ABSTRACT
El uso de corticoides en el tratamiento del dolor ha sido una práctica habitual desde mediados del siglo pasado. A raíz de una revisión de las complicaciones acontecidas con su administración por vía epidural, la Administración de Alimentos y Medicamentos de Estados Unidos (FDA) emitió una «controvertida alerta» solicitando se añada una «advertencia» en el etiquetado de los corticoides inyectables donde se deben describir dichos riesgos (pérdida de la visión, derrame cerebral, parálisis y muerte) al ser suministrados por esta vía. Es importante resaltar la existencia de diferentes clases de corticoides con características diversas que hace, que los potenciales efectos secundarios de su uso también sean distintos. Creemos necesario, en vista de los acontecimientos mencionados, las controversias que se han generado y la falta de estudios bien realizados sobre el uso de los corticoides, tanto en infiltraciones epidurales y como en otros procedimientos, comenzar por realizar una revisión general sobre sus indicaciones, efectos secundarios, complicaciones y características particulares de los diferentes compuestos en diversas enfermedades dolorosas (AU9
Corticosteroids been used frequently in pain treatments since the middle of last century (1952). Due to a review of the complications as a result of their application in epidural injections, the United States of America Food and Drug Administration (FDA) issued an «alert controversy» requesting that a warning label should be added to injectable corticosteroids, where risks must be described (loss of sight, brain damage, paralysis and death) when administering by this route. It must be mentioned that there are different types of corticosteroids with diverse characteristics, which as a result, may produce different side-effects. Due to the aforementioned developments, the controversies that have arisen, and the lack of well-conducted studies on the use of steroids in epidural injections, we must begin by reviewing their indications in different pain conditions (AU)
Subject(s)
Humans , Male , Female , Chronic Pain/drug therapy , Adrenal Cortex Hormones/classification , Adrenal Cortex Hormones/therapeutic use , Dexamethasone/therapeutic use , Triamcinolone/therapeutic use , Betamethasone/therapeutic use , Anesthesia, Epidural , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Adrenal Cortex Hormones/pharmacology , Anesthesia, Epidural/instrumentation , Anesthesia, Epidural/methods , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug-Related Side Effects and Adverse Reactions/prevention & control , Hypoglycemia/complications , Hyperglycemia/complications , Osteoporosis/complicationsABSTRACT
Corticosteroids been used frequently in pain treatments since the middle of last century (1952). Due to a review of the complications as a result of their application in epidural injections, the United States of America Food and Drug Administration (FDA) issued an «alert controversy¼ requesting that a warning label should be added to injectable corticosteroids, where risks must be described (loss of sight, brain damage, paralysis and death) when administering by this route. It must be mentioned that there are different types of corticosteroids with diverse characteristics, which as a result, may produce different side-effects. Due to the aforementioned developments, the controversies that have arisen, and the lack of well-conducted studies on the use of steroids in epidural injections, we must begin by reviewing their indications in different pain conditions.
Subject(s)
Chronic Pain/drug therapy , Adrenal Cortex Hormones , Glucocorticoids , Humans , Injections, Epidural , United States , United States Food and Drug AdministrationABSTRACT
BACKGROUND: Previous studies of variation in cartilage characteristics with age have involved comparison of young and adult individuals, but no data on short-term age-related change are available. Such data are important for studies of the response of cartilage to experimental stimuli in young rabbits, to distinguish the response to the stimuli from accompanying age-related changes. METHODS: We used light microscopy to study the thickness, cell density, and degree of histological definition of articular cartilage on the femoral trochlea of 6-, 7-, and 8-week-old rabbits. RESULTS: Thickness and cell density both decline significantly with age. The decline in cell density is more marked in surface layers of cartilage and is accompanied by an increase in the safranin O-staining affinity of the extracellular matrix and an extension of this affinity towards the surface. CONCLUSIONS: Our results indicate that the synthesis of matrix components becomes more important relative to proliferative activity. The traditionally defined histological layers (zones I, II, III, and IV) are not clearly distinguishable in rabbits of this age. In 6- and 7-week old animals only a "surface" (I/II) and a "deep" layer (III) can be distinguished. By 8 weeks, zones I and II are well defined but the mineralization front (marking the boundary between zones III and IV) is still absent.
