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Acetonide
Kinds of Acetonide Terms modified by Acetonide Selected AbstractsChemInform Abstract: A New Route for the Synthesis of (R)-Glyceraldehyde Acetonide: A Key Chiral Building Block.CHEMINFORM, Issue 24 2010K. Chandra Babu Abstract ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a "Full Text" option. The original article is trackable via the "References" option. [source] Detection of contact hypersensitivity to corticosteroids in allergic contact dermatitis patients who do not respond to topical corticosteroidsCONTACT DERMATITIS, Issue 2 2005Müzeyyen Gönül The delayed hypersensitivity development against topical corticosteroids which are used in allergic contact dermatitis (ACD) treatment is an important clinical problem. In our study, 41 ACD patients who did not show any response to topical corticosteroid treatment were patch tested with corticosteroid series and the commercial preparations of corticosteroids and their vehicles. In corticosteroid series, there were budesonide, bethametasone-17-valerate, triamcinolone acetonide, tixocortol pivalate, alclomethasone-17-21-dipropionate, clobetasole-17-propionate, dexamethasone-21-phosphate disodium and hydrocortisone-17-butyrate. We detected positive reaction to corticosteroids in 9 of our cases (22%) (5 single and 4 multiple). The sensitivity was mostly produced by tixocortol pivalate (6 patients). This was followed by triamcinolone acetonide (2 patients) budesonide (2 patients), alclomethasone dipropionate (2 patients), dexamethasone 21 phosphate disodium (2 patients) and betamethasone-17-valerate (1 patient). As a result, it should not be forgotten that the corticosteroids used to treat ACD patients may cause ACD themselves. In ACD patients who did not respond to corticosteroid treatment, routinely applying patch test with corticosteroids should be helpful in directing the treatment. [source] Imaging studies of biodistribution and kinetics in drug developmentDRUG DEVELOPMENT RESEARCH, Issue 2 2003Marc S. Berridge Abstract Although the intravenous route of administration is rarely used for drugs, it is by far the most common route for PET and SPECT radiotracers. This article discusses the use of planar and tomographic nuclear medicine technologies to image and quantify the distribution of drugs after local administration. In principle, this would include topical dermatologic, otic, ophthalmic, rectal, and vaginal administration, as well as the intramuscular, oral, and inhalation routes, although precedents do not yet exist for all of these. The studies reviewed focus mainly on oral ingestion and oral and nasal inhalation. The use of nondrug tracers for formulations is discussed, principally with planar imaging or SPECT using radionuclides such as 99mTc, as well as PET imaging where the active ingredient of a formulation can be labeled with 11C or sometimes 18F. An example of the latter type is a study of the deposition and kinetics in the lungs and airways of triamcinolone acetonide, an antiinflammatory steroid used for topical treatment of allergic rhinitis and asthma, dispensed from an inhaler. PET has high potential for evaluation of different formulations and delivery devices in the development of topically applied drugs. Drug Dev. Res. 59:208,226, 2003. © 2003 Wiley-Liss, Inc. [source] Repeat intrathecal triamcinolone acetonide application is beneficial in progressive MS patientsEUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2006V. Hoffmann Available immunomodulatory and conventional steroid treatment regimens provide a limited symptomatic benefit for patients with progressive multiple sclerosis (MS). We performed an open trial on the short-term efficacy of repeated intrathecal application of the sustained release steroid triamcinolone acetonide (TCA) in 27 progressive MS patients. Six TCA administrations, performed every third day, reduced the Expanded Disability Status Scale (EDSS) score [initial: 5.4 ± 1.3, 3,7.5 (mean ± SD, range); end: 4.9 ± 1.1; 2.5,6.5; P < 0.001] and significantly increased the walking distance and speed in particular after the fourth TCA injection. Concomitantly serially determined cerebrospinal fluid (CSF) markers of cell injury, neuron-specific enolase, total , -protein, S-100, and , -amyloid did not significantly change within the interval of TCA treatment. No serious side effects appeared. We conclude that repeat intrathecal injection of 40 mg TCA provides a substantial benefit in progressive MS patients with predominant spinal symptoms and does not alter CSF markers of neuronal cell injury. [source] Production and clearance of cyclobutane dipyrimidine dimers in UV-irradiated skin pretreated with 1% pimecrolimus or 0.1% triamcinolone acetonide creams in normal and atopic patientsEXPERIMENTAL DERMATOLOGY, Issue 5 2006Laurence Doelker Background:, Ultraviolet (UV)-induced pyrimidine dimers are an early step in skin carcinogenesis, which is accelerated in the setting of long-term immunosuppression with systemic calcineurin inhibitors. It is not known whether topical application of calcineurin inhibitors exposes to a similar risk. Objective:, To assess the formation and clearance of UV-induced dipyrimidine dimers in human epidermis treated with topical pimecrolimus as compared to topical