Effect of sodium hyaluronate eye drops combined with tobramycin,dexamethasone and pranoprofen eye drops in the treatment of dry eye after phacoemulsification

Purpose:To investigate the clinical effect of sodium hyaluronate eye drops combined with tobramycin, dexamethasone, and pranoprofen eye drops in the treatment of dry eye after phacoemulsification.Methods:Medical records of 188 patients with dry eye after phacoemulsification, treated in our hospital from August 2020 to August 2021, were included and divided into groups based on the type of dry eye treatment. Patients in the control group (n = 90) were treated with tobramycin, dexamethasone, and pranoprofen eye drops. Patients in the test group (n = 98) were treated with sodium hyaluronate, tobramycin, dexamethasone, and pranoprofen eye drops. The tear secretion test (TST), film rupture time (BUT), corneal fluorescence staining (FS) score, levels of interleukin (IL)-6, and tumor necrosis factor (TNF)-α before the treatment and at 1 month follow-up, the overall total effective rate and the number of completely cured cases were compared between the two groups. Multiple linear regression was used to calculate coefficients for predicting clinical variables. Ordinal logistic regression was used to compute coefficients and odds ratios for predicting effective scores.Results:The total effective rate in the observation group (99%) was significantly higher than that in the control group (80.00%). After the treatment, the TST and BUT indexes of the observation group were higher compared to the control group, and the FS score of the observation group was lower than that of the control group. TNF-α and IL-6 levels of the observation group were lower compared to the control group. Logistic regression analysis demonstrated that the differences in the effective rate and clinical variables between the two groups remained significant after adjusting for the effect of age.Conclusion:A combination of sodium hyaluronate, tobramycin, dexamethasone, and pranoprofen eye drops for the treatment of dry eye after phacoemulsification can improve the curative effect, reduce corneal fluorescein staining and inflammatory factor index levels compared to the treatment regimen lacking sodium hyaluronate eye drops.     

NPH Insulin Versus Insulin Glargine Versus NPH Insulin Plus Insulin Glargine for the Treatment of Dexamethasone-Induced Hyperglycemia in Patients With COVID-19: A Retrospective Cohort Study

Background:Dexamethasone use in patients hospitalized with COVID-19 significantly reduces mortality; however, it commonly results in hyperglycemia. Optimal treatment of dexamethasone-induced hyperglycemia is not well established.Objective:The study purpose was to assess the difference in blood glucose (BG) control between insulin glargine, neutral protamine hagedorn (NPH) insulin, and insulin glargine plus NPH insulin for dexamethasone-induced hyperglycemia in patients with type 2 diabetes (T2DM) and COVID-19 infection.Methods:This retrospective study was conducted in adult inpatients with T2DM and COVID-19 infection who received 6 mg of dexamethasone once daily and insulin during the 5-day study period. The primary outcome was the difference in mean point-of-care (POC) BG levels between study insulins. Secondary outcomes included the incidence of hyperglycemia and hypoglycemia, length of stay, and the percent difference between the mean daily inpatient and home basal insulin doses (for patients who were receiving basal insulin prior to admission in the insulin glargine and insulin glargine and NPH insulin groups only).Results:Ninety-six patients were included in the analysis (67 insulin glargine, 10 NPH insulin, and 19 insulin glargine plus NPH insulin). The difference in mean POC BG level was not different among groups (254 ± 60 mg/dL vs 234 ± 39 mg/dL vs 250 ± 51 mg/dL, respectively; P = 0.548). There were no significant differences in the secondary outcomes.Conclusions:No difference in the mean POC BG level was observed. Dexamethasone-induced hyperglycemia was poorly controlled in patients with T2DM and COVID-19 infection.     

Metyrapone tests in patients with panic disorder.

