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1.
The impact of intravitreal dexamethasone implant (Ozurdex®) on retrobulbar hemodynamics in patients with diabetic macular edema and retinal vein occlusions.
Gok, M, Altas, H, Kapti, HB
Cutaneous and ocular toxicology. 2019;(3):240-248
Abstract
Objective: To evaluate the effect of single intravitreal dexamethasone implant (Ozurdex®) on ocular blood flow velocities in patients with diabetic macular oedema (DME) and retinal vein occlusions (RVO). Methods: This prospective non-randomized interventional study included injected and fellow eyes of 12 patients with DME and of 16 patients with RVO treated with intravitreal Ozurdex®. Colour Doppler Ultrasonography (CDU) measures of the central retinal artery (CRA), posterior ciliary artery (PCA), ophthalmic artery (OA) those are peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI) and pulsatility index (PI) were performed in both injected and uninjected eyes before injection, at one week, one month after injection, and prior to re-injection. Results: Inter-eye comparison of all the measured CDU data (baseline, first week, first month, reinjection) showed no statistically significant difference in both DME and RVO group. PSV and EDV values of the CRA, OA, and PCA showed a decreasing trend in the first week and first-month visits and then increased at reinjection time. RI and PI measures of the CRA, OA, and PCA measures showed minimal alterations in the follow-up. But all these differences were not statistically significant. Significant visual gain and anatomic recovery were obtained by the intravitreal dex-implant both in the DME and RVO group. Conclusions: Single intravitreal dex-implant did not alter ocular blood flow in the treatment of macular oedema due to RVO and diabetes.
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2.
Association Between Changes in Coronary Artery Disease Progression and Treatment With Biologic Agents for Severe Psoriasis.
Hjuler, KF, Bøttcher, M, Vestergaard, C, Bøtker, HE, Iversen, L, Kragballe, K
JAMA dermatology. 2016;(10):1114-1121
Abstract
IMPORTANCE Inflammatory pathways of psoriasis share similarities with the mechanisms identified in atherosclerosis, and the association between psoriasis and cardiovascular disease due to accelerated coronary artery disease is well established. The effect of anti-inflammatory drugs on the development of coronary atherosclerosis remains essentially unknown. OBJECTIVE To investigate the association of biological therapy with changes in coronary artery disease progression, measured by repeated coronary computed tomography (CT). DESIGN, SETTING, AND PARTICIPANTS This single-center prospective, controlled, observer-blinded clinical study at a tertiary dermatology university hospital clinic enrolled patients with severe psoriasis initiating biological therapy and matched controls not receiving systemic therapy from April 11, 2011, through June 30, 2014. INTERVENTIONS Biological therapy approved for psoriasis (adalimumab, etanercept, infliximab, ustekinumab) with the possibility to switch between treatments to ensure tight control of inflammation. MAIN OUTCOMES AND MEASURES Patients underwent noncontrast coronary artery calcium (CAC) CT and contrast-enhanced coronary CT angiography at baseline and after 13 months of follow-up. Changes in CAC score, number of coronary plaques, severity of narrowing, composition, and vessel wall volume were measured. RESULTS There were 28 treated patients (mean [SD] age, 49.2 [10.2] years; 71% men; mean [SD] Psoriasis Area Severity Index [PASI], 15.4 [4.3]) and 28 controls (mean [SD] age, 52.8 [10.6] years; 71% men; mean [SD] PASI, 12.4 [3.9]). The CAC scores remained stable in the intervention group (mean [SD] yearly CAC change, -16 [56]; P = .15) and progressed in the control group (14 [29]; P = .02) (intervention vs controls: P = .02). The number of segments with luminal abnormalities remained unchanged in both groups. The severity of luminal narrowing in the diseased segments was unchanged in the intervention group (Wilcoxon W = 76, n = 483, P = .39) but increased at follow-up in the control group (Wilcoxon W = 281, n = 414, P = .02). Automated vessel wall volume index remained unchanged from baseline to follow-up in the intervention group (mean [SD] baseline, 7.1 [1.5], follow-up, 7.1 [1.7]; P = .91), while controls demonstrated statistically nonsignificant progression (baseline, 8.3 [1.6], follow-up, 8.9 [2.2]; P = .06). CONCLUSIONS AND RELEVANCE Clinically effective treatment with biologic agents was associated with reduced coronary artery disease progression in patients with severe psoriasis. These findings support a beneficial effect of biologic anti-inflammatory agents in preventing cardiovascular disease progression in addition to disease control in inflammatory diseases.