steroid, vehicle and untreated control. Methods:, Pretreated buttock skin of 20 human volunteers with (10) or without (10) atopic dermatitis was exposed to two minimal erythema doses (MED) of simulated solar radiation. DNA was extracted from epidermis 1 and 24 h postirradiation. Pyrimidine dimers were visualized by immuno slot blots and quantified by chemoluminescence image analysis. Results:, One-hour postirradiation, pimecrolimus-treated epidermis contains less DNA damage as compared to untreated control, but there were no statistically significant differences between pimecrolimus, triamcinolone acetonide and vehicle. Dimer levels at 24 h postirradiation showed no significant differences between different treatments. Conclusion:, Treatment with pimecrolimus cream, triamcinolone acetonide cream and vehicle is not associated with increased epidermal DNA damage at 1 and 24 h post-UV exposure. [source] Uncommon Sesquiterpenoids and New Triterpenoids from Jatropha neopauciflora (Euphorbiaceae)HELVETICA CHIMICA ACTA, Issue 1 2006Abraham García Abstract Eight new terpenoids (1,8) were isolated from the bark of Jatropha neopauciflora, together with eight known compounds. The new isolates include the sesquiterpenoids (1R,2R)-diacetoxycycloax-4(15)-ene (1); (1R,2R)-dihydroxycycloax-4(15)-ene (2), (2R)- , -cadin-4-ene-2,10-diol (3), (2R)- , -cadina-4,9-dien-2-ol (4), (1R,2R)-dihydroxyisodauc-4-en-14-ol (5) and its acetonide 6 (artifact), as well as the two triterpenoids (3,,16,)-16-hydroxylup-20(29)-en-3-yl (E)-3-(4-hydroxyphenyl)prop-2-enoate (7) and (3,,16,)-16-hydroxyolean-18-en-3-yl (E)-3-(4-hydroxyphenyl)prop-2-enoate (8). The structures of these compounds were established by extensive 1D- and 2D-NMR spectroscopic methods, and their absolute configurations were determined by circular-dichroism (CD) experiments, and by X-ray crystallographic analysis (compound 7; Fig.,3). A plausible biosynthesis of the sesquiterpenoids 1,5 is proposed (Scheme), starting from (,)-germacrene D as the common biogenetic precursor. [source] A convenient synthesis of oxazolidinone derivatives linezolid and eperezolid from (S)-glyceraldehyde acetonideHETEROATOM CHEMISTRY, Issue 3 2008Guangyu Xu A new convenient method for the synthesis of oxazolidinone antibacterials Linezolid and Eperezolid from readily available (S)-glyceraldehyde acetonide was developed. The key steps include reductive amination of arylamine and (S)-glyceraldehyde acetonide in the presence of NaBH4 and 4 Å sieve, followed by hydrolysis and regioselective cyclization. © 2008 Wiley Periodicals, Inc. Heteroatom Chem 19:316,319, 2008; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/hc.20435 [source] Substitution- and Elimination-Free Phosphorylation of Functionalized Alcohols Catalyzed by Oxidomolybdenum TetrachlorideADVANCED SYNTHESIS & CATALYSIS (PREVIOUSLY: JOURNAL FUER PRAKTISCHE CHEMIE), Issue 1 2010Cheng-Yuan Liu Abstract Among 14 oxidometallic species examined for catalytic phosphorylation of the tested alcohols, oxidomolybdenum tetrachloride (MoOCl4) was found to be the most efficient with a negligible background reaction mediated by triethylamine (Et3N). The new catalytic protocol can be applied to the chemoselective phosphorylations of primary, secondary and tertiary alcohols as well as the substitution-free phosphorylations of allylic, propargylic, and benzylic alcohols. Functionalized alcohols bearing acetonide, tetrahydropyranyl ether, tert -butyldimethylsilyl ether, or ester group are also amenable to the new catalytic protocol. The most difficult scenarios involve substitution-free phosphorylations of 1-phenylethanol and 1-(2-naphthyl)ethanol which can be effected in 95 and 90% yields, respectively. ESI-MS, IR, 1H, and 31P,NMR spectroscopic analyses of the reaction progress suggest the intermediacy of an alkoxyoxidomolybdenum trichloride-triethylamine adduct such as [(RO)Mo(O)Cl3 -Et3N] to be responsible for the catalytic turnover. [source] Prospective randomised single blind study of epidural steroid injection comparing triamcinalone acetonide with methylprednisolone acetateINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2005A. ANWAR Abstract Aim:, This study aims to assess the effectiveness of epidural steroid injection as well as comparing two agents commonly used in these procedures, namely triamcinalone acetonide and methylprednisolone acetate. Method:, Twenty subjects were recruited into each group receiving either agent. Results:, Overall result showed that there were marked improvement in symptoms in both agents but there were no differences in terms of superiority from one agent to another. Conclusion:, Epidural steroid injection is effective and both agents are equipotent. [source] Unifocal Langerhans cell histiocytosis of the oral mucosaJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 7 2009Susanna Fistarol Summary A 24-year-old man was admitted for a painful gingival ulcer. Histology and immunohistochemistry of a lesional biopsy revealed the diagnosis of Langerhans cell histiocytosis (LCH). To rule out multifocal disease, a complete staging was performed. There was no evidence of bony lesions or any other organ involvement. The diagnosis of LCH restricted to the oral mucosa was established. The complete oral lesion was ablated by CO2 laser and