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Abstract Background Current COVID-19 guidelines recommend the early use of systemic corticoids for COVID-19 acute respiratory distress syndrome (ARDS). It remains unknown if high-dose methylprednisolone pulse therapy (MPT) ameliorates refractory COVID-19 ARDS after many days of mechanical ventilation or rapid deterioration with or without extracorporeal membrane oxygenation (ECMO). Methods This is a retrospective observational study. Consecutive patients with COVID-19 ARDS treated with a parenteral high-dose methylprednisolone pulse therapy at the intensive care units (ICU) of two University Hospitals between January 1st 2021 and November 30st 2022 were included. Clinical data collection was at ICU admission, start of MPT, 3-, 10- and 14-days post MPT. Results Thirty-seven patients (mean age 55 ± 12 years) were included in the study. MPT started at a mean of 17 ± 12 days after mechanical ventilation. Nineteen patients (54%) received ECMO support when commencing MPT. Mean paO2/FiO2 significantly improved 3- (p = 0.034) and 10 days (p = 0.0313) post MPT. The same applied to the necessary FiO2 10 days after MPT (p = 0.0240). There were no serious infectious complications. Twenty-four patients (65%) survived to ICU discharge, including 13 out of 20 (65%) needing ECMO support. Conclusions Late administration of high-dose MPT in a critical subset of refractory COVID-19 ARDS patients improved respiratory function and was associated with a higher-than-expected survival of 65%. These data suggest that high-dose MPT may be a viable salvage therapy in refractory COVID-19 ARDS.

Background: Current COVID-19 guidelines recommend the early use of systemic corticoids for COVID-19 acute respiratory distress syndrome (ARDS). It remains unknown if high-dose methylprednisolone pulse therapy (MPT) ameliorates refractory COVID-19 ARDS after many days of mechanical ventilation or rapid deterioration with or without extracorporeal membrane oxygenation (ECMO). Methods: This is a retrospective observational study. Consecutive patients with COVID-19 ARDS treated with a parenteral high-dose methylprednisolone pulse therapy at the intensive care units (ICU) of two University Hospitals between January 1st 2021 and November 30st 2022 were included. Clinical data collection was at ICU admission, start of MPT, 3-, 10- and 14-days post MPT. Results: Thirty-seven patients (mean age 55 ± 12 years) were included in the study. MPT started at a mean of 17 ± 12 days after mechanical ventilation. Nineteen patients (54%) received ECMO support when commencing MPT. Mean paO2/FiO2 significantly improved 3- (p = 0.034) and 10 days (p = 0.0313) post MPT. The same applied to the necessary FiO2 10 days after MPT (p = 0.0240). There were no serious infectious complications. Twenty-four patients (65%) survived to ICU discharge, including 13 out of 20 (65%) needing ECMO support. Conclusions: Late administration of high-dose MPT in a critical subset of refractory COVID-19 ARDS patients improved respiratory function and was associated with a higher-than-expected survival of 65%. These data suggest that high-dose MPT may be a viable salvage therapy in refractory COVID-19 ARDS. [ABSTRACT FROM AUTHOR]

A late consequence of COVID-19, organizing pneumonia is characterized by significant imaging and pathological abnormalities. The goals of this study are to better understand these abnormalities. The use of corticoid continues to be the recommended course of treatment for COVID-19. On the other hand, it is not clear whether or not corticoid has the same impact on organizing pneumonia after COVID-19. A 53-year-old male patient was identified with organized pneumonia following COVID-19 infection. He was diagnosed after experiencing severe respiratory symptoms several days with no improvement. We initiated a high dose of corticoid based on imaging and pathological findings and observed a significant response. In addition, we looked into the research that has been done concerning the diagnosis and treatment of this peculiar ailment. Patients who have been diagnosed with pneumonia after COVID 19 are required to undergo a reevaluation that includes a chest CT scan, and some of these patients may be candidates for an early lung biopsy. The most effective and convincing therapy for COVID-19-induced organizing pneumonia is corticoid treatment at a dose equivalent to 0.5 mg/kg/day of prednisone. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT: The induction of labor aims to concentrate births to follow up better the parturient and the first care to the neonates. However, even if the labor induction technique with dexamethasone administration has been successfully described since the late 1970s, few studies report the technique of birth development and neonatal vitality in Santa Inês sheep. This study aimed to evaluate the efficiency of dexamethasone use in two doses (8 and 16mg) in labor induction of Santa Inês ewes at 145 days of gestation and to evaluate its effects on the birth characteristics. In this study, 58 ewes were used, raised in an extensive system in the experimental farms of UFBA, with confirmation pregnancy after fixed-time artificial insemination or controlled breeding. These female ewes were separated into three groups according to the dose of dexamethasone administered (G1 = 0mg, G2 = 8mg, and G3 = 16mg). From these births, 79 lambs were born. This study analyzed the period from induction of labor to birth, fetal presentation at birth, the weight of the placenta, and the period for placenta expulsion. The data were analyzed by the Statistical Analysis System (SAS v.9.1.3®, 2002), and the significance level considered for all analyzes was 5%. Births of induced groups occurred on average at 48.4±22.17 hours after induction, while the females with non-induced labor gave birth 131.96±41.9 hours on average after the placebo application (P0.05) between the doses used. There were no differences in delivery about the fetal static relation, time to placental attachment, and weight. With this study, it can be concluded that the induction at 145 days of gestation with eight or 16mg of dexamethasone is a useful technique and does not alter the labor in Santa Inês sheep.

