Dexamethasone ; administration & dosage ; Humans ; Infant, Newborn ; Infant, Premature ; Respiration, Artificial

Animals ; Dexamethasone ; administration & dosage ; metabolism ; pharmacokinetics ; Drug Administration Routes ; Ear, Middle ; Guinea Pigs ; Nanoparticles ; administration & dosage

OBJECTIVETo explore the efficacy and safety of subcutaneous injection of bortezomib in the treatment of de novo multiple myeloma (MM) patients.

METHODSA total of 36 MM patients treated with bortezomib, adriamycin and dexamethasone (PAD) from January 2012 to April 2013 were analyzed. Among them, 18 received improved PAD (improved PAD group) with the subcutaneous injection of bortezomib, another 18 received conventional PAD (PAD group). The efficacy and safety of two groups were analyzed.

RESULTSExcept 4 cases can not be assessed, 32 patients were evaluated. Of 32 cases, 19(59.4%) achieved complete remission (CR) or very good partial remission (VGPR) after induction therapy, which were 61.1% and 57.1% for PAD group and improved PAD group, respectively (P=1.000). No significant difference between the time to achieve maximum effectiveness in two groups was detected. In the PAD group, one patient (5.6%) died of serious lung infection and eight (44.4%) experienced grade 3 or higher adverse events, while only one (5.6%) discontinued treatment in improved PAD group due to similar toxicity. Compared to PAD group, grade 3 or worse adverse events was significantly reduced in improved PAD group, the most common symptoms were leucopenia (33.3% vs 61.1%, P=0.086), thrombocytopenia (50.0% vs 61.1%), anaemia (27.8% vs 16.7%), infection (16.7% vs 50.0%, P=0.075), diarrhea (5.6% vs 33.3%, P=0.088), peripheral neuropathy(0 vs 27.8%, P=0.045).

CONCLUSIONThe improved PAD regimen by changing bortezomib from intravenous administration to subcutaneous injection significantly reduced adverse events, improved the safety of clinical application of bortezomib without affecting curative effect, and had great progress.

Boronic Acids ; administration & dosage ; Bortezomib ; Dexamethasone ; administration & dosage ; Doxorubicin ; administration & dosage ; Humans ; Injections, Subcutaneous ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; Remission Induction

BACKGROUND AND OBJECTIVES: Corticosteroids have been used for therapeutic management of sudden sensorineural hearing loss (SSNHL). Because of the complications associated with systemic steroid therapy and low levels of steroid in the inner ear after systemic administration, intratympanic steroid injection (ITSI) is currently used. The purpose of this study was to compare the efficacy of systemic steroid therapy with systemic combined high frequency ITSI therapy. SUBJECTS AND METHODS: Forty-six SSNHL patients were divided into the only systemic dexamethasone therapy group (systemic steroid IV group, 27 patients) and the systemic with frequent intratympanic dexamethasone injection group (combined ITSI group, 19 patients). In the systemic steroid IV group, dexamethasone was administered intravenously for 5 days followed by oral tapered doses for 10 days. In the combined ITSI group, intratympanic dexamethasone was administered 5 times per day for 5 consecutive days in addition to intravenous administration of dexamethasone. Hearing was assessed both before therapy and at 15 days, 4 weeks, and 8 weeks after the initiation of therapy. RESULTS: The recovery rate and hearing gain were 74% (20 out of 27 patients) and 33 dB mean improvement in the systemic steroid IV group and 73.6% (14 out of 19 patients) and 41.5 dB mean improvement in the combined ITSI group. There was no statistically significant difference in hearing gain and the recovery rate between the two groups. CONCLUSIONS: The therapeutic effect of a combination of highly frequently administered intratympanic dexamethasone and systemic steroid therapy was not superior to only systemic steroid injection therapy.
Administration, Intravenous ; Adrenal Cortex Hormones ; Dexamethasone ; Ear, Inner ; Hearing ; Hearing Loss, Sensorineural ; Humans