subsequently treated topically with triamcinolone acetonide. The patient is still in remission after one year of follow-up. LCH confined to the oral mucosa is rare. It presents usually as an inflammatory or ulcerative lesion, easily leading to misinterpretation and delayed diagnosis. Patients with limited unifocal mucocutaneous disease, as in the present case, usually have an excellent prognosis. However, the oral lesion may represent an early sign of LCH, predating and progressing to an aggressive life-threatening multiorgan disease. [source] Ultrasonographic assessment of Baker's cysts after intra-articular corticosteroid injection in knee osteoarthritisJOURNAL OF CLINICAL ULTRASOUND, Issue 3 2006J. Carlos Acebes MD Abstract Purpose: To assess sonographic changes in Baker's cysts (BCs) of patients with knee osteoarthritis after a single intra-articular corticosteroid injection. Methods: Thirty patients with knee osteoarthritis complicated with a symptomatic BC received a single intra-articular injection of 40 mg triamcinolone acetonide. Knee pain, swelling, and range of motion were evaluated. BC area and thickness of the cyst wall were measured with sonography before and 4 weeks after local treatment. Results: A significant improvement in knee pain, swelling, and range of motion after corticosteroid injection was accompanied by a decrease in size of the BCs as well as in thickness of the cyst wall as measured by sonography. Moreover, the reduction of BC area on sagittal scans after treatment was significantly correlated with the improvement in range of motion. Conclusions: In this series of osteoarthritis patients, injection of corticosteroids inside the knee joint accounted for a reduction in BC dimensions as well as cyst wall thickness. Sonography can be used not only for the diagnosis of BCs but also to monitor response to therapy. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 34:113,117, 2006 [source] Role of liquid nitrogen alone compared with combination of liquid nitrogen and intralesional triamcinolone acetonide in treatment of small keloidsJOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2007Saurabh Sharma MD Summary Keloids are well-defined fibrous tissue overgrowths extending beyond the original defects. The purpose of our study was to compare the efficacy of liquid nitrogen cryosurgery alone with liquid nitrogen cryosurgery and intralesional triamcinolone acetonide combination. Study on 60 clinically diagnosed lesions of keloids from 21 patients was conducted to compare the efficacy of liquid nitrogen cryosurgery alone. The statistical analysis shows synergistic action of cryosurgery and corticosteroids may offer promise in the treatment. [source] Preparation of high specific activity tritium labeled 6,,9,-difluoro-11,,21-dihydroxy-16,,17-[(1-methylethylidene)bis(oxy)]pregna-1,4-diene-3,20-one, fluocinolone acetonideJOURNAL OF LABELLED COMPOUNDS AND RADIOPHARMACEUTICALS, Issue 4 2009D. Zhong Abstract Fluocinolone acetonide was tritiated by selective reduction of the 1,2-double bond of the O -protected analog under tritium, followed by re-establishment of the 1,2-double bond and deprotection. Protection of both hydroxyl functionalities was required. The product was obtained with specific activity 36.8,Ci/mmol. Copyright © 2009 John Wiley & Sons, Ltd. [source] The synthesis of tritiated (R)-2-methoxy- N - n -propyl-nor-apomorphine (MNPA)JOURNAL OF LABELLED COMPOUNDS AND RADIOPHARMACEUTICALS, Issue 13 2007Jonas Malmquist Abstract A method for the preparation of [3H]-MNPA ((R)-2-methoxy- N - n -propyl-norapomorphine) has been developed addressing the regioisomer problem as well as the oxidation problem. (R)-2, 10, 11-trihydroxy- N - n -propyl-norapomorphine was protected with 10, 11-dibenzyl or 10, 11-acetonide. The pure precursor was then methylated using [3H]-methyliodide. The product was isolated after deprotection and high-pressure liquid chromatography (HPLC) purification. Ascorbic acid was used as an antioxidant in the HPLC eluent and the stock solution. Characterization of the intermediates and products with 3H- and 1H-NMR was performed. A specific activity of 3.1,TBq/mmol (83.8,Ci/mmol) and 98.9% purity was obtained. Copyright © 2007 John Wiley & Sons, Ltd. [source] Expression of IFN-, before and after treatment of oral lichen planus with 0.1% fluocinolone acetonide in orabaseJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 9 2009Pornpan Youngnak-Piboonratanakit Background:, Oral lichen planus (OLP) is a common chronic inflammatory mucosal disease in which T-cell-mediated immune responses are implicated in the pathogenesis. The purpose of this study was to investigate the effect of 0.1% fluocinolone acetonide in orabase (FAO) on the in situ expression of IFN-, in patients with OLP. Methods:, Twenty OLP patients were enrolled in this study. Biopsy specimens and serum samples were obtained before and 1-month after the treatment with 0.1% FAO. In situ expression and serum levels of IFN-, were determined using immunohistochemistry and ELISA, respectively. Results:, The number of IFN-,-positive mononuclear cells in OLP lesions before the treatment was significantly higher as compared with that after the treatment. Similarly, the mean number of total mononuclear cells was clearly decreased after the