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3.
Anti-inflammatory profile of paricalcitol in hemodialysis patients: a prospective, open-label, pilot study.
Navarro-González, JF, Donate-Correa, J, Méndez, ML, de Fuentes, MM, García-Pérez, J, Mora-Fernández, C
Journal of clinical pharmacology. 2013;(4):421-6
Abstract
Inflammation is a strong predictor of increased morbidity and mortality in hemodialysis (HD) patients. Paricalcitol, a selective vitamin D receptor activator used for prevention and treatment of secondary hyperparathyroidism, has shown anti-inflammatory properties in experimental studies, although clinical data are scarce. In an open-label, prospective, single center, pilot study, 25 stable HD patients, previously receiving calcitriol, completed 12 weeks of therapy with oral paricalcitol. Serum and peripheral blood mononuclear cell (PBMC) expression profiles of inflammatory cytokines were analyzed. Serum interleukin (IL)-1, IL-10, and IL-18 did not change, unlike high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and IL-6, which experienced a significant mean percent decrease of 14.3%, 4.7%, and 5%, respectively. There was a significant reduction in the TNF-α/IL-10 and the IL-6/IL-10 ratios (P < .05). Serum intact parathyroid hormone concentration experienced a mild but significant reduction. In addition, expression levels of TNF-α and IL-6 decreased by 19.1% (P < .01) and 17.5% (P < .001), respectively, whereas expression of IL-10 increased by 17.7% (P < .01) after treatment. In conclusion, paricalcitol administration to HD patients is associated with a beneficial effect on the inflammatory cytokine serum and gene expression profile of PBMC. This effect may contribute to the survival benefits of paricalcitol observed in clinical studies.
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4.
Effects of sesame seed supplementation on clinical signs and symptoms in patients with knee osteoarthritis.
Eftekhar Sadat, B, Khadem Haghighian, M, Alipoor, B, Malek Mahdavi, A, Asghari Jafarabadi, M, Moghaddam, A
International journal of rheumatic diseases. 2013;(5):578-82
Abstract
AIM: Up to now there have been no human studies to evaluate the effect of sesame (Sesamum indicum L.) in osteoarthritis patients; this study was designed to assess the effect of administration of sesame on clinical signs and symptoms in patients with knee osteoarthritis (OA). METHODS Fifty patients with knee OA referred to the only specialty and subspecialty orthopedic centers in the north-west of Iran, were selected and divided into two groups, namely control and sesame groups. Twenty-five patients in the control group received standard treatment while 25 patients in the sesame group received 40 g/day sesame by oral administration during 2 months of the study along with standard drug therapy. The KOOS Questionnaire, Timed Up and Go (TUG) and Visual Analog Scale (VAS) tests were used for clinical assessments. RESULTS There was significant difference in pain intensity between the two groups (P = 0.004) after treatment. The mean score of the KOOS Questionnaire in both treatment and control groups was significantly increased (P = 0.001 and P = 0.001, respectively) compared with baseline. The mean score of the TUG Questionnaire in both treatment and control groups was significantly decreased (P = 0.001 and P = 0.001, respectively) compared with baseline. There was significant difference in post-treatment scores of the KOOS Questionnaire (P = 0.009) and TUG (P = 0.002) between the two groups. CONCLUSIONS The present study showed a positive effect of sesame in improving clinical signs and symptoms in patients with knee OA and indicated the fact that sesame might be a viable adjunctive therapy in treating OA.
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5.
Sulphurous thermal water increases the release of the anti-inflammatory cytokine IL-10 and modulates antioxidant enzyme activity.