Objectives: To compare the efficacy of photobiomodulation to that of topical clobetasol 0.05% in patients with symptomatic oral lichen planus (OLP). Subjects: Thirty‐four patients with symptomatic OLP were randomly allocated into two groups: (a) the Control group (n = 17), application of topical clobetasol propionate 0.05% three times a day for 30 consecutive days with laser placebo applied twice a week to mask the treatment, and (b) the photobiomodulation group (n = 17), laser application twice a week, totalling 8 sessions, and gel placebo for 30 consecutive days to mask the treatment. Evaluations were performed once a week during treatment and 30, 60 and 90 days after treatment. The following parameters were evaluated: pain, clinical scores, clinical resolution and recurrence rate. Results: Photobiomodulation and propionate clobetasol 0.05% were able to significantly decrease pain in oral lichen planus patients and improve clinical scores during treatment and follow‐up. Both the Control and photobiomodulation groups presented similar clinical resolution and recurrence rates. Most importantly, no difference was observed between treatments during treatment and follow‐up. Conclusions: These findings indicate that photobiomodulation twice a week is as effective as corticoid therapy in treating oral lichen planus. Moreover, photobiomodulation is a safe and non‐invasive therapy with the remarkable advantage of no adverse effects. [ABSTRACT FROM AUTHOR]

• Prednisone and prednisoline negatively altered the thyroid and liver morphology. • Both glucocorticoids were genotoxic and affected the tadpoles' immune system. • Prednisone altered development and caused oxidative stress. • Environmental concentrations of glucocorticoids affect tadpole health. Synthetic glucocorticoids are often found in surface waters and can cause harmful effects to aquatic organisms such as amphibians. In this work we evaluated the effects of the drugs prednisone (PD) and prednisolone (PL) on developmental, molecular, blood, biochemical and histological markers. Aquarana catesbeianus tadpoles were exposed for 16 days to environmentally relevant concentrations of 0, 0.1, 1 and 10 µg/L of both drugs. PD increased the transcript levels of the enzyme deiodinase III (Dio3), the hormones cortisol and T4 and delayed development. Changes in the thyroid gland occurred after tadpoles were exposed to both drugs, with a reduction in the diameter and number of follicles and an increase/or decrease in area. Also, both drugs caused a decrease in lymphocytes (L) and an increase in neutrophils (N), thrombocytes, the N:L ratio and lobed and notched erythrocytes. Increased activity of the enzymes superoxide dismutase, glutathione S -transferase and glucose 6-phosphate dehydrogenase was observed after exposure to PD. Furthermore, both drugs caused an increase in the activity of the enzymes catalase and glutathione peroxidase. However, only PD caused oxidative stress in exposed tadpoles, evidenced by increased levels of malondialdehyde and carbonyl proteins. Both drugs caused an increase in inflammatory infiltrates, blood cells and melanomacrophages in the liver. Our results indicate that PD was more toxic than PL, affecting development and causing oxidative stress. [ABSTRACT FROM AUTHOR]

• This is a case series of functional adrenal tumors and treatment outcomes. • A diversity of cases is presented with clinical, medical imaging, macroscopic and microscopic features included. • Successful management of two cases of adrenal insufficiency following classic adrenalectomy in a low resource community is reported. Adrenal tumors are often found incidentally during abdominal imaging. Functioning adrenal tumors are less frequent than these incidentalomas discovered unexpectedly. We report treatment outcomes (major complications) of 7 cases of symptomatic adrenal masses from 2009 to 2019. Seven cases of functioning adrenal tumors: four adenomas presenting with Cushing's syndrome, two adrenal carcinomas, and one pheochromocytoma are described. The preoperative diagnoses were made through clinical manifestations, an increase in urinary free cortisol with normal ACTH, elevated metanephrine and enlarged masses on CT. The diagnoses were established on histopathology of adrenalectomy specimens. Adrenal insufficiency in two patients following surgery was corrected with corticoid replacement therapy. One patient died of hypovolemia the day of surgery and another from anaphylactic shock (allergy) late in the post-operative period. Pre, intra and post-operative complications from vascular instability often complicate surgery in functioning adrenal tumors. Adrenal adenomas manifest as Cushing's syndrome in 10–15 % of patients. They are the most common adrenal tumor although the diagnosis is most often coincidental to abdominal imaging. The incidence of adrenal adenoma increases with age, up to 7 % in the seventh decade. Laparoscopic adrenalectomy, which was not available in our hospitals then, is standard treatment for most tumors. It is alleged to have better outcomes in trained and tested hands. Surgery of functioning adrenal tumors demands close collaboration of multiple clinical disciplines to manage vascular instability and adrenal insufficiency, especially in resource strapped communities. [ABSTRACT FROM AUTHOR]