treatment. However, the serum levels of IFN-, were not detectable. Conclusions:, Our results suggest that IFN-, expression in OLP tissue may involve in the immunopathogenesis and the treatment with 0.1% FAO had an immunomodulating effect on the decrease of IFN-,. [source] The efficacy of topical intralesional BCG-PSN injection in the treatment of erosive oral lichen planus: a randomized controlled trialJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 7 2009C. Xiong Background:, Nowadays, it has been widely accepted that the local cell-mediated immunologic disorders may play an important role in the pathogenesis of oral lichen planus (OLP). Therefore, we sieved out polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) from various immunomodulators to evaluate the short-term therapeutic efficacy and clinical safety of intralesional BCG-PSN injection for erosive OLP. Methods:, A total of 56 OLP patients were randomly assigned to receive either intralesional injection of 0.5 ml BCG-PSN every other day (31 of 56) or 10 mg triamcinolone acetonide (TA, a positive-controlled group, 25 of 56) every week for 2 weeks. After the cessation of treatment, those cured from erosion were followed up for 3 months. Another two researchers measured erosive areas and recorded visual analog scale (VAS) scores both at the start and the end of the treatment. We also registered adverse reactions and the recurrence intervals. Results:, After 2-week treatment, 27 of 31 BCG-PSN-treated patients (87.1%) and 22 of 25 TA-treated patients (88.0%) healed. There were no statistical differences between the two groups in erosive areas (27.86 ± 27.97 vs. 25.68 ± 34.65, P = 0.801) and VAS scores (2.45 ± 1.64 vs. 2.40 ± 1.38, P = 0.946). Three of 31 BCG-PSN-treated patients (9.7%) vs. 2 of 25 TA-treated patients (8.0%) experienced the swelling or burning sensation (P = 0.827). A total of 49 of 56 patients were followed up. There were no statistical differences in the recurrence rates (33.3% vs. 45.5%, P = 0.386) and intervals (80.89 ± 26.83 vs. 73.48 ± 28.11, P = 0.419). Conclusions:, Topical intralesional BCG-PSN injection is as effective as TA for erosive OLP, which suggests that topical intralesional BCG-PSN injection can be a promising therapeutic alternative for erosive OLP, especially for those insensitive, or even resistant, to glucocorticoids. [source] Short-term clinical evaluation of intralesional triamcinolone acetonide injection for ulcerative oral lichen planusJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 6 2006Juan Xia Background:, Efforts are made in a continued searching for novel therapies for symptomatic oral lichen planus (OLP). This study aimed to evaluate the efficacy and safety of intralesional triamcinolone acetonide (TA) injection for ulcerative OLP. Methods:, Forty-five patients with clinical and histologically confirmed ulcerative OLP on bilateral buccal mucosa, one for treatment and the other for control, were studied. All participants received 0.5 ml TA (40 mg/ml) on experimental sites. Visual analogue scale score and lesion areas were recorded at the time of injection and 1-week interval. After 2 weeks, if the treated ulceration reduced <81% in size, a second injection was given. Results:, The treated group gave rapid relief of signs and symptoms, while the control group showed minimal decrease. 38 (84.4%) patients demonstrated complete response in ulceration size. No complications were noted with TA injections. Conclusions:, Intralesional TA injection in ulcerative OLP is effective and safe in achieving lesion and pain regression. [source] Repeated intraarticular injections of triamcinolone acetonide alter cartilage matrix metabolism measured by biomarkers in synovial fluidJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 3 2005Christophe Céleste Abstract Although intraarticular (IA) corticosteroids are frequently used to treat joint disease, the effects of their repeated use on articular cartilage remains controversial. The aim of our study was to determine the effects of a clinically recommended dose of IA triamcinolone acetonide (TA), on synovial fluid (SF) biomarkers of cartilage metabolism. Ten adult horses, free of osteoarthritis (OA) in their radiocarpal joints, were studied. One radiocarpal joint of each horse was randomly chosen for treatment and the contralateral anatomically paired joint acted as the control. Aseptic arthrocentesis was performed weekly on both joints for 13 weeks. The initial results from the first 3 weeks of the experimental period established baseline untreated control marker levels for each joint, each being its own control. On weeks 3, 5, and 7, a sterile suspension of 12mg of TA was injected into the treated joint and an equivalent volume of sterile saline solution (0.9%) was injected into the control joint. SF was immunoassayed for biomarkers of aggrecan turnover (CS 846 & KS), types I and II collagen cleavage (C1,2C) and type II collagen synthesis (CPII). In treated joints, there was a significant increase in CS 846, KS, C1,2C and CPII epitope concentrations following IA TA injections when compared to baseline levels. There was also a significant increase in C1,2C and CPII epitope concentrations in the contralateral control joints following IA TA injections in the treated joint. Significant differences were observed between treated and control joints for all markers except CPII. These findings indicate that TA alters articular cartilage and collagen metabolism in treated and, interestingly, also in control joints, suggesting a systemic effect of the drug. Though intuitively the observed findings would favor the hypothesis that long-term IA TA treatment changes joint metabolism and this may have detrimental effects; further studies would be necessary to confirm this. