Kenalog
Effect of steroid injections on the rotator cuff: an experimental study in rats.

Tillander B, Franzen LE, Karlsson MH, Norlin R.

Department of Orthopaedics, University Hospital, Linkoping, Sweden.

The aim of this study was to evaluate the effects of repeated steroid injections into the subacromial space. Thirty rats were injected either 3 or 5 times with triamcinolone in a dosage equivalent to that given to human beings or 3 or 5 times with saline into the subacromial space. One rat received no injection. The supraspinatus and infraspinatus tendons were evaluated macroscopically and microscopically. Two different staining methods were used on each sample including hematoxylin eosin and Miller's elastin/van Gieson's solution. After 5 steroid injections, we found focal inflammation, necrosis, and fragmentation of collagen bundles in the tendon in 4 of 7 rats. The tendons of the controls showed a normal structure (P < .05). There were no pathologic changes among the rats that were injected with triamcinolone 3 times. These results show that repeated subacromial injections of triamcinolone may cause damage to the rotator cuff of the rat. This finding may indicate cautious use of subacromial steroid injections in human beings.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10389085&dopt=Abstract triamcinolone Kenalog



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Prevention of experimental proliferative vitreoretinopathy with daunomycin and triamcinolone based on the time course of the disease.

Hui YN, Hu D.

Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University, Xian, People's Republic of China.

BACKGROUND: Our previous experiments showed a limited effect of treatment with daunomycin when given at the inflammatory phase of the development of proliferative vitreoretinopathy (PVR) induced by macrophages in rabbits. In the present study, we tested the efficacy of daunomycin when given at the proliferative phase and combined with triamcinolone given separately at the inflammatory phase in the same model. METHODS: Four groups of rabbits, 16 animals in each, respectively received 5 microg daunomycin on day 6; 1 mg triamcinolone immediately after macrophage injection; 1 mg triamcinolone immediately and 5 microg daunomycin on day 6 (combined drugs); and 0.1 ml saline (controls). Ophthalmoscopy and 3H-thymidine autoradiography were use to evaluate the effects of drugs on traction retinal detachments and cellular proliferation in the vitreous and on the retina. RESULTS: Retinal detachment occurred in 33.3%, 16.1%, 8.3% and 83.3% (P<0.01) of the eyes treated with daunomycin, triamcinolone, combined drugs, and the controls, respectively. Autoradiography revealed significantly decreased numbers of labelled nuclei on days 7 and 14 in daunomycin-treated eyes compared with controls. Significantly decreased numbers of inflammatory cells and labelled cells were noted in eyes treated with triamcinolone and combined drugs. CONCLUSION: Daunomycin given at the proliferative phase, and combined with triamcinolone given at the inflammatory phase of PVR, can be more effective in preventing PVR development than daunomycin given at the inflammatory phase.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10424311&dopt=Abstract triamcinolone Kenalog



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Determination of betamethasone and triamcinolone acetonide by GC-NCI-MS in excreta of treated animals and development of a fast oxidation procedure for derivatisation of corticosteroids.

Courtheyn D, Vercammen J, Logghe M, Seghers H, De Wasch K, De Brabander H.

State Laboratory (ROLG), Ghent, Belgium.

The use of corticosteroids in combination with other hormonal substances has long been known to result in increased mass gain with bovines. Practice has demonstrated, however, that even the single use of a glucocorticoid may result in growth promoting effects. In addition to the popular dexamethasone, more recently other corticosteroids have also been misused for fattening purposes. The first part of this study deals with the detection of two of them, namely betamethasone and triamcinolone acetonide. Betamethasone was administered orally to a cow at a dose of 50 mg d-1 for 5 d, then later the same cow was injected intramuscularly with a dose of 50 mg of betamethasone dipropionate. Excretion in urine and faeces was followed with both HPLC-enzyme immunoassay and a previously described method based on negative chemical ionization mass spectrometry (NCI-MS) after oxidation. For the triamcinolone acetonide study a cow was treated with 50 mg d-1 of the drug during a 7 d period. Excretion in faeces was followed with GC-NCI-MS. As triamcinolone acetonide is resistant to the previously described oxidation procedure, however, a hydrolysis step had to be introduced prior to oxidation. In addition to this specific modification necessary for triamcinolone acetonide, in a subsequent part of this study the original oxidation procedure with pyridinium chlorochromate was re-investigated especially to shorten the procedure. With the introduction of potassium dichromate the reaction time could be decreased from 3 h to 10 min.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10435270&dopt=Abstract triamcinolone Kenalog



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Effects of high-dose inhaled corticosteroids on plasma cortisol concentrations in healthy adults.