Tubulointerstitial nephritis and uveitis syndrome is an uncommon clinical entity. Usually, renal involvement is moderate, and uveitis is acute, bilateral, anterior, and nongranulomatous (revised). We present the case of a 55-year-old female patient who went to the emergency department with complaints of asthenia, myalgia, and paresthesia. One week later, she complained of photophobia and was diagnosed with bilateral nongranulomatous acute anterior uveitis. The next day, due to hypotension and acute kidney injury, the patient was hospitalized. Renal biopsy showed tubulointerstitial nephritis. The patient was started on oral prednisolone, achieving uveitis resolution and renal function stability. After slow corticoid reduction, the patient presented uveitis recurrence complicated with bilateral optic disc (revised) edema and cystoid macular edema (CME) in the left eye. After oral prednisolone reduction, the patient suffered another relapse with CME worsening. We decided to initiate methotrexate 7.5 mg/week, achieving ocular and renal function stability. [ABSTRACT FROM AUTHOR]

Introduction: Nocardiosis is a rare kind of opportunistic infections. Because of its insidious onset and atypical clinical manifestations, diagnosis and early treatment are often delayed. Case presentation: Here we present a 60-year-old Chinese female patient with systemic Nocardia infection, who had been diagnosed with idiopathic thrombocytopenic purpura previously and was misdiagnosed for up to 6 months prior to presenting at our hospital and ultimately achieved clinical cure. Discussion: The patient took prednisone because of ITP for several years which led to immunosuppression. Nocardia infection began from the skin rupture and then spread all over the body with multiple system involvement. The pus culture eventually found Nocardia. Sulphonamides have been the standard treatment for decades and there are several other options. Patients with severe Nocardia infection or immunosuppression are suggested a combined therapy. Conclusion: Nocardiosis is an infection that often resulted in delayed diagnosis because of lack of specificity of the clinical profile and the difficulty in culturing the bacteria. It should be included in the differential diagnosis of patients in which there are cutaneous, respiratory or neurological manifestations, especially in immunosuppressed individuals. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of switching from prednisone (P) to dexamethasone (D) at asymptomatic prostate‐specific antigen (PSA) progression in patients with metastatic castration‐resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA). Materials and Methods: Among 93 patients treated with AA between January 2013 and April 2016 in our institution, 48 consecutive asymptomatic patients with mCRPC, who experienced biochemical progression on treatment with AA+P 10 mg/day, were included. A corticosteroid switch to AA+D 0.5 mg/day at PSA increase was administered until radiological and/or clinical progression. The primary endpoint was progression‐free‐survival (PFS). A prognostic score based on independent prognostic factors was defined. Results: The median time to PSA progression on AA+P was 8.94 months. The median PFS on AA+D and AA+corticosteroids (P then D) was 10.35 and 20.07 months, respectively. A total of 56.25% of patients showed a decrease or stabilization in PSA levels after the switch. In univariate analysis, three markers of switch efficiency were significantly associated with a longer PFS: long hormone‐sensitivity duration (≥5 years; median PFS 16.62 vs 4.17 months, hazard ratio [HR] 0.30, 90% confidence interval [CI] 0.16–0.56); low PSA level at the time of switch (<50 ng/mL; median PFS 15.21 vs 3.86 months, HR 0.33, 90% CI 0.18–0.60); and short time to PSA progression on AA+P (<6 months; median PFS 28.02 vs 6.65 months, HR 0.41 (90% CI 0.21–0.81). In multivariate analysis, hormone sensitivity duration and PSA level were independent prognostic factors. Conclusion: A steroid switch from P to D appears to be a safe and non‐expensive way of obtaining long‐term responses to AA in selected patients with mCRPC. A longer PFS has been observed in patients with previous long hormone sensitivity duration, and/or low PSA level and/or short time to PSA progression on AA+P. [ABSTRACT FROM AUTHOR]