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] The influence of relative humidity on the cohesion properties of micronized drugs used in inhalation therapyJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 3 2004Paul M. Young Abstract The influence of relative humidity (RH) on the cohesion properties of three drugs: salbutamol sulphate (SS), triamcinolone acetonide (TAA), and disodium cromoglycate (DSCG) was investigated using the atomic force microscope (AFM) colloidal probe technique. Micronized drug particles were mounted in heat-sensitive epoxy resin for immobilization. Multiple AFM force,distance curves were conducted between each drug probe and the immobilized drug particulates at 15, 45, and 75% RH using Force,Volume imaging. Clear variations in the cohesion profile with respect to RH were observed for all three micronized drugs. The calculated force and energy of cohesion to separate either micronized SS or DSCG increased as humidity was raised from 15 to 75% RH, suggesting capillary forces become a dominating factor at elevated RH. In comparison, the separation force and energy for micronized TAA particles decreased with increased RH. This behavior may be attributed to long-range attractive electrostatic interactions, which were observed in the approach cycle of the AFM force,distance curves. These observations correlated well with previous aerosolization studies of the three micronized drugs. © 2004 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 93: 753,761, 2004 [source] Synthesis and characterization of 2,2-bis(methylol)propionic acid dendrimers with different cores and terminal groupsJOURNAL OF POLYMER SCIENCE (IN TWO SECTIONS), Issue 7 2004Michael Malkoch Abstract Three sets of aliphatic polyester dendrimers based on 2,2-bis(methylol)propionic acid (bis-MPA) were synthesized. Two of the sets had benzylidene terminal groups and either a trimethylolpropane or triphenolic core moiety. The last set had acetonide terminal groups and a triphenolic core moiety. Benzylidene-[G#1]-anhydride and acetonide-[G#1]-anhydride were used as the reactive building blocks in the construction of all dendrimers. The large excess of building blocks used in the coupling reactions initially resulted in considerable material loss. This waste was eliminated through the development of a recycling method. 1H and 13C NMR and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) analysis were used to verify the purity of all compounds. Size exclusion chromatography (SEC) was used, as well as MALDI-TOF, for molecular weight determinations. The SEC measurements were conducted with a universal calibration method and an online right-angle laser light scattering detector. Measured dendrimer molecular weights were close to their theoretical molar masses. Observations were also made of the hydrodynamic radius and intrinsic viscosity for the different dendrimers. © 2004 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 42: 1758,1767, 2004 [source] Modulation of the atopy patch test: tacrolimus 0.1% compared with triamcinolone acetonide 0.1%ALLERGY, Issue 5 2006J. M. Oldhoff Background:, The atopy patch test (APT) is an in vivo model to study the induction of eczema by inhalant allergens in atopic dermatitis patients. We studied the effect of pretreatment with topical tacrolimus 0.1% on APT in nonlesional skin of patients with atopic dermatitis. Methods:, Nonlesional skin of the back of patients with atopic dermatitis (n = 8) was treated once daily for 3 weeks with tacrolimus 0.1% ointment. Cetomacrogol ointment (placebo) was used as a negative control and triamcinolone acetonide 0.1% ointment as positive control. Twenty-four hours after the last APT application, samples were taken from the three treated areas (t = 0 and 24 h) for immunohistochemical analysis. Results:, Pretreatment with tacrolimus ointment did not suppress nonlesional skin infiltrate, in contrast to triamcinolone acetonide. Furthermore, tacrolimus did not inhibit the induction of the APT macroscopically (t = 24 h). An equal influx of T cells, eosinophils, dendritic cells, CD64+ and Fc,RI-positive cells was present compared with placebo. Only CD36+ and CD68-positive cells were inhibited compared with placebo. All cell types were significantly inhibited in triamcinolone acetonide-treated sites compared with placebo. Conclusions:, Pretreatment with tacrolimus 0.1% ointment does not inhibit the APT reaction in patients with atopic dermatitis. [source] Size and Aggregation of Corticosteroids Used for Epidural InjectionsPAIN MEDICINE, Issue 2 2008Richard Derby MD ABSTRACT Objective., The purpose of this study was to document particulate size in commonly used corticosteroid preparations. Inadvertent injection of particulate corticosteroids into a vertebral or foraminal artery can cause brain and spinal