- Growth hormone-releasing peptide 6 prevents cutaneous hypertrophic scarring: early mechanistic data from a proteome study. [Journal Article]
- IWInt Wound J 2018 Feb 21
- Hypertrophic scars (HTS) and keloids are forms of aberrant cutaneous healing with excessive extracellular matrix (ECM) deposition. Current therapies still fall short and cause undesired effects. We a...
Hypertrophic scars (HTS) and keloids are forms of aberrant cutaneous healing with excessive extracellular matrix (ECM) deposition. Current therapies still fall short and cause undesired effects. We aimed to thoroughly evaluate the ability of growth hormone releasing peptide 6 (GHRP6) to both prevent and reverse cutaneous fibrosis and to acquire the earliest proteome data supporting GHRP6's acute impact on aesthetic wound healing. Two independent sets of experiments addressing prevention and reversion effects were conducted on the classic HTS model in rabbits. In the prevention approach, the wounds were assigned to topically receive GHRP6, triamcinolone acetonide (TA), or vehicle (1% sodium carboxy methylcellulose [CMC]) from day 1 to day 30 post-wounding. The reversion scheme was based on the infiltration of either GHRP6 or sterile saline in mature HTS for 4 consecutive weeks. The incidence and appearance of HTS were systematically monitored. The sub-epidermal fibrotic core area of HTS was ultrasonographically determined, and the scar elevation index was calculated on haematoxylin/eosin-stained, microscopic digitised images. Tissue samples were collected for proteomics after 1 hour of HTS induction and treatment with either GHRP6 or vehicle. GHRP6 prevented the onset of HTS without the untoward reactions induced by the first-line treatment triamcinolone acetonide (TA); however, it failed to significantly reverse mature HTS. The preliminary proteomic study suggests that the anti-fibrotic preventing effect exerted by GHRP6 depends on different pathways involved in lipid metabolism, cytoskeleton arrangements, epidermal cells' differentiation, and ECM dynamics. These results enlighten the potential success of GHRP6 as one of the incoming alternatives for HTS prevention.
- Segmental Spinal Myoclonus Complicating Lumbar Transforaminal Epidural Steroid Injection. [Journal Article]
- RAReg Anesth Pain Med 2018 Feb 16
- CONCLUSIONS: Segmental spinal myoclonus is a rare complication after lumbar transforaminal epidural steroid and local anesthetic injection. Pain physicians should be aware of this potential complication.
- The Role of Excipients in the Stability of Triamcinolone Acetonide in Ointments. [Journal Article]
- APAAPS PharmSciTech 2018 Feb 15
- Degradation of triamcinolone acetonide (TCA) in an ointment was investigated. TCA appeared to be concentrated in propylene glycol (PG) which in turn is dispersed in a lanolin-petrolatum mixture. Two ...
Degradation of triamcinolone acetonide (TCA) in an ointment was investigated. TCA appeared to be concentrated in propylene glycol (PG) which in turn is dispersed in a lanolin-petrolatum mixture. Two predominant degradation products were identified: a 21-aldehyde and a 17-carboxylic acid. The 21-aldehyde is formed after TCA is oxidized by O2, a reaction that is catalyzed by trace metals. Logically, the content of trace metals has a profound effect on the degradation rate. It was shown that trace metals are extracted from lanolin and petrolatum by PG, increasing the concentration in PG. In accordance with these findings, TCA degrades faster in PG that is present in the ointment formulation than in regular PG. The 21-aldehyde was confirmed to be a primary degradation product, while the 17-carboxylic acid was identified as a secondary degradation product. Based on the mechanism of degradation, the ointment can be stabilized by the addition of sodium metabisulfite which was shown to reside also in the PG phase within the ointment.
- A randomized controlled trial comparing ketorolac and triamcinolone injections in adults with trigger digits. [Journal Article]
- JHJ Hand Surg Eur Vol 2018 Jan 01; :1753193418756808
- We assessed the efficacy of ketorolac trometamol injections compared with triamcinolone acetonide injections in trigger digits. Patients with trigger digits were randomized to receive either ketorola...
We assessed the efficacy of ketorolac trometamol injections compared with triamcinolone acetonide injections in trigger digits. Patients with trigger digits were randomized to receive either ketorolac or triamcinolone. They were followed up at 3, 6, 12 and 24 weeks, and monitored for resolution of triggering, pain and total active motion. One hundred and twenty-one patients with single trigger digits were recruited (59 ketorolac, 62 triamcinolone). At 6 weeks, 54% of patients in the triamcinolone group had complete resolution of trigger, whereas no patients in the ketorolac group had resolution. At 12 weeks, 58% of patients in the triamcinolone group had complete resolution of trigger compared with 6.7% in the ketorolac group. At 24 weeks, both groups had comparable rates of resolution at 26% and 25%, respectively. Patients in the triamcinolone group had significantly better resolution of pain at 3, 6 and 12 weeks. But at 24 weeks, there was no significant difference in pain between both groups. Significantly less flexion deformity was reported at 3 weeks and 6 weeks in the triamcinolone group. In the short term, ketorolac was less effective in relieving symptoms of trigger digit than triamcinolone.