Prandelli, C, Parola, C, Buizza, L, Delbarba, A, Marziano, M, Salvi, V, Zacchi, V, Memo, M, Sozzani, S, Calza, S, et al
International journal of immunopathology and pharmacology. 2013;(3):633-46
Abstract
The beneficial effects of hot springs have been known for centuries and treatments with sulphurous thermal waters are recommended in a number of chronic pathologies as well as acute recurrent infections. However, the positive effects of the therapy are often evaluated in terms of subjective sense of wellbeing and symptomatic clinical improvements. Here, the effects of an S-based compound (NaSH) and of a specific sulphurous thermal water characterized by additional ions such as sodium chloride, bromine and iodine (STW) were investigated in terms of cytokine release and anti-oxidant enzyme activity in primary human monocytes and in saliva from 50 airway disease patients subjected to thermal treatments. In vitro, NaSH efficiently blocked the induction of pro-inflammatory cytokines and counterbalanced the formation of ROS. Despite STW not recapitulating these results, possibly due to the low concentration of S-based compounds reached at the minimum non-toxic dilution, we found that it enhanced the release of IL-10, a potent anti-inflammatory cytokine. Notably, higher levels of IL-10 were also observed in patients' saliva following STW treatment and this increase correlated positively with salivary catalase activity (r2 = 0.19, *p less than 0.01). To our knowledge, these results represent the first evidence suggesting that S-based compounds and STW may prove useful in facing chronic inflammatory and age-related illness due to combined anti-inflammatory and anti-oxidant properties.
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6.
Prospective controlled protocol for three months steroid withdrawal with tacrolimus, basiliximab, and mycophenolate mofetil in renal transplant recipients.
Oh, CK, Kim, SJ, Kim, JH, Lee, JH
Journal of Korean medical science. 2012;(4):337-42
Abstract
During the past few years, new immunosuppressants, such as tacrolimus, mycophenolate mofetil (MMF) and basiliximab, have been shown to successfully decrease the incidence of acute rejection, possibly acting as potent substrates for safe steroid withdrawal. Therefore, clinical outcome of 3 months steroid withdrawal, while using the above immunosuppressants, was analyzed. Clinical trial registry No. was NCT 01550445. Thirty de novo renal transplant recipients were enrolled, and prednisolone was slowly withdrawn 3 months post-transplantation by 2.5 mg at every two weeks, until 8 weeks. During steroid withdrawal, 10 patients (30.0%) discontinued the protocol and they were maintained on steroid treatment. Among 20 steroid free patients, 8 patients (40.0%) re-started the steroid within 12 months post-transplantation. By the study endpoint, 12 (40%) recipients did not take steroid and survival of patients and grafts was 100%. In conclusion, in kidney transplant patients, 3 months steroid withdrawal while taking tacrolimus, basiliximab and mycophenolate mofetil was not associated with increased mortality or graft loss. Despite various causes of failure of steroid withdrawal during the follow-up period, it is a strategy well advised for kidney transplant recipients with regard to long-term steroid-related complications.
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7.
Effects of eccentric exercise on systemic concentrations of pro- and anti-inflammatory cytokines and prostaglandin (E2): comparison between young and postmenopausal women.
Conceição, MS, Libardi, CA, Nogueira, FR, Bonganha, V, Gáspari, AF, Chacon-Mikahil, MP, Cavaglieri, CR, Madruga, VA
European journal of applied physiology. 2012;(9):3205-13
Abstract
The present study aimed to analyze the magnitude of muscle damage and inflammatory responses induced by eccentric exercise in young (YW) and postmenopausal women (PMW). Seventeen healthy women (nine YW, 23.89 ± 2.03 years; and eight PMW, 51.13 ± 5.08 years) performed five sets of six maximal eccentric actions of the elbow flexors. Changes in isometric strength, range of motion, muscle soreness, and upper-arm circumference were evaluated pre, post, 24, 48, and 72 h following eccentric exercise. Changes in creatine kinase activity, interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor-α (TNF-α), and prostaglandin E(2) (PGE(2)) were measured pre, 24, 48, and 72 h following eccentric exercise. For intra and inter-group analysis, a two-way repeated measures ANOVA was applied followed by a Tukey's post hoc test. Pearson's correlation was used to analyze the correlations between variables. It was observed no differences between groups for the markers of muscle damage, although significant modifications (p < 0.05) occurred within groups throughout time for all variables. Post menopausal women showed significantly higher values for TNF-α (p < 0.05). Also, IL-6 presented superior pre value for PMW. For YW, IL-6 and IL-10 values increased 72 h post-eccentric exercise compared to pre. Further, IL-10 was higher for YW than PMW 72 h post-eccentric exercise. Significant correlations (p < 0.05) were found between age and soreness, and between age and PGE(2). In conclusion, YW do not have attenuated muscle damage compared to PMW who do not make use of hormonal replacement therapy. In addition, YW have a greater anti-inflammatory response after eccentric exercise compared to PMW.