cord embolic infarcts and the size of the particles could be directly related to the chance that a clinically significant infarct would occur. One might assume that corticosteroids with particles significantly smaller than red blood cells might be safer. Design., The following four types of corticosteroid preparations were used in various solutions and evaluated under light microscopy: dexamethasone sodium phosphate injection, triamcinolone acetonide injectable suspension, betamethasone sodium phosphate and betamethasone acetate injectable suspension, and methylprednisolone acetate injectable suspension. Results., Dexamethasone sodium phosphate particle size was approximately 10 times smaller than red blood cells and the particles did not appear to aggregate; even mixed with 1% lidocaine HCl solution and with contrast dye, the size of the particles were unchanged. Triamcinolone acetonide and betamethasone sodium phosphate showed variable sizes; some particles were larger than red blood cells, and aggregation of particles was evident. Methylprednisolone acetate showed uniformity in size and the majority were smaller than red blood cells which were not aggregated, but the particles were densely packed. Conclusions., Compared with the particulate steroid solutions, dexamethasone sodium phosphate had particles that were significantly smaller than red blood cells, had the least tendency to aggregation, and had the lowest density. These characteristics should significantly reduce the risk of embolic infarcts or prevent them from occurring after intra-arterial injection. Until shown otherwise in clinical studies, interventionalists might consider using dexamethasone or another corticosteroid preparation with similar high solubility and negligible particle size when performing epidural injections. [source] Photochemistry and Phototoxicity of Fluocinolone 16,17-Acetonide,PHOTOCHEMISTRY & PHOTOBIOLOGY, Issue 2 2005Giorgia Miolo ABSTRACT Fluocinolone 16,17-acetonide is a corticosteroid used topically to treat various inflammatory skin diseases. Its photoreactivity was studied under UV-A and UV-B light in aqueous buffer in the presence of oxygen. This drug is photolabile under UV-B light and, to a lesser extent, under UV-A light, which is absorbed far less. In phosphate buffer, approximately 80% of fluocinolone acetonide decomposes after 5 J/cm2 of UV-B irradiation, whereas under 30 J/cm2 of UV-A light approximately only 20% decomposes. Both the drug and its photoproducts have been evaluated through a battery of in vitro studies and found to cause photohemolysis and induce photodamage to proteins (erythrocyte ghosts, bovine serum albumin) and linoleic acid. In addition, one of the photoproducts (the 17-hydroperoxy derivative) is highly toxic in the dark. Therefore, both loss of therapeutic activity and light-induced adverse effects may be expected when patients expose themselves to sunlight after drug administration. A major mechanism for phototoxicity involves radicals forming from drug breakdown, at least under UV-B, although reactive oxygen species may play a role, particularly under UV-A. [source] Canakinumab for the treatment of acute flares in difficult-to-treat gouty arthritis: Results of a multicenter, phase II, dose-ranging study,ARTHRITIS & RHEUMATISM, Issue 10 2010Alexander So Objective To assess the efficacy and tolerability of canakinumab, a fully human anti,interleukin-1, monoclonal antibody, for the treatment of acute gouty arthritis. Methods In this 8-week, single-blind, double-dummy, dose-ranging study, patients with acute gouty arthritis whose disease was refractory to or who had contraindications to nonsteroidal antiinflammatory drugs and/or colchicine were randomized to receive a single subcutaneous dose of canakinumab (10, 25, 50, 90, or 150 mg; n = 143) or an intramuscular dose of triamcinolone acetonide (40 mg; n = 57). Patients assessed pain using a 100-mm visual analog scale. Results Seventy-two hours after treatment, a statistically significant dose response was observed for canakinumab. All canakinumab doses were associated with numerically less pain than triamcinolone acetonide; thus, a dose with equivalent efficacy to triamcinolone acetonide 72 hours after treatment could not be determined. The reduction from baseline in pain intensity with canakinumab 150 mg was greater than with triamcinolone acetonide 24, 48, and 72 hours after treatment (differences of ,11.5 mm [P = 0.04], ,18.2 mm [P = 0.002], and ,19.2 mm [P < 0.001], respectively), and 4, 5, and 7 days after treatment (all P < 0.05). Canakinumab significantly reduced the risk of recurrent flares versus triamcinolone acetonide (P , 0.01 for all doses) (relative risk reduction 94% for canakinumab 150 mg versus triamcinolone acetonide). The overall incidence of adverse events was similar for canakinumab (41%) and triamcinolone acetonide (42%); most were mild or moderate in severity. Conclusion Our findings indicate that canakinumab 150 mg provides rapid and sustained pain relief in patients with acute gouty arthritis, and significantly reduces the risk of recurrent flares compared with triamcinolone acetonide. [source] Granulomas in common variable immunodeficiency: A diagnostic dilemmaAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 1 2004Karyn R Lun SUMMARY