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Steroid Group (steroid + group)
Selected AbstractsImpact of preoperative steroids administration on ischemia-reperfusion injury and systemic responses in liver surgery: A prospective randomized studyLIVER TRANSPLANTATION, Issue 6 2006Luca Aldrighetti Hepatic injury secondary to warm ischemia-reperfusion (I/R) injury and alterations in haemostatic parameters are often unavoidable events after major hepatic resection. The release of inflammatory mediator is believed to play a significant role in the genesis of these events. It has been suggested that preoperative steroid administration may reduce I/R injury and improve several aspects of the surgical stress response. The aim of this prospective randomized study was to investigate the clinical benefits on I/R injury and systemic responses of preoperatively administered corticosteroids. Seventy-six patients undergoing liver resection were randomized either to a steroid group or to a control group. Patients in the steroid group received preoperatively 500 mg of methylprednisolone. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, coagulation parameters, and inflammatory mediators, interleukin 6 and tumor necrosis factor alpha were compared between the 2 groups. Length of stay, and type and number of complications were recorded as well. Postoperative serum levels of ALT, AST, total bilirubin, and inflammatory cytokines were significantly lower in the steroid than in the control group at postoperative days 1 and 2. Changes in hemostatic parameters were also significantly attenuated in the steroid group. In conclusion, the incidence of postoperative complications in the steroid group tended to be significantly lower than the control group. It is of clinical interest that preoperative steroids administration before major surgery may reduce I/R injury, maintain coagulant/anticoagulant homeostasis, and reduce postoperative complications by modulating the inflammatory response. Liver Transpl 12:941,949, 2006. © 2006 AASLD. [source] Periradicular infiltration for sciatica: a randomized controlled trial. (University Hospital of Oulu, Helsinki, Finland).PAIN PRACTICE, Issue 4 2001Spine. In this study, 160 consecutive, eligible patients with sciatica who had unilateral symptoms of 1 to 6 months duration, and who never underwent surgery were randomized for a double-blinded injection with methylprednisolone bupivacaine combination or saline. Objective and self-reported outcome parameters and costs were recorded at baseline, at 2 and 4 weeks, at 3 and 6 months, and at 1 year. Recovery was better in the steroid group at 2 weeks for leg pain, straight leg raising, lumbar flexion, and patient satisfaction. Back pain was significantly lower in the saline group at 3 and 6 months. Sick leave and medical costs were similar for both treatments, except for cost of therapy visits and drugs at 4 weeks, which were in favor of the steroid injection. By 1 year, 18 patients in the steroid group and 15 in the saline group underwent surgery. Conclude improvement during the follow-up was found in both the methylprednisolone and saline groups. The combination of methylprednisolone and bupivacaine seems to have a short-term effect, but at 3 and 6 months, the steroid group seems to experience a "re-bound" phenomenon. [source] Steroid avoidance using sirolimus and cyclosporine in pediatric renal transplantation: One year analysisPEDIATRIC TRANSPLANTATION, Issue 1 2010Franca M. Iorember Iorember FM, Patel HP, Ohana A, Hayes JR, Mahan JD, Baker PB, Rajab A. Steroid avoidance using sirolimus and cyclosporine in pediatric renal transplantation: One year analysis. Pediatr Transplantation 2010: 14: 93,99. © 2009 John Wiley & Sons A/S. Abstract:, Steroids are commonly used in pediatric renal transplantation, but have numerous adverse effects. This retrospective study compares one-yr outcomes in 22 pediatric renal transplant recipients receiving SRL and CSA as primary immunosuppression (steroid-avoidance group) to age- and gender-matched historical controls receiving CSA, MMF, and prednisone (steroid group). At one yr, both groups had similar graft survival, acute rejection, and estimated GFR. Subjects in the steroid-avoidance group had better linear growth, less excessive weight gain and were less likely to have an increase in antihypertensive medication use. Subjects in the steroid-avoidance group were more likely to be started on lipid lowering medications and erythropoiesis stimulating agents. Despite having a greater proportion of living donors, the steroid-avoidance group had a similar GFR compared to the steroid group at one month. The steroid-avoidance group was also more likely to have a biopsy for elevated Cr that was not because of rejection and had more interstitial fibrosis noted. We conclude that using a steroid-avoidance immunosuppression regimen of SRL and CSA results in comparable rejection rates and short-term graft function with less steroid-associated morbidity. However, early findings also suggest possible potentiation of CSA nephrotoxicity by SRL in some children. [source] Preoperative topical non-steroidal anti-inflammatory drug or steroid and clinical outcomes after trabeculectomyACTA OPHTHALMOLOGICA, Issue 2009I STALMANS Purpose To investigate the benefit of preoperative topical non-steroidal anti-inflammatory drug (NSAID) or steroid after trabeculectomy. Methods In this prospective randomized placebo-controlled trial, 61 patients scheduled for trabeculectomy were randomized to one of 3 study medication groups: NSAID (ketorolac), steroid (fluorometholone) or placebo (artificial tears). Patients instilled one drop 4x daily for 1 month preoperatively and were examined on day 1, 2, at weeks 1, 2, and 4, and at months 3, 6, 12, 18 and 24 following trabeculectomy. Main outcome measures were incidence of postoperative interventions and IOP-lowering medications; complete and qualified success rate; final IOP and relative IOP reduction. Results Fifty-four eyes were entered for analysis. The percentage of patients requiring needling within the first year was 41% in the placebo, 6% in the NSAID and 5% in the steroid group (P = 0.006). The percentage of patients requiring IOP-lowering medication at one year was 24% in the placebo, 18% in the NSAID and 0% in the steroid group (P = 0.054 overall; P = 0.038 for steroids versus others). Log-rank test showed a significant (P = 0.019) difference in medication-free survival curves between the different groups; patients in the steroid group needed significantly less medication (P = 0.007). The inter-group differences in one-year IOP, relative IOP reduction and success rates were not significant. Conclusion Topical ketorolac or fluorometholone for one month preoperatively was associated with improved trabeculectomy outcomes in terms of likelihood of postoperative needling. Within the steroid group, there was a significant reduced need for postoperative IOP-lowering medication. [source] The effect of oral steroids with and without vitamin D3 on early efficacy of immunotherapy in asthmatic childrenCLINICAL & EXPERIMENTAL ALLERGY, Issue 12 2009P. Majak Summary Background The possibility of additional strategies to enhance the effectiveness of specific immunotherapy (SIT) is highly attractive. Aim The aim of our study was to assess the influence of oral corticosteroids and oral corticosteroids combined with vitamin D3 on the early clinical and immunological effects of SIT. Methods It was a randomized, double-blind, placebo-controlled trial conducted in 54 asthmatic children allergic to house dust mites. Intervention was based on receiving a single dose of oral steroid, with or without vitamin D3, or placebo only on the day of the build-up phase of SIT. Results After 12 months of SIT, the median daily inhaled corticosteroid (ICS) dose, which controls the symptoms of asthma, was reduced by 25% in the steroid group. However, a 50% reduction of the median daily ICS dose was observed in the control group. The clinical effects of SIT were not affected in the steroid+D3 group. Concomitantly, we found that intervention with prednisone significantly impaired the induction of T regulatory lymphocytes. Importantly, the clinical and immunological effects of SIT were not affected by intervention with steroids administered with vitamin D3. Conclusions Our study failed to show a beneficial effect of oral corticosteroids on allergen-specific immunotherapy. We observed that the combined administration of a corticosteroid drug and allergen extract suppressed the early clinical and immunological effects of SIT and that vitamin D3 prevented this ,adverse' influence of steroids. [source] | ||||||||||