• Title/Summary/Keyword: Corticosteroids

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Do corticosteroids reduce postoperative pain following third molar intervention?

  • Sugragan, Chollathit;Sirintawat, Nattapong;Kiattavornchareon, Sirichai;Khoo, Lee Kian;KC, Kumar;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.281-291
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    • 2020
  • Background: Corticosteroids have been widely used by oral surgeons for reducing swelling caused by wisdom teeth surgery. However, they have not been proven to decrease pain. This study was aimed at analyzing previous studies pertaining to corticosteroids and pain reduction following wisdom teeth surgery. Methods: The Science Direct, PubMed, and MEDLINE databases were searched for relevant journals according to a systematic search strategy (Patient Intervention Comparison Outcome Study). Randomized controlled trials published in English from 1998 to 2017 were extracted. Results: Twenty-seven articles were included, with a total of 36 comparative cases. Methylprednisolone and dexamethasone were the most commonly used corticosteroids. Intramuscular injections of corticosteroids were optimal for pain reduction, regardless of the time of administration. Conclusions: Corticosteroids can be used as an adjuvant for pain reduction following wisdom teeth surgery. Methylprednisolone and dexamethasone delivered via the intramuscular route is the best method for effective pain reduction. The ideal time for administration of corticosteroids is the preoperative period.

Patterns of Ulcerative Colitis Treatments and Factors Affecting the Prescribing of Systemic Corticosteroid using Health Insurance Claims Database (건강보험 청구자료를 이용한 궤양성 대장염 치료제의 처방 양상과 전신 스테로이드 처방에 미치는 영향요인)

  • Kim, Jiyool;Park, So-Hee;Shin, Ju-Young
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.2
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    • pp.102-112
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    • 2020
  • Objective: To analyze the prescription patterns for the treatment of ulcerative colitis (UC) and to investigate factors co-occurring with systemic corticosteroid use. Methods: We used patient-level data from Korean National Health Insurance claims database to identify patients diagnosed with UC (ICD-10 code : K51) and their medications prescribed for UC between January 1 and Decemeber 31, 2017. We found that medications for UC treatment were 5-aminosalicylic acid (5-ASA), immunomodulators, biologics, and corticosteroids. We presented the prescription pattern according to the sex, age group, type of health insurance, site of UC, type of medical institution, and concomitant medication. To evaluate factors associated with prescription of systemic corticosteroids for UC, we used a multivariate logistic regression model to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Results: Of 1,469 UC patients, 74.5% used 5-ASA and 15.2% used systemic corticosteroids. 5-ASA constituted 77.5% of all prescriptions and systemic corticosteroids accounted for 13.1%. The most widely used therapy was 5-ASA monotherapy (54.8%), followed by a double therapy with 5-ASA and immunomodulators (8.2%) or 5-ASA and systemic corticosteroids (7.2%). Systemic corticosteroids were more likely to be prescribed with immunomodulators (aOR=1.88, 95% CI=1.54-2.28) and biologics (aOR=2.82, 95% CI=2.28-3.50) than without them. Conclusions: We found that 15.2% of UC patients were prescribed with a systemic corticosteroid, which is less than reported previously. Systemic corticosteroids were more likely to be prescribed with immunomodulators and biologics.

Establishment of Library for the Identification of Corticosteroids in Various Known Sample Types (미지시료에서 부신피질호르몬제의 확인을 위한 라이브러리 구축)

  • Park, Mee-Jung;Hong, Hyo-Jeong;Lee, Sang-Ki
    • YAKHAK HOEJI
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    • v.55 no.4
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    • pp.289-294
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    • 2011
  • Illegal addition of steroids into cosmetics, ointments or drugs have been increased and their careless usage induced detrimental effect on health. We developed simultaneous analytical method using TLC, HPLC and LC/MS for the identification of 40 corticosteroids. 34 corticosteroids were well separated in HPLC with isocratic mode and remaining 6 drugs were also separated with gradient mode. All of the 40 corticosteroids were detected in negative mode in LC/MS. Halcinonide, prednisolone, triamcinolone acetonide and methylprednisolone hemisuccinate were detected in real samples.