Copyright of Revista Salud Bosque is the property of Universidad El Bosque and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tubulointerstitial nephritis and uveitis syndrome is an uncommon clinical entity. Usually, renal involvement is moderate, and uveitis is acute, bilateral, anterior, and nongranulomatous (revised). We present the case of a 55-year-old female patient who went to the emergency department with complaints of asthenia, myalgia, and paresthesia. One week later, she complained of photophobia and was diagnosed with bilateral nongranulomatous acute anterior uveitis. The next day, due to hypotension and acute kidney injury, the patient was hospitalized. Renal biopsy showed tubulointerstitial nephritis. The patient was started on oral prednisolone, achieving uveitis resolution and renal function stability. After slow corticoid reduction, the patient presented uveitis recurrence complicated with bilateral optic disc (revised) edema and cystoid macular edema (CME) in the left eye. After oral prednisolone reduction, the patient suffered another relapse with CME worsening. We decided to initiate methotrexate 7.5 mg/week, achieving ocular and renal function stability.

The aim of this study was to investigate antioxidant enzyme activities and lipid peroxidation levels after systemic corticoid therapy (Solu-Medrol, 250mg/day, for 7 days). The effects of corticoid treatment on superoxide dismutase (SOD) and glutathione peroxidase (GPX) activity were investigated. Fifteen patients diagnosed with sudden sensorineural hearing loss were enrolled. Serum markers of oxidative stress were measured using spectrophotometric methods. In ten cases, the SOD and GPX activities and malondialdehyde (MDA) serum levels before and after corticoid treatment were investigated. Corticoid treatment enhanced antioxidant activity by increasing SOD and GPX activities and decreasing MDA serum levels.

Croup, also known as laryngotracheobronchitis, frequently leads to blockages in the upper respiratory tract in young children, presenting symptoms, such as a raspy voice, a distinctive cough, and noisy breathing during inhalation. Despite being a condition that often resolves on its own, it puts considerable strain on healthcare resources due to regular doctor visits, emergency room usage, and occasional hospital stays. Research focused on larger populations suggests that only a small percentage of children with croup end up requiring hospital admission for their condition. In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we executed a meticulous systematic review by scouring databases, such as PubMed, Google Scholar, and the Cochrane Library. A total of 10 articles met our inclusion criteria and were selected for in-depth analysis. These scholarly works provided substantive insights into the pharmacological agents deployed in the treatment of croup. From a clinical standpoint, the management of croup is highly contingent on the patient's hemodynamic status. Our review discerned a pronounced preference for corticosteroids as the primary therapeutic intervention over other alternatives, which are largely relegated to second-line or emergency applications. Interestingly, we found negligible differences among the various corticosteroid treatment options in terms of statistical significance, underscoring their broad utility in ameliorating the condition. In addition to corticosteroids, our review also explored other therapeutic options, such as heliox, nebulized adrenaline, and even natural interventions, such as exposure to outdoor cold air. The efficacy of these treatments demonstrated variable results, reinforcing the notion that while they may be useful in specific circumstances, they are not universally applicable or as robustly effective as corticosteroids. Given the preponderance of evidence favoring corticosteroids, further research is warranted to solidify their status as the first-line treatment in different medical settings, be it inpatient hospitals, outpatient clinics, or even for home-based care. Such studies will not only add a layer of confidence in current medical practice but could also potentially optimize treatment protocols, contributing to improved patient outcomes. Therefore, advancing our understanding of the effectiveness of corticosteroids as the cornerstone of croup management remains an area of paramount scientific and clinical importance., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Garzon Mora et al.)

Résumé Introduction La maladie de Still de l'adulte est une pathologie inflammatoire rare dont la triade diagnostique associe une fièvre hectique, un érythème maculo-papuleux et des arthralgies inflammatoires. Observation Nous présentons l'observation d'un patient âgé de 33 ans chez qui a été diagnostiquée une maladie de Still dans un contexte de fièvre, d'arthralgies de rythme inflammatoire et de manifestations oro-pharyngées. Lors du bilan, il a été retrouvé une végétation tricuspidienne rapidement progressive nécessitant une prise en charge chirurgicale en urgence associée à une corticothérapie systémique. L'analyse histologique conclut à une lésion fibrino-cruorique non infectieuse. Conclusion L'apparition d'une végétation tricuspidienne est une manifestation cardiaque rare de la maladie de Still de l'adulte. Il s'agit d'un diagnostic d'élimination avec nécessité d'éliminer une cause infectieuse notamment. Abstract Introduction Adult-onset Still's Disease is a rare multisystemic inflammatory disease characterized by fever, maculo-papular erythematous rash and arthralgia. Adult-onset Still's disease is a diagnosis of exclusion. Case report We report the case of a 33 years old man, hospitalized for fever, arthralgia and throat manifestations, leading to Adult-onset Stills's Disease diagnosis. Cardiac ultrasound revealed tricuspid vegetation. Once infectious causes were ruled out, the vegetation was related to Adult-onset Still's Disease according to Fautrel and Yamaguchi criteria. The patient was treated with systemic high doses corticosteroid and cardiac surgery. Histological examination excluded infection and neoplasia, and showed cruoric and fibrinous vegetation. Conclusion Non-infectious endocarditis, with a vegetation made of cruoric and fibrinous material, is a rare complication of Adult-onset Still's disease. [ABSTRACT FROM AUTHOR]