Following short-term intubation for general anesthesia, respiratory difficulty may result from laryngeal or subglottic edema after extubation. We have hypothesized that this problem could be pretreated by administering a high-dose of dexamethasone intravenously before extubation. After glottic injuries were made under direct laryngoscopic view, intubation was performed and maintained for 1 hour in 33 rabbits. The rabbits were divided into 3 groups; dexamethasone (1 mg/kg) was administered to group 1(n=12) immediately after intubation and group 2(n=10) just before extubation; group 3(n=11) received normal saline, just before extubation. After extubation, subglottic excursion pressure was measured for 4 hours. 15 injured rabbit larynges and 3 normal ones were extracted for histologic section. 2 of 12 rabbits in group 1; 3 of 10 in group 2; and 5 of 11 in group 3, showed mild stridor after extubation(p>0.05). All rabbits developed maximum increase in subglottic pressure within 2 hours after extubation. Group 1 and 2 showed less increase in pressure compared to group 3(p<0.05), but here was no statistical difference between group 1 and 2(p>0.05). Histologic sections of the larynges showed less submucosal edema, including other changes in group 1 and 2, than in group 3(p<0.05). In conclusion, administering a high-dose of dexamethasone before extubation, is effective in prophylaxis and treatment of laryngeal injuries following short-term intubation in rabbits. This is especially true in edema.
Animal ; Dexamethasone/administration & dosage/*therapeutic use ; Intubation, Intratracheal/*adverse effects ; Laryngeal Edema/etiology/*prevention & control ; Rabbits

OBJECTIVETo evaluate the efficacy and feasibility of bortezomib plus dexamethasone (BD) in patients with primary systemic (AL) amyloidosis.

METHODSEleven AL amyloidosis patients, including four relapsed or progressed after previous therapies and 7 newly diagnosed were treated with BD. Ten patients had two or more organs involved. Precursor protein analysis showed that 1 was κ light chain, 9 λ light chain; 5 patients with positive immunofixation including 1 IgG κ, 3 IgG λ and 1 IgA λ. BD was administered according to standard two-week schedule.

RESULTSEight patients were evaluable, the median number of treatment cycles was 3 (range 1 - 6). Median follow-up duration was 6 months. At least one affected organ response was observed in six patients and median time to organ response was 2 months. Three patients progressed and two of them died. Toxicities were mainly diarrhea, thrombocytopenia, peripheral neuropathy, fatigue and herpes zoster, and 7 evaluable patients who had toxicities were adjusted dosage and 2 of them interrupted therapy. Epilepsia, paralytic ileus, acute cardiac dysfunction, and postural hypotention were occurred in 3 inevaluble patients.

CONCLUSIONBortezomib plus dexamethasone is effective in AL amyloidosis. Adverse events are common, and in some patients are severe.

Amyloidosis ; drug therapy ; Boronic Acids ; therapeutic use ; Bortezomib ; Dexamethasone ; administration & dosage ; Humans ; Multiple Myeloma ; drug therapy

The prolonged use of steroids, especially the topical administration of ccrticosteroid, will causes an intraocular pressure(IOP) devation in some patients with clinical finding that typically resemble primary open-angle glaucoma. The authors experienced a case of steroid-induced glaucoma following systemic and topical use of dexamethasone for seborrheic dermatitis of both eyelids 3 years previously. During the past few months patient had noted complete lloss of vision in right eye and decrease of vision considerably, in left eye and a trabeculectomy was done on the left eye. We report a case of steroid-induced glaucoma and the literatures were reviewed briefly.
Administration, Topical ; Dermatitis, Seborrheic ; Dexamethasone ; Eyelids ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Steroids ; Trabeculectomy