Determination of Corticosteroids in Moisturizers by LC-MS/MS

  • Park, Sumin;Choi, Gye Young;Lee, Seon-Ah;Kim, Hyun Jeong;Yum, Hye Yung;Paeng, Ki-Jung
    • Mass Spectrometry Letters
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    • v.7 no.1
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    • pp.26-29
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    • 2016
  • Simultaneous determination of three corticosteroids (clobetasol propionate, betamethasone dipropionate, fluticasone propionate) in moisturizers was performed by using liquid chromatography (LC) coupled with tandem mass spectrometry (MS/MS). Sample preparation was conducted by the liquid-liquid extraction (LLE). Moisturizers include emulsifying agent and it forms micelles. In order to improve the extraction efficiency of corticosteroids trapped in micelle, newly developed-optimized extraction conditions which can remove the matrix effect from moisturizers was applied with various pH conditions in LLE extraction stage of sample preparation. Thus, the addition of 10 μL of 1 M HCl into moisturizers sample before extraction could improve the extraction efficiency. For the quantitative analysis, SRM table that contained specific transition of all of target corticosteroids was created. The developed method was validated for linearity, accuracy, precision, limit of detection (LOD), limit of quantization (LOQ) and recovery. Over the 0.99 r2 value was obtained in calibration standard range. Effective accuracy and precision were also obtained. LODs were below 31 ng/mL and LOQs were estimated below 94 ng/mL for all corticosteroids tested.

Comparison of Leukotriene Receptor Antagonist and Theophylline in Addition to Inhaled Corticosteroid in Adult Asthma: A Meta-Analysis

  • Fang, Huijuan;Wang, Jianmiao;Jin, Di;Cao, Yong;Xu, Yongjian;Xiong, Weining
    • Biomolecules & Therapeutics
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    • v.19 no.3
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    • pp.296-301
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    • 2011
  • This meta-analysis was performed to evaluate the difference of the therapeutic effi cacy and adverse effects of leukotriene receptor antagonist and theophylline added to inhaled corticosteroids in adult asthma. Databases were searched for studies published through Nov, 2010. Randomized-controlled trials containing inhaled corticosteroids plus leukotriene receptor antagonist and inhaled corticosteroids plus sustained-release theophylline for asthma therapy were selected. For each report, data were extracted to the outcomes analyzed: mean change in morning peak expiratory flow, mean change in evening peak expiratory flow, mean change in morning forced expiratory volume in 1 sec, mean change in daily short bete2-agonist use, asthma exacerbation and adverse effects. Four assessable trials including 182 asthmatic patients were identified. Inhaled corticosteroids plus leukotriene receptor antagonist was superior to inhaled corticosteroids plus theophylline therapy in improving morning peak expiratory flow in asthmatics (mean difference 19.08 [95% confidence interval 13.37-23.79] l/min, p<0.001) and morning forced expiratory volume in 1 sec in asthmatics (mean difference 0.09 [95% confidence interval 0.03-0.14] liter, p=0.001). In evening peak expiratory flow, daily short bete2-agonist use, asthma exacerbation and adverse effects, there was no significant difference between these two therapies (All p>0.05). Our meta-analysis showed that the combination of inhaled corticosteroids plus leukotriene receptor antagonist resulted in more improvement in both peak expiratory flow and forced expiratory volume in 1 sec in the morning than inhaled corticosteroids plus sustained-release theophylline in adult asthmatics. Further trials are necessary to evaluate the dominant effects of the former combination.

Nerve Root Block with Corticosteroids, Hyaluronidase, and Local Anesthetic in the Failed Back Surgery Syndrome (FBSS) (Failed Back Surgery Syndrome (FBSS) 환자에서 Hyaluronidase를 사용한 신경근차단술의 효과)

  • Lee, Kyung-Jin;Han, Sang-Gun;Yoon, Seuk-Hwan;Kim, Jin-Soo;Lee, Young-Suk
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.191-194
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    • 1999
  • Background: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics. Methods: The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection. Results: Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed. Conclusions: This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

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Concomitant use of corticosteroid and antimicrobials for liver abscesses in patients with chronic granulomatous disease

  • Shin, Kyung-Sue;Lee, Mu Suk
    • Clinical and Experimental Pediatrics
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    • v.59 no.4
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    • pp.196-201
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    • 2016
  • Chronic granulomatous disease (CGD) is a rare inherited disorder caused by defective nicotinamide adenine dinucleotide phosphate oxidase enzyme and characterized by recurrent bacterial and fungal infections. Although liver abscess is a common manifestation of CGD, its management in CGD patients is not well-defined. In addition, the generalized guidelines for treating liver abscesses do not necessarily apply to CGD patients. Corticosteroids are commonly used to control granulomatous complications, such as inflammatory gastrointestinal and genitourinary lesions, in patients with CGD, Corticosteroids have also been used in combination with antimicrobials to treat refractory infections in patients with CGD. Because corticosteroids are capable of suppressing symptomatic inflammation, all potential infections must be adequately controlled prior to corticosteroid initiation. We report 3 typical CGD cases with liver abscesses refractory to conventional treatments that were successfully treated with the concomitant use of corticosteroid and antimicrobials. It remains unclear whether corticosteroid therapy is required for liver abscesses in CGD refractory to conventional treatments. However, based on our observations, use of corticosteroids in combination with optimal antimicrobials should be considered for refractory liver abscesses in CGD.

