Humans , Injections, Intralesional , Needles , Triamcinolone Acetonide , Triamcinolone
20.
Rev. Col. Bras. Cir ; 45(4): e1861, 2018. graf
Article in Portuguese | LILACS | ID: biblio-956565

ABSTRACT

RESUMO Objetivo: estudar a eficácia e segurança do uso de acetato de triancinolona subconjuntival isolado ou em associação à mitomicina C como modulador da cicatrização de trabeculectomias em coelhos. Métodos: trinta coelhos machos, albinos, raça Nova Zelândia foram submetidos à trabeculectomia bilateralmente. Os animais foram divididos em quatro grupos experimentais com 15 olhos por grupo: controle, mitomicina C, acetato de triancinolona e acetato de triancinolona + mitomicina C. Tonometria de aplanação e análise clínica da bolha através do Sistema de Graduação de Moorfields foram obtidas no pós-operatório. Para a avaliação da cicatrização, procedeu-se à análise quantitativa do infiltrado inflamatório (polimorfonucleares) através da coloração Hematoxilina & Eosina e da proliferação vascular por imuno-histoquímica. Resultados: foi observada em todos os grupos diminuição significativa da pressão intraocular pós-operatória em relação à pré-operatória (p<0,001). Contudo, não houve diferença entre os grupos (p=0,186). O grupo acetato de triancinolona + mitomicina C apresentou melhores índices na altura máxima da bolha e na vascularização da área central da bolha (p=0,001); além disso, houve menor resposta inflamatória (p=0,001) e menor proliferação vascular (p=0,001) na fase intermediária do estudo em relação às monoterapias. Conclusão: a associação da mitomicina C ao acetato de triancinolona resultou numa ação sinérgica entre esses agentes, com bolhas mais amplas e difusas e menor infiltrado inflamatório e menor proliferação vascular em estágio intermediário do acompanhamento neste modelo animal.


ABSTRACT Objective: to study the efficacy and safety of the use of subconjunctival triamcinolone acetate alone or in combination with mitomycin C as a modulator of trabeculectomy healing in rabbits. Methods: we submitted thirty male, albino, New Zealand rabbits to bilateral trabeculectomy. We divided the animals into four experimental groups with 15 eyes per group: control, mitomycin C, triamcinolone acetate and triamcinolone acetate + mitomycin C. We performed aplanation tonometry and clinical analysis of the bleb through the Moorfields Graduation System in the postoperative period. For the evaluation of healing, we carried out the quantitative analysis of the inflammatory infiltrate (polymorphonuclear) through Hematoxylin & Eosin staining, and vascular proliferation, through immunohistochemistry. Results: we observed a significant decrease in postoperative intraocular pressure in all groups compared with the preoperative pressure (p<0.001). However, there was no difference between groups (p=0.186). The triamcinolone + mitomycin C acetate group presented better indices as for the maximum bleb height and vascularization of the bleb central area (p=0.001); in addition, there was a lower inflammatory response (p=0.001) and lower vascular proliferation (p=0.001) in the intermediate phase of the study compared with the monotherapies. Conclusion: the combination of mitomycin C and triamcinolone acetate resulted in a synergistic action between these agents, with broader and more diffuse blebs, less inflammatory infiltrate and less vascular proliferation in the intermediate stages of follow-up in this animal model.


Subject(s)
Animals , Male , Wound Healing/drug effects , Triamcinolone/pharmacology , Glaucoma/surgery , Mitomycin/pharmacology , Anti-Inflammatory Agents/pharmacology , Postoperative Care , Rabbits , Triamcinolone/administration & dosage , Trabeculectomy/rehabilitation , Blister/pathology , Treatment Outcome , Mitomycin/administration & dosage , Conjunctiva/drug effects , Conjunctiva/pathology , Disease Models, Animal , Drug Therapy, Combination , Intraocular Pressure/drug effects , Anti-Inflammatory Agents/administration & dosage , Neutrophils
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