A 60-year-old man with common variable immunodeficiency presented with a 7-year history of violaceous plaques and papules on the thighs, arms and trunk. In the preceding 2 years he had developed new lesions on both hands. He had been previously diagnosed with sarcoidosis on the basis of skin and visceral histology, but subsequent opinion was that these were sarcoid-like granulomas rather than being representative of true sarcoidosis. Biopsy of the hand lesions showed necrotizing granulomas, and a single acid-fast bacillus (AFB) was identified on Wade,Fite stain. Subsequent repeat tissue biopsies for histology, culture and polymerase chain reaction testing failed to confirm the presence of mycobacterial organisms and it was felt that the organism was a contaminant introduced during tissue processing. The hand lesions responded well to intralesional injections of triamcinolone acetonide 10 mg/mL and oral tetracycline 500 mg b.d. was later introduced with a good clinical response. The diagnostic dilemma of finding granulomatous inflammation in a patient with common variable immunodeficiency, and the significance of a single AFB on histology are discussed. The treatment of sarcoid-like granulomas with tetracycline therapy is also commented on. [source] Combined intravitreal bevacizumab and triamcinolone in exudative age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 6 2010Jost B. Jonas Acta Ophthalmol. 2010: 88: 630,634 Abstract. Purpose:, We report on the combined application of intravitreal bevacizumab and triamcinolone acetonide for treatment of exudative age-related macular degeneration (AMD). Methods:, The clinical interventional case-series study included 16 patients (16 eyes) with exudative AMD who had previously received 3.5 ± 1.8 mono-injections of bevacizumab (1.5 mg) without significant improvement in visual acuity (VA) or reduction in macular exudation. All patients underwent a combined intravitreal injection of bevacizumab (1.5 mg) and triamcinolone acetonide (about 20 mg). Main outcome measures were VA and macular thickness as determined by optical coherence tomography. All patients were re-examined at 2,3 months after the intervention. Results:, Visual acuity improved significantly (p = 0.03) from 0.80 ± 0.40 logMAR prior to the combined injection to 0.65 ± 0.42 logMAR at 3 months after the injection. An improvement of , 1 Snellen line was found in eight subjects, an increase of , 2 lines in five subjects, and an improvement of , 3 lines in two subjects. One patient lost 1 line and one patient lost 3 lines. Central retinal thickness decreased significantly from 272 ± 62 ,m to 220 ± 47 ,m (p = 0.03). At the 6-month follow-up examination, central retinal thickness had increased again to 319 ± 142 ,m, which was not significantly (p = 0.30) different from baseline measurements. Conclusions:, The combined intravitreal application of bevacizumab and triamcinolone may temporarily be helpful in the treatment of exudative AMD if previous intravitreal bevacizumab mono-injections have failed to improve vision and reduce macular oedema. [source] Protective effects of triamcinolone acetonide upon the upregulation and phosphorylation of GAP 43 in an animal model of retinopathy of prematurityACTA OPHTHALMOLOGICA, Issue 6 2010In Y. Chung Acta Ophthalmol. 2010: 88: e217,e221 Abstract. Purpose:, The aim of the current study was to investigate the effects of triamcinolone acetonide (TA) upon the expression and phosphorylation of growth-associated protein 43 (GAP 43) in the retinas of oxygen-induced retinopathy (OIR) rats. Methods:, Oxygen-induced retinopathy was induced by exposing Sprague-Dawley rats to hyperoxia (80% oxygen) from postnatal (P) days 2,14 and then returning the rats to normoxic conditions. Triamcinolone acetonide or a conditioned saline (control) was injected intravitreally into the right or left eye, respectively, of OIR rats at P15. We then assessed the molecular and histological changes in the expression of GAP 43 and phospho-GAP 43 in OIR and control rat retinas, and also after treatment with TA by RT-PCR, Western blotting and immunohistochemistry. Results:, Growth-associated protein 43 mRNA levels were found to be increased by 1.6-fold (p = 0.001, n = 5) in the retinas of P18 OIR rats compared with the control rats. The protein levels of GAP 43 and phospho-GAP43 were found to be elevated in the retina of P18 OIR rats (2.40- and 2.39-fold greater than each control, p<0.001, n = 5, respectively). Immunoreactivities of GAP 43 and phospho-GAP 43 were stronger in the inner plexiform layer in OIR rat retinas compared with the control. However, treatment with TA attenuated GAP 43 and phospho-GAP 43 upregulation in the OIR retinas. Conclusion:, Our results indicate that GAP 43 and phospho-GAP 43 participate in retinal (potentially pathologic) changes following oxygen-induced damage. Triamcinolone acetonide protects the retinal damage in relatively hypoxic retinas of OIR rats. Therefore, TA treatment does not induce the expression and phosphorylation of GAP 43 in OIR rat retinas. [source] Retinal sensitivity and fixation changes 1 year after triamcinolone acetonide assisted internal limiting membrane peeling for macular hole surgery , a MP-1 microperimetric studyACTA OPHTHALMOLOGICA, Issue 6 2010Hakan Ozdemir Acta Ophthalmol. 