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[en] The development of the eye in vertebrates is dependent upon glucocorticoid signalling, however, specific components of the eye are sensitive to synthetic glucocorticoids. The presence of synthetic glucocorticoids within the aquatic environment may therefore have important consequences for fish, which are heavily reliant upon vision for mediating several key behaviours. The potential ethological impact of synthetic glucocorticoid oculotoxicity however has yet to be studied. Physiological and behavioural responses which are dependent upon vision were selected to investigate the possible toxicity of prednisolone, a commonly occurring synthetic glucocorticoid within the environment, during early life stages of zebrafish. Although exposure to prednisolone did not alter the morphology of the external eye, aggregation of melanin within the skin in response to increasing light levels was impeded and embryos exposed to prednisolone (10 μg/l) maintained a darkened phenotype. Exposure to prednisolone also increased the preference of embryos for a dark environment within a light dark box test in a concentration dependent manner. However the ability of embryos to detect motion appeared unaffected by prednisolone. Therefore, while significant effects were detected in several processes mediated by vision, changes occurred in a manner which suggest that vision was in itself unaffected by prednisolone. Neurological and endocrinological changes during early ontogeny are considered as likely candidates for future investigation. - Highlights: • The oculotoxicity of prednisolone was assessed during zebrafish embryogenesis. • Exposure to 10 μg/l resulted in a darkened phenotype during light adaptation. • Preference for a dark environment was differentially altered by prednisolone. • The detection of motion appeared unaffected by all concentrations of prednisolone. • Effects are hypothesised to be mediated via non-visually controlled pathways. - Exposure to prednisolone alters physiological and behavioural responses to visual stimuli during zebrafish embryogenesis via proposed non-ocular mechanisms.
[en] Objective: To evaluate the efficacy of intravenous dexamethasone for preventing postoperative nausea and vomiting in women undergoing gynecological laparoscopic surgery. Design: Double blind trial. Place and duration of Study: December 2001 to June 2002 at Hayatabad Medical Complex, Peshawar. Patients and Methods: A 100 admitted female patients of ASA-1-II scheduled for diagnostic gynecological laparoscopic surgery were included in this study. Patients with severe systemic or endocrine disease who had predisposing factors for delayed gastric emptying, such as diabetes, chronic choleystills neuromuscular disorders were excluded. In addition patients who suffered from postoperative nausea and vomiting (PONV) or had received and antiemetic agent or narcotic medications within last 24 hours were also excluded. Patients were divided into two equal groups, patients in one group were given dexamethasone while saline was injected to patients in the second group. Nausea and vomiting were assessed immediately after operation, at 1 hour interval for 4 hours in the recovery and from 410 hours in the Ward. Result was compared in two groups by chi-square test. Results: During patient's stay in the Post anesthesia Care Unit (4 hours postoperatively) 26% patients in the dexamethasone group in comparison with 54% of patients in the saline group reported PONV (P<0.01). Sixteen percent of patients in the dexamethasone group, in comparison with 28% of patients in the saline group needed rescue antiemtic (P 0.05), postoperative nausea vomiting (P<0.01). During the postoperative observation period of 10 hours, 42% of the patients in the dexamethasone group in comparison with 82% of patients in the saline group reported postoperative nausea and vomiting (P<0.01). Conclusion: Dexamethasone significantly reduced the incidence of postoperative nausea and vomiting in women undergoing laparoscopic surgery. Furthermore, it is freely available, is less costly and has few side-effects. So, it should be more frequently used as prophylactic antiemetic in women undergoing gynecological laparoscopic surgery. (author)
[en] The monitoring of salivary cortisol as a key biomarker of an individual’s stress response has been increasingly focused on. This paper describes the development of a novel cortisol immuno-assay method based on an indirect competitive method using a commercially available surface plasmon resonance instrument. The surface of an Au chip was modified with PEG6-COOH aromatic dialkanethiol self-assembled monolayers and hydrocortisone 3-(O-carboxymethyl) oxime (hydrocortisone 3-CMO) as a cortisol analog. A detection limit of 38 ppt range with a measurement range of 10 ppt–100 ppb was accomplished without the incubation of a mixing solution consisting of standard cortisol and an anti-cortisol antibody, and the time for quantification of cortisol concentration was 8 min from the sample injection. We experimentally compared our immuno-assay with a commercialized salivary cortisol enzyme-linked immunosorbent assay (ELISA) kit using human saliva samples. It was found that the results obtained by the cortisol immuno-assay had a good correlation with those obtained by ELISA assay (R = 0.96). Our findings indicate the potential utility of the cortisol immuno-assay for measurements of human salivary cortisol levels.
