Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new betamethasone research articles will be listed here shortly after becoming available to us.
Medical research on betamethasone
BMC Infect Dis. 2010 Mar 6; 10(1): 49
Gentile I, Talamo M, Borgia G
ABSTRACT: BACKGROUND: Drug-Induced Hypersensitivity Syndrome (DIHS) is a severe and rare systemic reaction triggered by a drug (usually an antiepileptic drug). We present a case of DISH and we review studies on the clinical features and treatment of DIHS, and on its pathogenesis in which two elements (Herpesvirus infection and the drug) interact with the immune system to trigger such a syndrome that can lead to death in about 20% of cases. CASE PRESENTATION: We report the case of a 26-year old woman with fever, systemic maculopapular rash, lymphadenopathy, hepatitis and eosinophilic leukocytosis. She had been treated with antibiotics that gave no benefit. She was taking escitalopram and lamotrigine for a bipolar disease 30 days before fever onset. Because the patient's general condition deteriorated, betamethasone and acyclovir were started. This treatment resulted in a mild improvement of symptoms. Steroids were rapidly tapered and this was followed with a relapse of fever and a worsening of laboratory parameters. Human herpesvirus 6 (HHV-6) DNA was positive as shown by PCR. Drug-Induced Hypersensitivity Syndrome (DIHS) was diagnosed. Symptoms regressed on prednisone (at a dose of 50 mg/die) that was tapered very slowly. The patient recovered completely. CONCLUSIONS: The search for rare causes of fever led to complete resolution of a very difficult case. As DIHS is a rare disease the most relevant issue is to suspect and include it in differential diagnosis of fevers of unknown origin. Once diagnosed, the therapy is easy (steroidal administration) and often successful. However our case strongly confirms that attention should be paid on the steroidal tapering that should be very slow to avoid a relapse.
Int Braz J Urol. 2010 Jan-Feb; 36(1): 75-85
Nobre YD, Freitas RG, Felizardo MJ, Ortiz V, Macedo A
Purpose: To compare the efficacy and costs of circumcision versus topical treatment using a prospective pharmacoeconomic protocol. Materials and Methods: We treated 59 patients (3-10 years of age) randomized into two groups: 29 underwent an 8-week course of topical treatment with 0.2% betamethasone-hyaluronidase cream twice a day; and 30 underwent circumcision. Topical treatment success was defined as complete exposure of the glans. In cases of treatment failure, circumcision was performed and its cost imputed to that of the initial treatment. The pharmacoeconomic aspects were defined according to the Brazilian National Public Health System database and the Brazilian Community Pharmacies Index. Results: The two groups were statistically similar for all clinical parameters evaluated. Topical treatment resulted in complete exposure of the glans in 52% of the patients. Topical treatment was associated with preputial pain and hyperemia. However, treatment suspension was unnecessary. Minor complications were observed in 16.6% of the surgical group patients. The mean cost per patient was US$ 53.70 and US$ 125.20, respectively, for topical steroid treatment (including the costs related to treatment failure) and circumcision. The total costs were US$ 2,825.32 and US$ 3,885.73 for topical treatment and circumcision, respectively. Conclusions: Topical treatment of phimosis can reduce costs by 27.3% in comparison with circumcision. Therefore, topical treatment of phimosis should be considered prior to the decision to perform surgery.
Topical steroid is effective for the treatment of phimosis in young children.
J Med Assoc Thai. 2010 Jan; 93(1): 77-83
Sookpotarom P, Porncharoenpong S, Vejchapipat P
BACKGROUND AND OBJECTIVE: The purpose of the present study was to evaluate the effects of non-operative treatment using topical steroids on phimosis in infants and young children. MATERIAL AND METHOD: Between June 2003 and May 2005, the parents of the children with phimosis were instructed to apply and massage the phimotic skin with 0.05% betamethasone valerate cream twice daily for 2 months. During non-operative treatment, the patients whose parents were not satisfied with the results would undergo circumcision. RESULTS: Ninety-two phimotic boys with an average age of 32.62 months (range, 1 to 144 months) were enrolled for steroid application. Of the 92 patients, 79 (85.9%) were satisfied with their results. The other 13 patients whose outcomes clinically improved but did not satisfy their parents finally underwent circumcision. Histologically, circumcised skins of patients initially receiving steroid therapy revealed markedly interstitial edema and slightly increased vasculature. There were no systemic side effects or significant dermal atrophy in the present study. CONCLUSION: Topical steroid treatment for phimosis is successful in young children. This therapeutic approach is a safe, easy, and inexpensive alternative to circumcision.
