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Recent Developments in Therapies and Strategies Against COVID-19
Published in Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga, The Covid-19 Pandemic, 2023
Misbah Hameed, M. Zia-Ul-Haq, Marius Moga
Corticosteroids show different anti-inflammatory potential with different kinetic profiles. For intensive and rapid effect, intravenous treatment may be required. Oral and intravenous dexamethasone is being evaluated in the RECOVERY trial. Should be used with caution in pregnancy as dexamethasone cross the placental barrier, thus, prednisolone or hydrocortisone are recommended in pregnant patients as they are converted into inactive forms by the placenta.
Hypertensive Disorders
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Corticosteroids. Eleven trials (550 women) have assessed corticosteroids versus placebo/no treatment for HELLP syndrome, and are summarized in a meta-analysis [127]. The dose of dexamethasone was usually 10-mg IV every 6–12 hours for two to three doses, followed by 5- to 6-mg IV 6–12 hours later for two to three more doses. There is no difference in the risk of maternal death, maternal death or severe maternal morbidity, or perinatal/infant death. The only significant effect of treatment on individual outcomes is improved platelet count: This effect is strongest if the treatment is started antenatally.
Multiple Myeloma
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Renal failure due to cast nephropathy is an emergency requiring vigorous hydration and immediate anti-myeloma treatment following diagnosis. Dexamethasone is often used to immediately reduce myeloma tumor burden. Definitive treatment in this setting is usually with a bortezomib-based regimen such as bortezomib–cyclophosphamide–dexamethasone (VCD) and can reverse renal failure in a majority of patients.17 There is no benefit for early plasmapheresis, and two trials using high cut-off membrane for hemodialysis designed to efficiently remove serum light chains show conflicting results, and hence this cannot be recommended. In some patients renal function recovers as the disease responds to treatment, but in around 10% of patients long-term dialysis may be needed.
Extract of Pinus densiflora needles suppresses acute inflammation by regulating inflammatory mediators in RAW264.7 macrophages and mice
Published in Pharmaceutical Biology, 2022
Seul-Yong Jeong, Won Seok Choi, Oh Seong Kwon, Jong Seok Lee, Su Young Son, Choong Hwan Lee, Sarah Lee, Jin Yong Song, Yeon Jin Lee, Ji-Yun Lee
We applied 0.1, 0.3 and 1 mg of PINE to mouse ears and the concentration of the test agent was based on previous research of the topical application of 0.1, 0.3 and 1 mg extracts/ear in mouse studies (Ascari et al. 2019; Formagio-Neto et al. 2019). Dexamethasone, a synthetic glucocorticoid, induces anti-inflammatory effects through inhibition of the NF-κΒ signalling pathway (Chen et al. 2021). Dexamethasone has been commonly used as a positive control in inflammation-related studies (Huang et al. 2018). We used 0.1 mg/ear of dexamethasone for topical application based on the findings of a previous study (de Brum et al. 2016). We measured the anti-inflammatory activity of PINE in inflamed ICR mouse ears by using arachidonic acid to induce oedema in ear tissues. All tested concentrations of PINE significantly suppressed ear oedema and MPO activity. Elevated MPO levels are associated with inflammation and increased oxidative stress (Ndrepepa 2019). This study showed that MDA levels, which are a marker of oxidative stress (Gaweł et al. 2004), decreased after PINE treatment. Thus, the results suggest that PINE exerts anti-inflammatory activity not only in vitro but also under in vivo conditions.
The effect of nebulized dexmedetomidine as sedative premedication in pediatrics undergoing cochlear implantation
Published in Egyptian Journal of Anaesthesia, 2022
Rania M Ali, Noura M. Youssri Mahmoud
0.15 mg/kg dexamethasone was given for prevention of postoperative nausea and vomiting. Induction of anesthesia was performed with 1–2 mg/kg of propofol, 2 μg/kg of fentanyl and 0.5 mg/kg of atracurium. After insertion of appropriately sized endotracheal tube, anesthesia was maintained with 50% O2-air mixture, 2–3% sevoflurane and incremental doses of atracurium. Ventilation was controlled to maintain an end-tidal carbon dioxide partial pressure of 35 to 40 mmHg. No other sedatives or opioids was administered during the procedure. Quality of surgical field (QSF) was evaluated by the operating surgeon using Modena bleeding score as follows: 1 = No bleeding, 2 = Bleeding easily controlled by suctioning, washing, or packing without any significant modification or slowing of surgical procedure, 3 = Bleeding slowing surgical procedure, 4 = Most of the maneuvers dedicated to bleeding control, 5 = Bleeding that prevents every surgical procedure except those dedicated to bleeding control [13].
Intrahepatic cholestasis of pregnancy: from an obstetrician point of view
Published in Journal of Obstetrics and Gynaecology, 2022
Mohsen M. A. Abdelhafez, Karim A. M. Ahmed, Win Win Than, Dg Marshitah Pg Baharuddin, Fairrul Kadir, Saffree Jeffree, Mohammad Firdaus Hayati, Mohd Nazri Bin Mohd Daud, Aya M. Eldiastey, Kai Xin Tay
Dexamethasone is one of the drugs evaluated for the treatment of ICP. In a small cohort of Finnish women, the drug was demonstrated to improve both pruritus as well as decrease bile acid levels (Williamson and Geenes 2014a), due to inhibition of oestrogen precursor production by the adrenal glands with dexamethasone therapy and subsequent decrease placental production of oestrogens (Ovadia and Williamson 2016). However, no large trials supported this assumption and the findings were not reproduced in follow-up studies (Kretowicz and McIntyre 1994; Glantz et al. 2005; Diac et al. 2006), in addition to the concerns regarding the adverse effects associated with dexamethasone use for both mother and foetus (Geenes and Williamson 2009). Hence, the drug is currently rarely to be used for treatment of ICP (Williamson and Geenes 2014b).