Purpose: To determine the profile of ophthalmic manifestations in chronic inflammatory rheumatic diseases (CIRD).Methods: Observational study at the Yaounde Central Hospital and Innel Medical Centre (2004 to 2012).Results: The study population (n = 36) consisted of 14 men and 22 women with average age of 47.9 ± 17.2 years. Cases of CIRD were rheumatoid arthritis (n = 16), systemic lupus erythematosus (n = 8), ankylosing spondylitis (n = 8), mixed connective tissue disease (n = 2), scleroderma (n = 1), and juvenile idiopathic arthritis (n = 1). Ophthalmic manifestations found in 22 (61.1%) patients were dry eye syndrome (n = 7), cataract (n = 6), anterior uveitis (n = 6), glaucoma (n = 4), and suspected maculopathy (n = 1). No association was found between steroids used and supcapsular cataract (p = 0.06) or glaucoma (p = 0.06).Conclusion: Ocular manifestations occurred in 61.1% of CIRD. Dry eye syndrome and anterior uveitis were commonly observed. [ABSTRACT FROM AUTHOR]

Copyright of Pesquisa Veterinaria Brasileira is the property of Colegio Brasileiro de Patologia Animal - CBPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fatigue is a common “ghost” symptom in patients with multiple sclerosis (MS), an autoimmune disease mediated by T cells that target myelin antigens of the central nervous system. As fatigue has been associated with inflammatory states, its occurrence may negatively impact MS progression. The aim of this study was to evaluate the impact of fatigue on the cytokine profile of patients with relapsing-remitting (RR) MS. For our study, blood were collected from MS patients in clinical remission phase with (n = 15) and without (n = 15) fatigue. Cytokines were detected by ELISA in the plasma and supernatant collected from anti-CD3/anti-CD28-activated T cells or LPS-stimulated monocytes. In some wells, different doses of hydrocortisone (HC) were added at the beginning of the culture. Here, peripheral levels of IL-6 and TNF-α, as well as in vitro production of cytokines related to Th17 (IL-6, IL-17, IL-22, and GM-CSF) or Th1 (IFN-γ) phenotypes, were elevated in fatigued patients and their levels were associated with fatigue severity. The same phenomenon was observed between the production of IL-6, TNF-α, IL-1β, and IL-23 by monocytes and fatigue. Moreover, HC was less efficient in inhibiting in vitro inflammatory cytokine production in patients with fatigue, mainly those produced by both CD8 + T cells and monocytes. Our data, although preliminary, suggests that the occurrence of fatigue, by favoring the in vitro production of Th1/Th17-related cytokines and corticoid resistance, may negatively impact the course of MS. [ABSTRACT FROM AUTHOR]

Foods and botanical supplements can interfere with the endocrine system through the presence of phytosteroids – chemicals that interact with steroids receptors. Phytoestrogens are well studied, but compounds such as kaempferol, apigenin, genistein, ginsenoside Rf, and glycyrrhetinic acid have been shown to interact with non-estrogen nuclear receptors. These compounds can have agonist, antagonist, or mixed agonist/antagonist activity depending on compound, receptor, cell line or tissue, and concentration. Some phytosteroids have also been shown to inhibit steroid metabolizing enzymes, resulting in biological effects through altered endogenous steroid concentrations. An interesting example, compound A (4-[1-chloro-2-(methylamino)ethyl]phenyl acetate hydrochloride (1:1)) is a promising selective glucocorticoid receptor modulator (SGRM) based on a phytosteroid isolated from Salsola tuberculatiformis Botschantzev . Given that $6.9 billion of herbal supplements are sold each year, is clear that further identification and characterization of phytosteroids is needed to ensure the safe and effective use of botanical supplements. [ABSTRACT FROM AUTHOR]