Neuroscience. 2010 Feb 24;
Leroux P, Hennebert C, Catteau J, Legros H, Hennebert O, Laudenbach V, Marret S
Glutamate excitotoxicity is among the main cellular mechanisms leading to perinatal insults in human newborns. We used intracerebral injection of the glutamatergic glutamate N-methyl-d-aspartate-receptor agonist ibotenate to produce excitotoxic lesions mimicking the acquired white matter lesions seen in human preterm infants. We evaluated whether nonsteroidal antiinflammatory drugs (NSAIDs) protected against glutamate excitotoxicity. Aspirin (0.01-100 mug/d), indomethacin (0.1-10 mug/d), paracetamol (10-100 mug/d), or NS-398 (12.5 mug/d) was given daily before ibotenate (P1 to P5) or after ibotenate (P5 to P9). Lesion size was measured on Cresyl Violet-stained brain sections collected on P10. None of the drugs tested alone or in combination increased lesion size. Pretreatment with low- or high-dose aspirin and post-treatment with paracetamol or NS-398 protected against white matter lesions, whereas cortical lesions were decreased by pretreatment with low- or high-dose aspirin or post-treatment with NS-398. The corticosteroid betamethasone (0.18 mug/d) was neuroprotective when given before or after ibotenate and this effect was reversed by concomitant aspirin therapy (10 mug/d). In conclusion, perinatal NSAID administration may have beneficial effects on brain injury if appropriately timed.
Skin Pharmacol Physiol. 2010 Feb 25; 23(4): 177-182
Wohlrab J, Beck GM, Neubert RH, Sischka U, Kreft B
The evaluation of the benefit/risk ratio (BRR) for topical glucocorticoids (TGC) allows the comparison of active ingredients and thereby includes aspects of dosage (blanching response, BR) as well as adverse effects (skin atrophy). In the present study, the BRR of hydrocortisone aceponate, prednicarbate and betamethasone valerate was investigated according to an adapted procedure for investigating the BR. The main difference is the longer application period of the investigational substance without occlusion. Thus, the pharmacokinetic characteristics of all of the systems are considered more intensely and the penetration conditions are designed in a realistic way, namely oriented towards the preparation in order to improve the significance and relevance of the BRR for practical use. The results demonstrate that the investigated substances also show differences in the extent of the BR, but on the other hand they show that the improved penetration characteristics of the double-esterified compounds are clearly less effective. In comparison to the BRR, this results to a large extent in a balanced picture without relevant advantages for single preparations. Nevertheless, the already mentioned positive characteristics of the investigated TGC and the positive practical clinical experiences have been approved. Further investigations have to show whether the method presented here for investigating the BR offers advantages in the comparative assessment of TGC.
Effects of glucocorticoid on brain acetylcholinesterase of developing chick embryos.
J Obstet Gynaecol Res. 2010 Feb; 36(1): 11-8
Yamate S, Nishigori H, Kishimoto S, Tezuka Y, Fukushima A, Sugiyama T, Nishigori H
AIM: Fetal exposure to excessive or deficient glucocorticoids may alter the programming in differentiation and maturation of various tissues including the brain and nervous system, leading to dysfunctions later in life. For further exploration of this possibility, we established an animal model using developing chick embryos. METHODS: (i) Reverse-transcription polymerase chain reaction was used to determine the expression of glucocorticoid receptor mRNA in the brain of chick embryos. (ii) Embryos on day 15 were administered betamethasone or mifepristone and their cerebrum, cerebellum and optic lobe were investigated to determine the activity of acetylcholinesterase. RESULTS: (i) Glucocorticoid receptor mRNA was shown to be present in the cerebrum, cerebellum and optic lobe. (ii) After the administration of betamethasone, acetylcholinesterase activities in the cerebrum, cerebellum and optic lobe on day 19 were 1.5- to 2-fold higher than those of untreated control. Weights of body and brain parts were 0.65-0.75-fold relative to control values. However, these differences were less noticeable on day 22. (iii) Administration of mifepristone before treatment with betamethasone prevented high-dose betamethasone-induced changes in acetylcholinesterase activity and bodyweights on day 19. Administration of mifepristone alone did not induce differences from the control. CONCLUSIONS: The cerebrum, cerebellum and optic lobe of chick embryos could be influenced by glucocorticoids because of the presence of glucocorticoid receptor mRNA. Although the effects observed after treatment with excess glucocorticoids (even no effects after mifepristone treatment) were transitory, they may alter the developmental program in ways that could result in lasting change and influence behavioral activities after hatching.
Colloids Surf B Biointerfaces. 2010 Feb 4;
Goyal RN, Bishnoi S
A sensitive voltammetric method has been described for the determination of betamethasone sodium phosphate (BSP) using edge plane pyrolytic graphite electrode (EPPGE) modified with single walled carbon nanotubes-cetyltrimethyl ammonium bromide nanocomposite film. The reduction of BSP occurred in a well-defined peak having E(p) -1062mV in phosphate buffer solution (PBS) of pH 7.2. The voltammetric response of betamethasone sodium phosphate enhanced effectively using cationic surfactant cetyltrimethyl ammonium bromide (CTAB) as electrode surface modifier. The nanotubes-surfactant modified edge plane pyrolytic graphite electrode shows great improvement in peak current and shift of the reduction potential towards less negative potential. The role of cetyltrimethylammonium bromide on electrocatalytic property is discussed. The limit of detection (3sigma/slope) was found to be 0.25x10(-9)M and limit of quantification was 0.86x10(-9)M. The analytical utility of the proposed method is demonstrated by the direct assay of betamethasone in urine samples of pregnant women.