The effects of topical dexamethasone on the endothelial healing and the change of aqueous composition were examined in the repair process of experimental corneal alkali wounds. Corneal alkali wounds were induced, then the eyes were treated topically with either 0.1%dexamethasone or abalanced salt solution[BSS]4 times per day for 8 weeks. Endothelial wound morphometry was performed after alizarin red and trypan blue staining. The concentrations of ascorbic acid, glucose, and the ions, Na, K , Ca2 and Mg2 , were measured in the aqueous humor. Endothelial healing in control corneas showed a biphasic pattern of healing:an initial short-term healing for the first week and then a late long-term healing following a secondary endothelial breakdown. Topical administration of 0.1%dexamethasone deterred endothelial healing during the early period and prevented secondary endothelial breakdown. Total repair process of endothelium was accelerated by the dexamethasone treatment. Among the various components of the aqueous humor examined, ascorbic acid seemed most sensitive to change caused by the alkali injury and dexametha-sone treatment. The present data indicate that dexamethasone may have a therapeutic potential in the management of endothelial healing after corneal alkali injury.
Administration, Topical ; Alkalies* ; Aqueous Humor ; Ascorbic Acid ; Cornea ; Dexamethasone ; Endothelium ; Glucose ; Ions ; Trypan Blue ; Wounds and Injuries*

BACKGROUND AND OBJECTIVES: Tonsillectomy is a very common surgical procedure in otolaryngology. Steroid is often given to decrease postoperative morbidity from the procedure. This study was designed to determine the intraoperative and postoperative efficacy of the intravenous administration of dexamethasone sodium phosphate, the long-acting steroid, before or after tonsillectomy. MATERIALS AND METHODS: Sixty children aged between 3 to 15 years were divided into three groups. Twenty children received intravenous dexamethasone sodium phosphate (1 mg/kg up to 15 mg) before undergoing sharp dissection tonsillectomy (group I). Another twenty children received it after operation (group II). The third group was control and did not receive the intravenous dexamethasone sodium phosphate (group III). Intraoperatively blood loss, surgical and anesthesia time were checked. After the operation, each child was evaluated for pain, oral intake, vomiting, body temperature, and bleeding. RESULTS: There were no statistically significant differences noted in blood loss, surgical time, anesthesia time, pain score, oral intake, vomiting, and postoperative bleeding among the three groups of patients. CONCLUSION: The results showed that a single dose of the intravenous dexamethasone sodium phosphate did not affect the postoperative morbidity in children undergoing sharp dissection tonsillectomy.
Administration, Intravenous ; Anesthesia ; Blood Loss, Surgical ; Body Temperature ; Child ; Dexamethasone* ; Hemorrhage ; Humans ; Otolaryngology ; Sodium ; Tonsillectomy* ; Vomiting

OBJECTIVE: We wanted to evaluate the feasibility and efficacy of using a dexamethasone (DM) -eluting nitinol stent to inhibit the pseudointimal hyperplasia following stent placement in the transjugular intrahepatic portosystemic shunt tract (TIPS) of a swine. MATERIALS AND METHODS: Fifteen stents were constructed using 0.15 mm-thick nitinol wire; they were 60 mm in length and 10 mm in diameter. The metallic stents were then classified into three types; type 1 and 2 was coated with the mixture of 12% and 20%, respectively, of DM solution and polyurethane (PU), while type 3 was a bare stent that was used for control study. In fifteen swine, each type of stent was implanted in the TIPS tract of 5 swine, and each animal was sacrificed 2 weeks after TIPS creation. The proliferation of the pseudointima was evaluated both on follow-up portogram and pathologic examination. RESULTS: One TIPS case, using the type 1 stent, and two TIPS cases, using the type 2 stent, maintained their luminal patency while the others were all occluded. On the histopathologic analysis, the mean of the maximum pseudointimal hyperplasia was expressed as the percentage of the stent radius that was patent, and these values were 51.2%, 50% and 76% for the type 1, 2, and 3 stents, respectively. CONCLUSION: The DM-eluting stent showed a tendency to reduce the development of pseudointimal hyperplasia in the TIPS tract of a swine model with induced-portal hypertension.
Swine ; *Stents ; *Portasystemic Shunt, Transjugular Intrahepatic ; Hyperplasia ; Dexamethasone/*administration & dosage ; Animals ; Alloys