BACKGROUND

Psoriasis is a chronic disease that often requires lifelong treatment. While topical steroids remain as first-line therapy, there is a need for alternative treatments due to steroid-induced long-term side effects. Azelaic acid is a natural, plant-sourced, saturated dicarboxylic acid that can potentially be beneficial for the treatment of psoriasis plaques. Objectives The study was conducted to determine whether azelaic acid 15% cream is non-inferior to betamethasone valerate 0.1% cream in efficacy and safety for the treatment of plaque-type psoriasis.

METHODS

Twenty-nine patients with mild to moderate plaque psoriasis applied azelaic acid 15% cream and betamethasone valerate 0.1% cream on symmetric and contralateral lesions for 6 weeks.

RESULTS

There was no statistically significant difference between the azelaic acid and betamethasone valerate groups in terms of pruritus, erythema, induration, scaling, and DLQI scores at baseline, 2 weeks, 4 weeks, and 6 week (p>0.05). Azelaic acid was also non-inferior to betamethasone valerate in terms of safety, and the study showed a much lower frequency of mild adverse events with azelaic acid than a previous study.

CONCLUSION

Azelaic acid 15% cream was noninferior to betamethasone valerate 0.1% cream in terms of efficacy and safety in the treatment of plaque-type psoriasis and may be a promising alternative to topical steroids

Azelaic Acid ; Betamethasone ; Psoriasis

OBJECTIVE: To compare clinical effects of compound betamethasone and compound betamethasone with hyaluronic acid in treating moderate-severe knee osteoarthritis (KOA). METHODS: A prospective randomized controlled study was conducted in 116 patients with unilateral moderate-severe KOA patients from February 2017 to November 2017 and divided into observation group and control group, 58 patients in each group. In observation group, there were 15 males and 43 females aged from 45 to 80 years old with an average of (66.45±6.31) years old;according to Kellgren-Lawrence(K-L) classification, 42 patients were type Ⅲ and 16 patients were type Ⅳ;the courses of disease ranged from 4 to 8 years with an average of (5.25±2.21) years;the patients were treated by injecting 1 ml compound betamethasone into knee joint. In control group, there were 13 males and 45 females aged from 45 to 80 years old with an average of (64.89±6.41) years old;according to K-L classification, 43 patients were type Ⅲ and 15 patients were type Ⅳ;the courses of disease ranged from 4 to 10 years with an average of (5.41±2.35) years;the patients were treated by knee joint injection of 4 ml hyaluronic acid and 1 ml compound betamethasone. Visual analog scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to evaluate clinical effects before treatment and 1 week, 1, month, 3 and 6 months after treatment. RESULTS: Totally 55 patients in observation group were followed up for 6 months, and 3 patients were quit at 3 months after treatment for poor efficacy. Totally 56 patients in control group were followed up for 6 months, and 2 patients were withdrew from the follow-up on the first and third month respectively for poor efficacy. There were no statistical difference in VAS and WOMAC between two groups before treatment and different time points after treatment ( CONCLUSION For patients with moderate-severe KOA, there is no significant difference in therapeutic effect between compound betamethasone injection and compound betamethasone combined with hyaluronic acid injection, and long-term effect of two methods is not good.
Betamethasone ; Child ; Child, Preschool ; Female ; Humans ; Hyaluronic Acid ; Injections, Intra-Articular ; Male ; Osteoarthritis, Knee/drug therapy* ; Prospective Studies ; Treatment Outcome