Background and Objective. Cicatricial hyperplasia, denomination which gathers the hypertrophic scar and keloid, represents a big challenge in surgical practice. These pathologies rushing only on human beings have been associated by different works, in particular the keloid, with black and yellow races, confirmed fact in the state of Bahia - Brazil, where large number of reduction mammoplasty, they are accompanied by hyperplasic scars and where the afro-descendant genetic is very significant. These anomalies generate great insatisfaction in patients and surgeons. Our objective is to demonstrate than we can prevent this type of scars before the skin incision, and before the firing of the cascade of repair, molding the early stages of healing using an specific corticoid. Methods. We conduct a prospective study of longitudinal prevalence and self-controlled, on 60 breast from 30 women with diagnostic of gigantomasty, all subject to reduction mammoplasty with T inverted and graft-mammillary areola plate (Thorek-Pitanguy), and comparing between 2 groups: the first one with 30 right breast infiltrated with a solution of corticoid anti-chemoattractant in the dermis and subcutaneous, under the surgical predial design ink and before incisions (intervention group); and the second one with 30 left breast whithout infiltration (control group), to statistically determine, after a period of monitoring, the prophylactic efficacy of dexamethasone acetate in preventing the hyperplasic scar. Patients were accompanied between 6-15 months, and their kind of healing was classified by the scale of Vancouver with photographic documentation. Statistical studies were made by the Chi-square test and the Kruskal-Wallis test for experimental analysis. Results. It is shown a significant reduction, statistically, in hyperplasic scar when compared the 2 breasts (p=0.02): the right breast infiltrated with corticoid had minor incidence (p=0.06). Data confirmed by the statistical experimental test. Conclusions. Prophylactic therapeutic intervention, intra-local, with dexamethasone acetate in the transoperative is highly effective, reducing significantly the presence of the hyperplasic scar. [ABSTRACT FROM AUTHOR]

A proteína glial fibrilar ácida (GFAP) constitui o principal marcador dos astrócitos, as células gliais mais numerosas do tecido nervoso e que exibem receptores a diversos hormônios esteroidais, os quais exercem aparente influência sobre a expressão gênica das mesmas. O objetivo do presente estudo foi o de avaliar se a administração de dexametasona (DX) em protocolos terapêuticos para cães seria capaz de afetar a expressão astrocitária dessa proteína. Para tal, amostras da ponte e da medula espinhal torácica de cães, tratados (n=6) ou não (n=6) com DX, foram submetidas à marcação imuno-histoquímica para a GFAP e a reatividade astrocitária foi determinada por colorimetria em um sistema computacional de análise de imagens. Diferença estatisticamente significativa foi constatada para as médias das áreas marcadas para GFAP na ponte de cães tratados e não-tratados com DX, assim como na medula espinhal torácica dos que haviam recebido previamente o corticoide ou não, com clara tendência, induzida pela droga, de redução da expressão astrocitária da proteína. Além disso, a expressão de GFAP na medula espinhal foi maior que na ponte, independentemente do emprego de DX ou não.Glial fibrillary acidic protein (GFAP) is the most important marker of astrocytes, that are the major glial cells in the nervous tissue and exhibit receptors to several steroid hormones, which have an apparent influence in their genic expression. The aim of this study was to evaluate if dexamethasone (DX) administration in therapeutic protocols to dogs would be capable of affecting the astrocytic expression of the protein. Samples from the pons and the spinal cord of dogs, treated (n=6) or not (n=6) with DX, were submitted to GFAP immunohistochemical staining and astrocytic reactivity was determined by colorimetry in a computer system for image analysis. Difference statistically significant was noted for the mean areas stained with GFAP in the pons of dogs treated and non-treated with DX, as well as in the spinal cord of dogs which previously received or not DX, with clear tendency of drug-induced reduction in the astrocyte expression of this protein. GFAP expression in the spinal cord was greater than in the pons, regardless the use of DX or not.

The nefrotoxicity of prednisone in cats was evaluated, using an immunesupressor dose (5 mg/kg/day), by establishing blood count, serum biochemistry (urea and creatinine) and urinary (GGT, protein and creatinine) parameters and urinalysis. Eight cats were used. The animals were of undefinied breed, adults and with average weight of 3 kg. They were housed in four cubicles and fed with two measures of commercial ration per day and water ad libitum during an adaptation period of seven days. The trial design was entirely random, being rejected any specific criterion of inclusion in this study besides the absence of any previous kidney damage. Animals received 5 mg / kg prednisone, orally, every 24 hours for a period of 14 days. The samples were collected in two different times, with the animals resting before prednisone administration (M1), and 14 days after the administration (M2). Significant differences were found in some hematological and biochemical parameters as well as in urinalysis. It was concluded that the prednisone (5 mg / kg / day), during a period of 14 days, is potentially nephrotoxic and the determination of the urinary GGT activity was proven to be precisely sensitive to early proximal tubular injury.