[en] It is reported that 10-7M cortisol has a significant suppressive effect on radiation-induced transformation in vitro in C3H10T 1/2 cells. Previously reported data showed a significant enhancing effect for similar experiments performed with cortisone. Thus, these two structurally similar glucocorticoid hormones have opposite effects on transformation induced by ionizing radiation. (author)
[en] We have studied the interactions of glucocorticoid hormones with radiation in the induction of transformation in vitro in C3AH10T1/2 cells. We have observed that cortisone has its primary enhancing effect on radiation transformation when present after the radiation exposure during the ''expression period'', or the time after carcinogen exposure during which promoting agents have been shown to enhance radiation transformation in vitro, and that two different glucocorticoid hormones, dexamethasone and cortisone, have a suppressive effect on the 12-O-tetradecanoylphorbol-13-acetate (TPA) enhancement of radiation transformation in vitro
[en] Previous studies of glucocorticoid (GC) therapy and mortality have had inconsistent results and have not considered possible perimortal bias—a type of protopathic bias where illness in the latter stages of life influences GC exposure, and might affect the observed relationship between GC use and death. This study aimed to investigate all-cause and cause-specific mortality in association with GC therapy in patients with rheumatoid arthritis (RA), and explore possible perimortal bias. A retrospective cohort study using the primary care electronic medical records. Oral GC exposure was identified from prescriptions. Mortality data were obtained from the UK Office for National Statistics. Multivariable Cox proportional hazards regression models assessed the association between GC use models and death. Several methods to explore perimortal bias were examined. The cohort included 16,762 patients. For ever GC use there was an adjusted hazard ratio for all-cause mortality of 1.97 (95 % CI 1.81–2.15). Current GC dose of below 5 mg per day (prednisolone equivalent dose) was not associated with an increased risk of death, but a dose–response association was seen for higher dose categories. The association between ever GC use and all-cause mortality was partly explained by perimortal bias. GC therapy was associated with an increased risk of mortality for all specific causes considered, albeit to a lesser extent for cardiovascular causes. GC use was associated with an increased risk of death in RA, at least partially explained by perimortal bias. Importantly, GC doses below 5 mg were not associated with an increased risk of death.
[en] Objectives: To compare the effect of postoperative intravenous dose of dexamethasone on morbidity in patients undergoing tonsillectomy. Design: Randomized control trial. Place and Duration of Study: This study was conducted in ENT Department Shaikh Khalifa Bin Zayed Al Nahyan Hospital (CMH) Muzaffarabad from 10th Jan 2010 to 15th Feb 2011. Patients and Methods: After getting informed consent, a total of 60 patients who fulfilled the inclusion criteria were selected and tonsillectomy by dissection method was carried out. They were divided into two groups of 30 each using a random numbers table. Group A received 0.25 mg/kg body weight (maximum 20 mg) of Dexamethasone postoperatively intravenously for 03 days while group B (control group) did not receive any steroid. Results: In group A, 80% patients had mild pain, 16.7% had moderate pain and 3.3% had a severe pain while in group B, 30% patients had mild pain, 6.7% had moderate pain and 63.3% had severe pain (p< 0.05). In group A, 76.7% patients had mild emesis while in group B, 86.7% had moderate emesis (p< 0.05). There was an insignificant difference in secondary hemorrhage. Conclusion: Dexamethasone given postoperatively significantly reduces the morbidity that is pain, episodes of emesis thus early recovery to a normal lifestyle with no effect on secondary hemorrhage in patients undergoing Tonsillectomy by dissection method. (author)
[en] In a prospective study, 37 consecutive patients with radiation-induced proctosigmoiditis were randomized to receive a four-week course of either 3.0 g oral sulfasalazine plus 20 mg twice daily rectal prednisolone enemas (group I, N = 18) or 2.0 g twice daily rectal sucralfate enemas plus oral placebo (group II, N = 19). The two groups were comparable with respect to demographic features, duration of symptoms, and clinical and endoscopic staging of the disease. Fifteen patients in group I and 17 in group II completed the trial. At four weeks, both groups showed significant clinical improvement (P less than 0.01 for group I and P less than 0.001 for group II) and endoscopic healing (P less than 0.01 for group I and P less than 0.001 for group II). When the two groups were compared, sucralfate enemas showed a significantly better response as assessed clinically (P less than 0.05), although endoscopically the response was not statistically different (P greater than 0.05). We conclude that both treatment regimens are effective in the management of radiation proctitis. Sucralfate enemas give a better clinical response, are tolerated better, and because of the lower cost should be the preferred mode of short-term treatment
[en] The addition of vorinostat to lenalidomide/dexamethasone represents a novel combination therapy in multiple myeloma (MM), informed by laboratory studies suggesting synergy. This was a phase I, multicenter, open-label, non-randomized, dose-escalating study in patients with relapsed or relapsed and refractory MM. Clinical evaluation, electrocardiogram, laboratory studies and adverse events were obtained and assessed. The maximum-tolerated dose was not reached owing to a non-occurrence of two dose-limiting toxicities per six patients tested at any of the dosing levels. Patients tolerated the highest dose tested (Level 5) and this was considered the maximum administered dose: at 400 mg vorinostat on days 1–7 and 15–21, 25 mg lenalidomide on days 1–21 and 40 mg dexamethasone on days 1, 8, 15 and 22, per 28-day cycle. Drug-related adverse events were reported in 90% of patients serious adverse experiences were reported in 45% of the patients and 22% of all patients had adverse experiences considered, possibly related to study drug by the investigators. A confirmed partial response or better was reported for 14/30 patients (47%) evaluable for efficacy, including 31% of patients previously treated with lenalidomide. Vorinostat in combination with lenalidomide and dexamethasone proved tolerable with appropriate supportive care, with encouraging activity observed