Stress can induce a serious epileptic encephalopathy that occurs during early infancy. Recent studies have revealed that prenatal stress exposure is a risk factor for the development of infantile spasms. Our previous work demonstrates that prenatal stress with betamethasone-induced alterations to the expression of the K⁺/Cl⁻ co-transporter (KCC2) in gamma-aminobutyric acid (GABA) interneurons lowers the seizure threshold in exposed animals. Here, we further investigated the mechanisms involved in this KCC2 dysfunction and explored possible treatment options. We stressed Sprague-Dawley rats prenatally and further treated dams with betamethasone on gestational day 15, which increases seizure susceptibility and NMDA (N-Methyl-D-aspartate)-triggered spasms on postnatal day 15. In this animal model, first, we evaluated baseline calpain activity. Second, we examined the cleavage and dephosphorylation of KCC2. Finally, we checked the effect of a calpain inhibitor on seizure occurrence. The phosphorylated-N-methyl-D-aspartate Receptor 2B (NR2B):non-phosphorylated NR2B ratio was found to be higher in the cortex of the prenatally stressed beta-methasone model. We further found that the betamethasone model exhibited increased phosphorylation of calpain-2 and decreased phosphorylation of KCC2 and Glutamic acid decarboxylase 67 (GAD67). After using a calpain inhibitor in prenatal-stress rats, the seizure frequency decreased, while latency increased. GABAergic depolarization was further normalized in prenatal-stress rats treated with the calpain inhibitor. Our study suggests that calpain-dependent cleavage and dephosphorylation of KCC2 decreased the seizure threshold of rats under prenatal stress. Calpain-2 functions might, thus, be targeted in the future for the development of treatments for epileptic spasms.
Animals ; Betamethasone ; Brain Diseases ; Calpain ; Epilepsy ; gamma-Aminobutyric Acid ; Glutamate Decarboxylase ; Humans ; Infant ; Infant, Newborn ; Interneurons ; Models, Animal ; N-Methylaspartate ; Phosphorylation ; Rats ; Rats, Sprague-Dawley ; Risk Factors ; Seizures ; Spasm ; Spasms, Infantile

PURPOSE: Many studies have reported associations of early postnatal growth failure in preterm infants with several morbidities. However, the risk factors for postnatal weight loss (PWL) in late preterm infants have not been identified. We investigated the independentrisk factors for PWL in late preterm infants.METHODS: This was a retrospective cohort study. We enrolled 369 late preterm infants born at 34⁺⁰ to 36⁺⁶ weeks gestational age who were admitted to the Soonchunhyang University Cheonan Hospital between 2015 and 2017. PWL% was calculated as (birth weight–lowest weight)/birth weight×100. The infants were classified into lower (< 5%) and higher (≥10%) PWL% groups by propensity score matching for gestational age, sex, and birth weight. Perinatal risk factors were analyzed using multivariable logistic regression.RESULTS: The lower and higher PWL% groups included 62 and 31 infants, respectively. Antenatal steroids administered within 1 week before birth (odds ratio [OR], 3.26; 95% confidence interval [CI], 1.015 to 10.465; P=0.047), lower total calorie intake during days 1 to 7 (OR, 0.98; 95% CI, 0.977 to 0.999; P=0.027), and phototherapy (OR, 5.28; 95% CI, 1.327 to 21.024; P=0.018) were independent risk factors for the higher PWL%.CONCLUSION: Further studies are needed to identify the risk factors that cause high PWL% according to gestational age and short- and long-term morbidities based on the degree of PWL.
Betamethasone ; Birth Weight ; Chungcheongnam-do ; Cohort Studies ; Comorbidity ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Logistic Models ; Parturition ; Phototherapy ; Propensity Score ; Retrospective Studies ; Risk Factors ; Steroids ; Weight Loss