We sought to evaluate the effectiveness of thermal radiofrequency ablation combined with corticosteroid injection for medial branch block in the management of chronic low back pain, which originates from lumbar facet joint (LFJ) pain. A prospective observational study of 82 patients with chronic LFJ pain undergoing thermal radiofrequency ablation combined with corticosteroid injection was conducted. Primary outcomes included pain relief and functional recovery, measured by the visual analog scale (VAS) and Oswestry Disability Index, respectively. Secondary outcome was the time of recurrent low back pain at the same spinal segment after treatment. Adverse events were also recorded. Mean age is 55.7 ± 15.2 years old, and duration of LFJ pain was 18.2 ± 9.5 months. Median VAS at baseline was 7.0 (7.0−9.0) for all ages. After intervention, VAS and Oswestry Disability Index improved significantly (P < 0.001). Pain relief lasted for 1 month, 3 months, 6 months, 12 months, and 12−24 months' follow-up. During this period, only 5 patients required another radiofrequency neurotomy procedure (6.1%). No complications occurred in the study group. Thermal radiofrequency ablation combined with corticosteroid injection should be a potential method of choice for its effectiveness, long-lasting effect, and safety in the management of LFJ pain. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective: To evaluate safety and efficacy of first and second-line treatments for immune thrombocytopenic purpura (ITP) in patients older than 15 years. Material and method: A retrospective study was done with patients with immune thrombocytopenic purpura from January 2001 to December 2011. Treatment of first-line included: corticoids (prednisone or hydrocortisone) or immunoglobulin (IgG). Second-line: splenectomy, rituximab, immunosuppressive drugs (cyclophosphamide, azathioprine or mycophenolate) and danazol were prescribed. Respond criteria: complete (CR), platelets > 100 x 109/L; partial (PR), platelets > 30 x 109/L, without bleeding; no response, the remaining. Results: 116 patients were included, 74% women. Mean age was 45 years (15-90). The average initial platelets were 28 x 109/L (0-90). The mean follow-up was 19 months (12-120). The corticoids were administered on 108 and IgG on 8. They were cured 59 (51%); three deaths (3%) by intracranial hemorrhage. Complications: arterial hypertension and hyperglycemia (10 and 9). Fifty-four patients received second-line treatment. The most common was splenectomy but none showed more efficiency (p=0.5). Overall final results: CR 82%, temporal remissions with relapses 10% and without remission 3%. Complications: infections, cytopenias, increase of transaminases and pancreatitis (7, 4, 2, 1). All were related to the use of immunosuppressive drugs. Conclusions: First-line treatment is enough to cure 51% of the patients. The second-line treatments were effective in 31%. By lower toxicity, splenectomy and rituximab are preferable to immunosuppressant. [ABSTRACT FROM AUTHOR]

Meningitis is a serious inflammatory process affecting the meninges, which are membranes that cover the brain, and are usually of infectious cause, including fungi, bacteria and viruses. The etiological agents vary with the age of the individuals, however independent of age the severity of the disease is accentuated generating a high mortality rate. The use of antibiotic therapy is fundamental for the treatment of the disease and its association with corticosteroids, such as dexamethasone, has been studied to improve the prognosis of the disease. There are indications that the use of adjuvant corticosteroids reduces mortality, but further studies are needed to more clearly confirm the role of corticosteroids in the disease. [ABSTRACT FROM AUTHOR]

Background: Corticoids have potent anti-inflammatory effects, which may help in relieving pain and dysfunction associated with lumbar canal stenosis. We assessed the effectiveness of a decreasing-dose regimen of oral corticoids in the treatment of lumbar canal stenosis in a prospective, double-blind, randomized, placebo-controlled trial. Results: Sixty-one patients with lumbar canal stenosis (50-75 years; canal area < 100 mm2 at L3/L4, L4/L5, and/or L5/S1 on magnetic resonance imaging; and claudication within 100 m were electronically randomized to an oral corticoid group (n = 31) or a placebo group (n = 30). The treatment group received 1 mg/kg of oral corticoids daily, with a dose reduction of one-third per week for 3 weeks. Patients and controls were assessed by the Short Form 36 Health Survey, Roland–Morris Questionnaire, 6-min walk test, visual analog scale, and a Likert scale. All instruments showed similar outcomes for the corticoid and placebo groups (P > 0.05). Obese patients exhibited more severe symptoms compared with non-obese patients. L4/L5 stenosis was associated with more severe symptoms compared with stenosis at other levels. Conclusion: The oral corticoid regimen used in this study was not effective in the treatment of lumbar canal stenosis. [ABSTRACT FROM AUTHOR]

We report the case of a 73 year old patient with a COPD. A severe exazerbation was treated with glucocorticoids and Quinolones. A few days later both ankles were tender and painful. Ultrasound examination showed bilateral Achilles tendon ruptures. Diagnostics, etiology and therapeutic options are discussed. [ABSTRACT FROM AUTHOR]