Arteriovenous malformation of the base of tongue in pregnancy: case report.
Acta Otorhinolaryngol Ital. 2009 Oct; 29(5): 274-8
Martines F, Immordino V
Arteriovenous malformation of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent a lethal benign disease. An unusual case is presented of an arteriovenous malformation of the base of tongue in a 32-year-old primigravida at 23.2 weeks of gestation with a history of haemoptysis. The patient was admitted to hospital with 10.7 g/dl of haemoglobin and 32.1% of haematocrit but due to recurrent massive haemoptysis, in the next few days, dropped to 6.7 g/dl of haemoglobin and 20.2% of haematocrit which required immediate blood transfusions. To maintain the upper airways patent the patient underwent tracheostomy; during angiography, showing an arteriovenous malformation with its feeding arteries (lingual artery, internal maxillary artery, and maxillary artery) embolization was made without a significant blood flow reduction. After surgical ligation of the external carotid artery, on the right side, the patient was readmitted for further angiographic evaluation, which confirmed complete occlusion of the carotid artery but, at the same time, revealed the integrity of the arteriovenous malformation perfusion on account of a new feeding artery (left lingual artery). A new superselective catheterization of the lingual artery was performed but due to the effect of progesterone, which causes smooth muscle relaxation and leads to arteriovenous malformation dilatation and rupture, the primigravida again presented haemoptysis. In agreement with the gynaecologists, the patient was given betamethasone to induce foetal lung maturation, and induction of labour was planned at 26 weeks, and a healthy baby was delivered naturally. Over the following days, the patient had no further haemoptysis and so far clinical examination showed no evidence of the original mass (slight haemorrhagic suffusion of the right anterior amygdala region).
Intratympanic Steroid Prevents Long-Term Spiral Ganglion Neuron Loss in Experimental Meningitis.
Otol Neurotol. 2010 Feb 9;
Worsøe L, Brandt CT, Lund SP, Ostergaard C, Thomsen J, Cayé-Thomasen P
HYPOTHESIS:: Intratympanic steroid treatment prevents hearing loss and cochlear damage in a rat model of pneumococcal meningitis. BACKGROUND:: Sensorineural hearing loss is a long-term complication of meningitis affecting up to a third of survivors. Streptococcus pneumoniae is the bacterial species most often associated with a hearing loss. METHODS:: Rats were randomly assigned to 3 treatment groups: a group treated with intratympanic betamethasone and 2 control groups treated with either intratympanic or systemic saline. Treatment was initiated 21 hours after infection and repeated once a day for 3 days. Hearing loss and cochlear damage were assessed by distortion product otoacoustic emissions, auditory brainstem response at 16 kHz, and spiral ganglion neuron density. RESULTS:: Fifty-six days after infection, auditory brainstem response showed no significant differences between groups, and distortion product otoacoustic emissions showed significant hearing loss at the low frequencies in animals treated with intratympanic steroid compared with animals treated with systemic saline (p < 0.05; Mann-Whitney test). However, intratympanic steroid significantly increased the number of viable neurons in the spiral ganglion compared with both intratympanic and systemic saline (p = 0.0082 and p = 0.0089; Mann-Whitney test). Histology revealed fibrosis of the tympanic membrane and cavity in steroid-treated animals, which plausibly caused the low-frequency hearing loss. CONCLUSION:: Intratympanic betamethasone treatment prevents long-term spiral ganglion neuron loss in experimental pneumococcal meningitis. This finding is clinically relevant in relation to postmeningitic hearing rehabilitation by cochlear implantation. However, the drug instillation in the middle ear induced local fibrosis and a concurrent low-frequency hearing loss.
[Treatment of severe preeclampsia: until when and for what risks/benefits?]
Rev Med Liege. 2009 Dec; 64(12): 620-5
Petit P, Top M, Chantraine F, Brichant JF, Dewandre PY, Foidart JM
The four major hypertensive disorders related to pregnancy are preeclampsia, chronic hypertension, preeclampsia superimposed upon chronic hypertension, and gestational hypertension. The development of hypertension and proteinuria in pregnancy is usually due to preeclampsia, particularly in a primigravida. These findings typically become apparent in the latter part of the third trimester and progress until delivery, but some women develop symptoms in the latter half of the second trimester, or intrapartum, or the early postpartum period. Preeclampsia is characterized as mild or severe. Severe hypertension, coagulopathy, thrombocytopenia, liver function abnormalities, and fetal growth restriction are features of severe disease. Laboratory evaluation should assess haemoglobin/hematocrit and platelet count, renal and hepatic function, as well as assessment of fetal well-being and growth. Timing of delivery is based upon gestational age, maternal and fetal condition, and the severity of preeclampsia. Maternal end organ dysfunction and nonreassuring tests of fetal well-being are indications for delivery at any gestational age. Antihypertensive treatment aims at protecting the mother from severe hypertensive encephalopathy, but may jeopardize the fetus. We recommend antenatal corticosteroids (betamethasone) be given to women with preeclampsia at 26 to 34 weeks of gestation. Magnesium sulfate is more effective than phenytoin for prevention of eclamptic seizures.