BACKGROUND: Studies of hypothalamic secretion of corticotropin-releasing hormone (CRH) in patients with panic disorder in the nonpanic state (using CRH tests) are contradictory. No data about the hypothalamic-pituitary response to metyrapone are available. METHODS: Study participants included 14 patients with panic disorder (DSM-IV criteria) and 14 healthy control subjects who underwent a standard overnight metyrapone test and a combined metyrapone/low-dose dexamethasone test. RESULTS: Significant treatment effects of metyrapone and combined metyrapone/dexamethasone were found on plasma corticotropin, cortisol, and 11-deoxycortisol, but no differences between patients and control subjects emerged. Considering visual analogue scale ratings of anxiety, tension, restlessness, and Beck Depression Inventory scores as covariates, no group effects were detected. CONCLUSIONS: Standard overnight metyrapone tests do not support a hypersecretion of hypothalamic CRH in panic disorder. Furthermore, no evidence for increased glucocorticoid negative feedback in panic was found. Hypothalamic CRH secretion in the nonpanic state needs further research.     

Dexamethasone Increases Growth Hormone (GH)-Releasing Hormone (GRH) Receptor mRNA Levels in Cultured Rat Anterior Pituitary Cells

To examine the effects of glucocorticoid (GC) on growth hormone (GH)-releasing hormone (GRH) receptor gene expression, a highly-sensitive and quantitative reverse-transcribed polymerase chain reaction (RT-PCR) method was used in this study. Rat anterior pituitary cells were isolated and cultured for 4 days. The cultured cells were treated with dexamethasone for 2, 6, and 24  h. GRH receptor mRNA levels were determined by competitive RT-PCR using a recombinant RNA as the competitor. Dexamethasone significantly increased GRH receptor mRNA levels at 5  nM after 6- and 24  h-incubations, and the maximal effect was found at 25  nM. The GC receptor-specific antagonist, RU 38486 completely eliminated the dexamethasone-induced enhancement of GRH receptor mRNA levels. Dexamethasone did not alter the mRNA levels of β -actin and prolactin at 5  nM for 24  h, whereas GH mRNA levels were significantly increased by the same treatment. The GH response to GRH was significantly enhanced by the 24-h incubation with 5  nM dexamethasone. These findings suggest that GC stimulates GRH receptor gene expression through the ligand-activated GC receptors in the rat somatotrophs. The direct effects of GC on the GRH receptor gene could explain the enhancement of GRH-induced GH secretion.     

Abortive Migraine Therapy in the Office with Dexamethasone and Prochlorperazine

SYNOPSIS
Corticosteroids are commonly used in the abortive therapy of status migrainosus. However, this practice is based more on clinical experience than on published data. At my office, over a period of two years, 108 patients (156 migraine episodes) were treated with intravenous dexamethasone. Most of these patients had prolonged migraines that had resisted other forms of abortive therapy. The first 22 patients (32 migraine episodes) were given 10 mg of dexamethasone over 5 minutes, the next 39 patients (55 migraine episodes) were given 20 mg over 10 minutes, and the last 47 patients (69 migraine episodes) were given 3.5 mg of prochlorperazine over 5 minutes followed by 20 mg of dexamethasone over 10 minutes. Adverse effects were minor and patients with episodic migraines responded more favorably than those with intractable migraines. In the episodic migraine groups, response rates ranged from 80–89%, relapse rates from 29–35%, and remission rates from 57–83%. After the intravenous injections, repetitive oral abortive therapy was often required to treat relapses and secure remission. Adding 3.5 mg of pro-chlorperazine to 20 mg of intravenous dexamethasone significantly shortened the response time.     

地塞米松对哮喘豚鼠模型肺匀浆CC10的影响

目的:观察腹腔内注射地塞米松对豚鼠支气管哮喘模型肺组织Clara细胞蛋白10(CC10)的影响。方法:以27只健康豚鼠为实验动物,随机分为3组:即正常组、哮喘组和地塞米松(DEX)组。用卵蛋白致敏、雾化建立豚鼠哮喘模型,用酶联免疫吸附试验检测肺匀浆CC10的含量并观察其在组间的含量变化。结果:哮喘组豚鼠肺匀浆中CC10含量明显低于正常对照组(P<0.05);经DEX预处理后,肺匀浆CC10水平较哮喘组明显升高(P<0.05)。结论:CC10参与了哮喘的发病,可能是其中一种重要的内源性抗炎保护因子;而糖皮质激素在哮喘中的抗炎作用可能是通过提高CC10在肺组织的含量而实现的。