PURPOSE: The aim of this study was to elucidate whether intrasynovial corticosteroid injections for trigger digit reduced the volume of the tendon and pulley on high-resolution ultrasonography. METHODS: Twenty-three digits of 20 patients with trigger digit were included. Each affected finger was graded clinically according to the following classification: grade I for pre-triggering, grade II for active triggering, grade III for passive triggering, and grade IV for presence of contracture. Axial ultrasound examinations were performed before an intrasynovial corticosteroid injection and at an average of 31 days after the injection. The transverse diameter, thickness, and cross-sectional area of the tendon and the thickness of the pulley were measured by two independent, blinded researchers. RESULTS: At least 1 grade of improvement was achieved in this study group by the time of the second examination. The transverse diameter and cross-sectional area of the tendon and the thickness of the pulley significantly decreased (P < 0.05). CONCLUSION: The injection of a single dose of betamethasone improved clinical symptoms by reducing the volume of both the tendon and pulley, which may be related to the fact that tendon and pulley ruptures are delayed by corticosteroid injections.
Adrenal Cortex Hormones ; Betamethasone* ; Classification ; Contracture ; Fingers ; Humans ; Rupture ; Tendons* ; Trigger Finger Disorder* ; Ultrasonography*

OBJECTIVETo assess the early curative effect of epidural or intravenous administration of steroids during a percutaneous endoscopic lumbar discectomy (PELD).

METHODS28 consecutive patients who underwent PELD due to large lumbar disc herniation between November 2014 and January 2016 were followed up for 6 months. These patients were divided into two groups according to the treatment they received after PELD. 14 patients (Group A) were treated by PELD and epidural steroids, while the other 14 patients (Group B) were treated by PELD and intravenous steroids. We evaluated the effectiveness by the preoperative and postoperative visual analogue scale (VAS) scores for back and leg pain, and the postoperative Oswestry disability index (ODI) at 3 weeks after surgery via the clinical charts and telephone interview. Postoperative hospital stay and time return to work were investigated as well.

RESULTSThere is a significant decrease in VAS (back, leg), ODI, and time return to work (p < 0.05). For VAS (back), Group A showed a significant decrease compared with Group B at 1 day and 1 week after surgery (p = 0.011, p = 0.017). As for VAS (leg), Group A showed a significant decrease compared with Group B at 1 day, 1 week, 3 weeks, and 3 months follow-up examinations (p = 0.002, p = 0.006, p < 0.001, p < 0.001). For ODI, Group A showed a notable decrease compared with Group B (p < 0.001). The postoperative hospital stay in two groups was not statistically different (p = 0.636). But the time return to work in Group A was significantly shorter than that in Group B (p = 0.023).

CONCLUSIONPatients who underwent PELD with epidural steroid administration for large lumbar disc herniation showed favorable curative effect compared with those who underwent PELD with intravenous steroid administration.

Adult ; Betamethasone ; administration & dosage ; Diskectomy, Percutaneous ; methods ; Endoscopy ; Female ; Glucocorticoids ; administration & dosage ; Humans ; Injections, Epidural ; Injections, Intravenous ; Intervertebral Disc Displacement ; surgery ; Length of Stay ; Lumbar Vertebrae ; surgery ; Male ; Pain Measurement ; Retrospective Studies

OBJECTIVE: To evaluate at which pH level various local anesthetics precipitate, and to confirm which combination of corticosteroid and local anesthetic crystallizes. METHODS: Each of ropivacaine-HCl, bupivacaine-HCl, and lidocaine-HCl was mixed with 4 different concentrations of NaOH solutions. Also, each of the three local anesthetics was mixed with the same volume of 3 corticosteroid solutions (triamcinolone acetonide, dexamethasone sodium phosphate, and betamethasone sodium phosphate). Precipitation of the local anesthetics (or not) was observed, by the naked eye and by microscope. The pH of each solution and the size of the precipitated crystal were measured. RESULTS: Alkalinized with NaOH to a certain value of pH, local anesthetics precipitated (ropivacaine pH 6.9, bupivacaine pH 7.7, and lidocaine pH 12.9). Precipitation was observed as a cloudy appearance by the naked eye and as the aggregation of small particles (<10 µm) by microscope. The amount of particles and aggregation increased with increased pH. Mixed with betamethasone sodium phosphate, ropivacaine was precipitated in the form of numerous large crystals (>300 µm, pH 7.5). Ropivacaine with dexamethasone sodium phosphate also precipitated, but it was only observable by microscope (a few crystals of 10-100 µm, pH 7.0). Bupivacaine with betamethasone sodium phosphate formed precipitates of non-aggregated smaller particles (<10 µm, pH 7.7). Lidocaine mixed with corticosteroids did not precipitate. CONCLUSION: Ropivacaine and bupivacaine can precipitate by alkalinization at a physiological pH, and therefore also produce crystals at a physiological pH when they are mixed with betamethasone sodium phosphate. Thus, the potential risk should be noted for their use in interventions, such as epidural steroid injections.
Adrenal Cortex Hormones ; Anesthetics, Local* ; Betamethasone ; Bupivacaine ; Crystallization* ; Dexamethasone ; Hydrogen-Ion Concentration ; Lidocaine ; Sodium