Glial fibrillary acidic protein (GFAP) is the most important marker of astrocytes, that are the major glial cells in the nervous tissue and exhibit receptors to several steroid hormones, which have an apparent influence in their genie expression. The aim of this study was to evaluate if dexamethasone (DX) administration in therapeutic protocols to dogs would be capable of affecting the astrocytic expression of the protein. Samples from the pons and the spinal cord of dogs, treated (n=6) or not (n=6) with DX, were submitted to GFAP immunohistochemical staining and astrocytic reactivity was determined by colorimetry in a computer system for image analysis. Difference statistically significant was noted for the mean areas stained with GFAP in the pons of dogs treated and non-treated with DX, as well as in the spinal cord of dogs which previously received or not DX, with clear tendency of drug-induced reduction in the astrocyte expression of this protein. GFAP expression in the spinal cord was greater than in the pons, regardless the use of DX or not. [ABSTRACT FROM AUTHOR]

We suggest a new, easily applicable way of myocardial hypertrophy induction in rats. Forty randomized age-matched male Wistar rats were divided into 2 groups of 20 each: a control group and an orally administered fludrocortisone/salt group. Myocardial hypertrophy was estimated by measuring body weight, heart-weight-to-body-weight ratio and ventricular free wall thickness. Moderate myocardial hypertrophy without heart failure was established in fludrocortisone/salt group in 4 weeks. Our method is effective and low cost, and it provides a model of hypertrophic heart. [ABSTRACT FROM AUTHOR]

Copyright of Ciência Animal Brasileira is the property of Universidade Federal de Goias, Escola de Veterinaria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cryptogamie Mycologie is the property of Museum National d'Histoire Naturelle, Paris and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: The species composition of wood-inhabiting fungi (polypores and corticoids) was investigated on 1138 spruce logs and 992 pine logs in 90 managed and 34 natural or near-natural spruce and pine forests in SE Norway. Altogether, the study included 290 species of wood-inhabiting fungi. Comparisons of logs with similar properties (standardized tree species, decay class, dimension class) in natural and managed forests showed a significant reduction in species number per log in managed spruce forests, but not in managed pine forests. The species number per log in managed spruce forests was 10–55% lower than on logs from natural spruce forests. The reduction was strongest on logs of large dimensions. A comparison of 200–400 spruce logs from natural and managed forests showed a 25% reduction in species richness corresponding to a conservative loss of ca. 40 species on a regional scale. A closer inspection revealed that species confined to medium and very decayed spruce logs were disfavored in managed forests, whereas species on early decay classes and decay generalists were unaffected. Similarly, species preferring large spruce logs were disfavored in managed forests. Forest management had strongest impact on low-frequent species in the spruce forests (more than 50% reduction), whereas common species were modestly affected. Corticoid fungi were more adversely affected than polypore fungi. These results indicate that wood-decaying fungi in pine forests are more adapted to forest disturbances than spruce-associated species. Management measures securing a continuous supply of dead wood are more important in spruce forests than in pine forests. [Copyright &y& Elsevier]

Primary biliary cirrhosis (PBC) is characterized by unknown etiologies, anti-mitochondrial antibodies, injury of the biliary duct and the lack of a definite remedy. The etiologies of PBC have been well-discussed, including microorganisms and xenobiotics as the triggers for initiating the disease, and an abnormality of immune-tolerance. Recently, several animal models of PBC have been developed that may lead to the development of new therapies. Here, we reviewed the articles that address the etiology of PBC and the therapy for this disease for the confirmation of our current positions and future directions. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Mycology / Journal de Mycologie Médicale is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The anti-inflammatory properties of topical corticosteroids are well documented; additionally, their sensitization potential is also known. We aimed to assess the relative sensitization potential of hydrocortisone and tixocortol pivalate in an animal assay as it relates to potential for sensitization in humans. Using the guinea pig maximization test (GPMT), animals were sensitized intradermally on d0, and again topically on d7. On d21 the animals were challenged topically with a closed patch for 24 h and readings were taken 24 h and 48 h post-challenge. A sham control group received the same induction and challenge applications excluding the test agent. Animals were subsequently rechallenged with open application; the tixocortol pivalate group was further retested at different test agent concentrations to determine threshold concentration that elicited response. Tixocortol pivalate resulted in sensitization rates of 42% (24 h) and 80% (48 h); hydrocortisone exhibited 0% (24 h) and 5% (48 h). Scores ranged from 0% (sham group) to 2.4 (48 h tixocortol pivalate). Open rechallenge also resulted in greater tixocortol pivalate sensitization rates compared to hydrocortisone, 82% verse 16% at 48 h, respectively. All tested concentrations of tixocortol pivalate induced sensitization, albeit at differing rates dependant on concentration and timepoint. We conclude that the GPMT remains largely for hazard identification, as it was originally designed, and requires further data sets regarding quantitative induction and elicitation for risk assessment of various compounds in clinical implications. [ABSTRACT FROM AUTHOR]