- Satisfactory treatment of a large connective tissue nevus with intralesional steroid injection. [Journal Article]
- DPDermatol Pract Concept 2018; 8(1):12-14
- Collagenoma is a type of connective tissue nevi, a rare hamartomatous malformation characterized by the predominant proliferation of normal collagen fibers and normal, decreased, or increased elastic...
Collagenoma is a type of connective tissue nevi, a rare hamartomatous malformation characterized by the predominant proliferation of normal collagen fibers and normal, decreased, or increased elastic fibers. Collagenomas present as multiple or solitary, hereditary or sporadic, asymptomatic, skin-colored papules, nodules, and plaques with variable sizes, and are usually located on the trunk, arm, and back. Here, we report on a 14-year-old boy who presented with an isolated giant collagenoma of the frontal area that dramatically responded to intralesional triamcinolone acetonide.
- Incidence of Endophthalmitis after Intravitreal Injections: Risk Factors, Microbiology Profile, and Clinical Outcomes. [Journal Article]
- OIOcul Immunol Inflamm 2018 Feb 13; :1-10
- CONCLUSIONS: Adherence to strict aseptic protocols and use of prefilled compounded bevacizumab injections reduces the rate of post-IVI endophthalmitis.
- Corticosteroid and Cortisol Serum Levels Following Intra-articular Triamcinolone Acetonide Lumbar Facet Joint Injections. [Journal Article]
- PPPain Pract 2018 Feb 12
- CONCLUSIONS: The peak serum concentration of triamcinolone following intra-articular facet joint injections occurred within 24 hours. The median terminal elimination half-life was 213 hours but baseline cortisol levels were suppressed for an average of 4.4 days. Clinically, the prolonged half-life and endocrine effects of triamcinolone could increase the risk of serious drug-drug interactions in patients taking medications that inhibit corticosteroid metabolism. This article is protected by copyright. All rights reserved.
- Granulomatous/sarcoid-like lesions associated with checkpoint inhibitors: a marker of therapy response in a subset of melanoma patients. [Journal Article]
- JIJ Immunother Cancer 2018 Feb 12; 6(1):14
- CONCLUSIONS: The development of granulomatous/sarcoid-like lesions associated with CPIs is a recognized manifestation with the current class of immune checkpoint therapy that may clinically and radiographically mimic disease recurrence. Awareness of this type of toxicity is important for appropriate management and possible measurement of therapeutic response in a subset of patients who manifest this type of immune-mediated reaction.
- Scedosporium apiospermum infectious scleritis following posterior subtenon triamcinolone acetonide injection: a case report and literature review. [Case Reports]
- BOBMC Ophthalmol 2018 Feb 13; 18(1):40
- CONCLUSIONS: This case was successfully treated by topical and systemic VRCZ and repeated surgical debridement. Infectious scleritis caused by SASC rarely develops after posterior STTA. SASC can produce conidia in the enclosed subtenon space. Late-onset infectious scleritis after a posterior STTA injection suggests the presence of a fungal infection, including SASC, thereby requiring extensive and prolonged medical and surgical treatment.
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- Factors Controlling Drug Release in Cross-linked Poly(valerolactone) Based Matrices. [Journal Article]
- MPMol Pharm 2018 Feb 13
- There is keen interest in the development of biocompatible and biodegradable implantable delivery systems (IDDS) that provide sustained drug release for prolonged periods in humans. These systems hav...
There is keen interest in the development of biocompatible and biodegradable implantable delivery systems (IDDS) that provide sustained drug release for prolonged periods in humans. These systems have the potential to enhance therapeutic outcomes, reduce systemic toxicity and improve patient compliance. Herein, we report the preparation and physico-chemical characterization of cross-linked polymeric matrices from poly(valerolactone)-co-poly(allyl-δ-valerolactone) (PVL-co-PAVL) copolymers for use in drug delivery. A series of well-defined PVL-co-PAVL copolymers (PDI < 1.5), that vary in terms of M.W and AVL content were prepared by ring opening polymerization catalyzed by 1,5,7-triazabicyclo[4.4.0]dec-5-ene (TBD). A subsequent cross-linking reaction using 1,6 hexanedithiol lead to solid cylindrical amorphous or semi-crystalline matrices as potential IDDS. High loading levels (up to 20% (w/w)) of several model drugs that vary in physicochemical properties, including paclitaxel, triamcinolone acetonide and hexacetonide, curcumin and acetaminophen, was achieved using a post-loading method in organic solvent. Drugs-IDDS interactions were evaluated via the group contribution method, X-ray diffraction as well as calorimetric, spectroscopic and microscopic techniques. Results indicate superior drug-matrix compatibility for drugs bearing phenyl groups. In vitro release studies under distinct sink conditions highlight the key factors (i.e. state and loading level of drug, solubility of drug in external media, composition of release media) that impact drug release.