No abstract available.
Betamethasone* ; Butyrates* ; Diethylpropion* ; Humans* ; Keratinocytes*

BACKGROUND: Various systemic agents have been assessed for the treatment of alopecia areata (AA); however, there is a paucity of comparative studies. OBJECTIVE: To assess and compare cyclosporine and betamethasone minipulse therapy as treatments for AA with regard to effectiveness and safety. METHODS: Data were collected from 88 patients who received at least 3 months of oral cyclosporine (n=51) or betamethasone minipulse therapy (n=37) for AA. Patients with ≥50% of terminal hair regrowth in the alopecic area were considered responders. RESULTS: The responder of the cyclosporine group was 54.9% and that of the betamethasone minipulse group was 37.8%. In the cyclosporine group, patients with mild AA were found to respond better to the treatment. Based on the patient self-assessments, 70.6% of patients in the cyclosporine group and 43.2% of patients in the betamethasone minipulse group rated their hair regrowth as excellent or good. Side effects were less frequent in the cyclosporine group. CONCLUSION: Oral cyclosporine appeared to be superior to betamethasone minipulse therapy in terms of treatment effectiveness and safety.
Alopecia Areata* ; Alopecia* ; Betamethasone* ; Cyclosporine* ; Hair ; Humans ; Pulse Therapy, Drug ; Self-Assessment ; Treatment Outcome

PURPOSE: The aim of this study is to prove the association between potential fetal hypoxia and retinopathy of prematurity (ROP) development and absolute nucleated red blood cell (aNRBC) is used to evaluate it in premature infants without any hypoxic or ischemic history. METHODS: Medical records of 43 premature infants with ROP who were admitted to the neonatal intensive care unit at Wonkwang University Hospital from January 2004 to December 2014 were analyzed retrospectively. We excluded 15 infants who had a confounding medical condition that could have increased the aNRBC count. Finally, 28 premature infants affected by ROP were enrolled and compared with 28 pair-matched controls. The aNRBC counts at birth in these infants were compared. Statistical analysis was performed with a paired t-test for continuous data, and a Fisher's exact test for categorical data. P<0.05 was considered significant. RESULTS: There were no significant differences in perinatal characteristics such as gestational age (GA), birth weight (BWt), Apgar scores, premature rupture of membrane (>24 hours), prenatal betamethasone, surfactant or respiratory distress syndrome between the ROP and the control infants. In addition, neither group differed in major morbidities such as patent ductus arteriosus, periventricular leukomalacia, intraventricular hemorrhage (> or =Grade 2), or bronchopulmonary dysplasia. Regardless of the severity of ROP, the aNRBC counts at birth in premature infants with ROP were not higher than in the control infants. CONCLUSION: The aNRBC counts at birth may not be related directly to the development of ROP.
Betamethasone ; Birth Weight ; Bronchopulmonary Dysplasia ; Ductus Arteriosus, Patent ; Erythrocyte Count* ; Erythrocytes* ; Fetal Hypoxia ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Leukomalacia, Periventricular ; Medical Records ; Membranes ; Parturition ; Retinopathy of Prematurity* ; Retrospective Studies ; Rupture