2010: 88: e222,e227 Abstract. Purpose:, To evaluate microperimetric changes 1 year after macular hole surgery with triamcinolone acetonide assisted internal limiting membrane (ILM) peeling. Methods:, Twenty-two eyes of 22 patients with stage 3 and 4 idiopathic macular holes of <6 months' duration underwent vitrectomy with triamcinolone acetonide assisted ILM peeling. Best corrected visual acuity (BCVA) (logarithm of the minimum angle of resolution), and central retinal sensitivity were documented before and 1, 3, 6, and 12 months after surgery. Macular sensitivity (mean sensitivity in decibels -dB), and stability and location of fixation (preferred retinal locus) were determined using MP-1 microperimetry (Nidek). The MP-1 microperimetry sensitivity map was overlaid onto infrared images recorded on a Heidelberg scanning laser ophthalmoscope using dedicated MP-1 software to evaluate the fixation location before surgery. Anatomical success was evaluated with optical coherence tomography (OCT). Optical coherence tomography scans were recorded on an OCT 3000 scanner. Results:, Anatomical success was achieved in all 22 eyes. All patients completed 1 year follow-up. No recurrence of macular hole was seen in any patients in the follow-up period. The mean BCVA improved from 0.75 ± 0.2 before surgery to 0.31 ± 0.1 logMAR at the last visit (p < 0.001). Mean sensitivity improved from 3.7 ± 0.6 to 5.3 ± 1.0 dB at the last visit (p < 0.001). Before surgery, the preferred retinal locus was located on the margin of the hole in all, in 18 eyes on its upper part and in four eyes to the side or on its lower part. Preoperatively, 12 eyes were stable and 10 were relatively unstable, but 12 month after surgery, fixation stability had improved, and 20 eyes were stable and two were relatively unstable. Conclusions:, MP-1 microperimetry sensitivity map overlaid onto an infrared image using dedicated MP-1 software can be used successfully to evaluate fixation location in patients with a macular hole before surgery. With microperimetry findings, we can also measure functional macular changes more precisely than using BCVA alone after macular hole surgery. Our results also showed that retinal sensitivity and fixation properties were improved after vitrectomy with triamcinolone acetonide assisted ILM peeling in patients with idiopathic macular hole. [source] 3415: Treatment of postoperative macular edemaACTA OPHTHALMOLOGICA, Issue 2010I PETROPOULOS Purpose Cystoid macular edema (CME) is a frequent complication of a number of interventions in ophthalmology, such as cataract surgery (Irvine-Gass syndrome), laser procedures, and trabeculectomy. The purpose of this talk is to present the latest bibliographic data regarding the appropriate treatment of postoperative CME. Methods A review of the existing literature concerning the treatment of postoperative CME is performed. Characteristic personal cases are presented. Results In more than two-thirds of the cases, postoperative CME resolves spontaneously within weeks or months. Prophylactic topical treatment with indomethacin or flurbiprofen seems to reduce the frequency of clinical and angiographic CME, but its beneficial effect on final visual acuity is not established. Curative therapy includes topical corticosteroids; topical non-steroidal anti-inflammatory drugs (e.g. ketorolac); oral acetazolamide; sub-Tenon or intravitreal injection of triamcinolone acetonide; intravitreal injection of anti-VEGF drugs; and pars plana vitrectomy. The indications, role, and efficacy of each of the above treatment modalities are discussed, based on the latest bibliographic data. Conclusion Most cases of postoperative CME are mild and resolve spontaneously. In refractory cases, sub-Tenon or intravitreal injection of triamcinolone acetonide can be effective, but the risk of ocular hypertony is high. Intravitreal injection of anti-VEGF drugs offers promising results, yet large-scale randomized studies are necessary to validate their utility. Finally, pars plana vitrectomy is the treatment of choice when vitreomacular traction and/or epiretinal membrane is present. [source] Macular function after intravitreal triamcinolone acetonide injection for diabetic macular oedemaACTA OPHTHALMOLOGICA, Issue 5 2010Murat Karacorlu Abstract. Purpose:, We aimed to evaluate the effect of intravitreal triamcinolone acetonide (IVTA) on macular function in patients with diabetic macular oedema (DMO). Methods:, Eleven eyes in 11 patients with DMO were enrolled. In each eye, at baseline and at 30 days after IVTA injection, logMAR visual acuity (VA), macular sensitivity, fixation stability and fixation location by MP-1 microperimetry and optical coherence tomography (OCT) foveal thickness were assessed. Results:, Thirty days after IVTA injection, eyes with DMO showed a significant (p < 0.001) reduction in foveal thickness and significant (p < 0.01) increases in logMAR VA and MP-1 retinal sensitivity (p < 0.001). There was also significant (p = 0.046) improvement in fixation location and some improvement in fixation stability, although the latter was not significant (p = 0.08). Conclusions:, In eyes with DMO, short-term improvement in retinal sensitivity and fixation properties can be achieved by IVTA injection. [source] | ||||||||||||||||||||||||||||