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8.
The efficacy of nicotinamide gel 4% as an adjuvant therapy in the treatment of cutaneous erosions of pemphigus vulgaris.
Iraji, F, Banan, L
Dermatologic therapy. 2010;(3):308-11
Abstract
The high rate of morbidity and mortality resulting from long-term use of corticosteroids in pemphigus vulgaris (PV) warrants discovery of a new treatment strategy. Based on the pathophysiology of PV, nicotinamide can block the process of blister formation through its anti-inflammatory properties. This study was conducted to evaluate the clinical effectiveness of nicotinamide gel in the treatment of skin lesions of PV. In a double-blind, placebo-controlled study, eight PV patients with a total of 60 skin lesions were treated by either nicotinamide or placebo gel. After 30 days of treatment, epithelialization index of the two groups was compared. The mean of the epithelialization index in skin lesions that received nicotinamide was significantly higher than that of the placebo group (26 vs. -5.8, p < 0.001). Our results were suggestive that nicotinamide gel can effectively be used as an adjunctive treatment for PV lesions.
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9.
Inspired nitric oxide and modulation of oxidative stress during cardiac surgery.
Elahi, MM, Worner, M, Khan, JS, Matata, BM
Current drug safety. 2009;(3):188-98
Abstract
Evidence in the literature is contradictory regarding the precise role of nitric oxide (NO) in modulating systemic inflammatory response induced by cardiopulmonary bypass (CPB). We studied the impact of inspired NO gas on physiological function and markers of inflammation-oxidative stress for subjects (n=15, age 62+/-4.5 and 12/3 M/F) scheduled for coronary artery bypass graft (CABG) operation. Outcomes from subjects that received 5 ppm and 20 ppm of inspired NO (n=5/group) were compared to those not given NO gas. Breath-to-breath measurement commenced at the start of intubation and continued up to 4h later. Indices of cardiovascular function, alveolar-capillary gas exchange and haematological parameters were not significantly different in outcomes for the inspired NO groups as compared with control. We observed a reduction in mean systemic arterial in all subjects at 30 min and 4h after bypass when compared with pre bypass values. Markers of systemic inflammatory response and oxidative stress increased during CPB particularly at 4h and 24h after the initiation of bypass. In contrast, we observed a reduction in expired NO, at 24h after surgery in the groups given inspired NO. In addition, there was also a significant reduction in oxidative stress markers in blood at 24h after surgery for the groups given inspired NO as compared with the control group. In contrast, cytokines response remained similar in all the three groups at all time points. The results suggested that inspired NO gas has an antioxidant property that reduces the levels of cell death, and is not associated with significantly worse-off physiological outcomes.
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10.
Dexamethasone decreases cerebrospinal fluid soluble tumor necrosis factor receptor 1 levels in bacterial meningitis.
Ichiyama, T, Matsushige, T, Kajimoto, M, Tomochika, K, Matsubara, T, Furukawa, S
Brain & development. 2008;(2):95-9
Abstract
It is known that the use of adjunctive dexamethasone in bacterial meningitis reduces audiologic and neurologic sequelae. The cerebrospinal fluid (CSF) level of soluble tumor necrosis factor 1 (sTNFR1) is an important indicator of neurologic sequelae in bacterial meningitis. We measured the CSF levels of IL-6 and sTNFR1 before administration of antibiotics (CSF1) and 1-3 days after administration of antibiotics (CSF2) in nine patients with bacterial meningitis who received dexamethasone sodium and five without dexamethasone. The CSF2 IL-6 levels of patients with/without dexamethasone were significantly lower than for CSF1 IL-6 levels (p = 0.0077, and p = 0.0431, respectively). There were no significant differences of the ratio of CSF2/CSF1 IL-6 levels between patients with dexamethasone and those without dexamethasone. CSF2 sTNFR1 levels of patients with dexamethasone were significantly lower than for CSF1 sTNFR1 levels (p = 0.0208). However, CSF2 sTNFR1 levels of patients without dexamethasone were significantly higher than for CSF1 sTNFR1 levels (p = 0.0422). The ratio of CSF2/CSF1 sTNFR1 levels of patients with dexamethasone was significantly lower than that without dexamethasone (p = 0.0063). Our present study suggests that dexamethasone inhibits increase of CSF sTNFR1 levels after antibiotics therapy in bacterial meningitis.