Add-on Therapy for Symptomatic Asthma despite Long-Acting Beta-Agonists/Inhaled Corticosteroid

  • Dreher, Michael;Muller, Tobias
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.1
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    • pp.1-5
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    • 2018
  • Asthma, remains symptomatic despite ongoing treatment with high doses of inhaled corticosteroids (ICS) in conjunction with long-acting beta-agonists (LABA), is classified as "severe" asthma. In the course of caring for those patients diagnosed with severe asthma, stepping up from ICS/LABA to more aggressive therapeutic measures would be justified, though several aspects have to be checked in advance (including inhaler technique, adherence to therapy, and possible associated comorbidities). That accomplished, it would be advisable to step up care in accordance with the Global Initiative for Asthma (GINA) recommendations. Possible strategies include the addition of a leukotriene receptor antagonist or tiotropium (to the treatment regimen). The latter has been shown to be effective in the management of several subgroups of asthma. Oral corticosteroids have commonly been used for the treatment of patients with severe asthma in the past; however, the use of oral corticosteroids is commonly associated with corticosteroid-related adverse events and comorbidities. Therefore, according to GINA 2017 these patients should be referred to experts who specialize in the treatment of severe asthma to check further therapeutic options including biologics before starting treatment with oral corticosteroids.

Favorable effect of corticosteroids in treating acute-on-chronic liver failure underlying chronic hepatitis B

  • Kim, Hyeji;Kwon, Jung Hyun;Kim, Yong Hee;Nam, Soon Woo;Lee, Jong Yul;Jang, Jeong Won
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.430-435
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    • 2018
  • Acute-on-chronic liver failure (ACLF) occurs in the presence of a chronic liver disease or cirrhosis, and often results from exacerbation of chronic hepatitis B (CHB). The efficacy of corticosteroid treatment in ACLF patients with underlying CHB remains unclear. We report the case of a 50-year-old woman who experienced ACLF due to CHB exacerbation and was treated with a combination of corticosteroids and nucleot(s)ide analogue (NUC). The patient showed rapid decompensation due to CHB exacerbation. Three months of antiviral therapy produced no improvement in liver function. Combination therapy with corticosteroids and NUC was started, which did result in improvement of liver function. This case shows that the combined therapy of corticosteroids and NUC can be effective in treating ACLF due to CHB exacerbation.

Effect of Insamyangyoung-tang on the TEWL of High Dose Steroid Injected Hairless Mice (인참양영탕(人參養榮湯)이 장기간 고용량 스테로이드 투여 hairless mice의 피부장벽에 미치는 영향)

  • Nam, Hae-Jeong;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.21 no.2
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    • pp.19-27
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    • 2008
  • Objective : The side effect of prolonged use of topical corticosteroids to skin is well-known. Moreover, resent studies have shown that prolonged use of systemic corticosteroids also negatively impacts skin barrier function. Corticosteroids have a major role in the practical management of many variable conditions. So, it is important to find the drug or the method which could protect the skin from the damage caused by corticosteroids. At former study, we investigated that Insamyangyoung-tang has some effect on skin barrier function of DNCB induced contact dermatitis hairless mice. So, this study was performed to research the effect of Insamyangyoung-tang on the TEWL with high dose steroid injected hairless mice. Method : Hairless mice were divided into 4 groups ; Control group, Group A, Group B and Group C. All groups were injected triamcinolone O.4mg for 10 times. Control group was medicated distilled water during the experimental period. Group A was medicated distilled water for 5 days before the $1^{st}$ injection day, and then medicated Insamyangyoung-tang extract during the experimental period. Group B was medicated Insamyangyoung-tang extract for 5 days before the $1^{st}$ injection day, and then medicated distilled water during the experimental period. Group C was medicated Insamyangyoung-tang extract for 5 days before the $1^{st}$ injection day, and then medicated Insamyangyoung-tang extract during the experimental period. TEWL of each group was measured for 5 times. After the $10^{th}$ injection, the tissue sample was made and the damage of epithelial cell was examined. Statistical significance was set at p<0.05 by using non parametric methods and repeated-anova.. Results : Group C showed significant effect on TEWL change of hairless mice evoked by triamcinolone injection. Group A and Group B also showed some effect, but there was no statistical significance.

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