Brus R.

IntroGene BV, Leiden, the Netherlands.

BACKGROUND: Recent studies suggest that inhaled corticosteroids may differ significantly in their systemic effects. OBJECTIVE: To compare the systemic effects, as measured by plasma cortisol suppression, of inhaled beclomethasone dipropionate, budesonide, flunisolide, fluticasone propionate, and triamcinolone acetonide at doses of approximately 1000 microg twice daily. METHODS: Sixty healthy adult male volunteers participated in this randomized, open-label, parallel-design study. Twenty-four-hour plasma cortisol determinations (cortisol-AUC24) were measured after a single dose of placebo medication and after a single dose and 7 consecutive doses of active medication. RESULTS: After a single dose, all inhaled corticosteroid preparations caused statistically significant mean reductions in cortisol-AUC24 compared with placebo as follows: flunisolide, 7% (P= .02); budesonide, 16% (P= .001); beclomethasone, 18% (P= .003); triamcinolone, 19% (P=.001); and fluticasone, 35% (P<.001). After multiple doses, flunisolide was not significantly different from placebo (5%; P = .24), while budesonide (18%; P = .002), triamcinolone (25%; P<.001), beclomethasone (28%; P<.001), and fluticasone (79%; P<.001) all resulted in statistically significant suppression of cortisol-AUC24. After both single and multiple doses, beclomethasone, budesonide, flunisolide, and triamcinolone were not statistically different from each other, while fluticasone was significantly (P<.001) more suppressive than the other 4 medications. CONCLUSIONS: These results indicate that there are differences in the systemic effects of inhaled corticosteroids when used in high doses and emphasize the importance of using the minimum dose of inhaled corticosteroids required to maintain control of asthma symptoms.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10493320&dopt=Abstract triamcinolone Kenalog



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Intravitreal triamcinolone acetonide for exudative age related macular degeneration.

Jonas JB, Kreissig I, Hugger P, Sauder G, Panda-Jonas S, Degenring R.

Department of Ophthalmology and Eye Hospital, Faculty for Clinical Medicine Mannheim, Ruprecht-Karls-University Heidelberg, Germany. JostJonas augen.ma.uni-heidelberg.de

AIM: To evaluate the effect of intravitreal triamcinolone acetonide on the visual acuity of patients with exudative age related macular degeneration, to assess the duration of a possible effect, and to evaluate clinical side effects of the treatment. METHODS: The study included 67 patients (71 eyes) who presented with exudative age related macular degeneration of predominantly or total occult type (n = 68) or classic type (n = 3), and who received once, or repeatedly, an intravitreal injection of 25 mg of crystalline triamcinolone acetonide. Mean follow up time was 7.46 (SD 3.54) months (range 3.1-19.57 months). RESULTS: Visual acuity increased significantly (p <0.001) from 0.16 (0.11) to a mean maximum of 0.23 (0.17). Postoperative visual acuity was highest 1-3 months after the injection. 47 (66.2%) eyes gained in maximal visual acuity and 11 (15.5%) eyes lost in visual acuity. Intraocular pressure increased significantly (p <0.001) from 15.1 (3.1) mm Hg at baseline to a maximal value of 23.0 (8.25) mm Hg. At the end of follow up, intraocular pressure again decreased significantly (p<0.001) to 16.8 (4.9) mm Hg. No cases of postoperative infectious endophthalmitis, rhegmatogenous retinal detachment, or proliferative vitreoretinopathy occurred. Owing to a decrease in visual acuity after an initial increase, six patients received a second intravitreal triamcinolone acetonide injection after which visual acuity increased again in three eyes. CONCLUSIONS: Intravitreal injection of 25 mg of crystalline triamcinolone acetonide merits further study for the treatment of exudative age related macular degeneration.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12642311&dopt=Abstract triamcinolone Kenalog



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Intravitreal triamcinolone and elevated intraocular pressure.

Wingate RJ, Beaumont PE.

rwingate internet-australia.com

PURPOSE: To ascertain whether intravitreal triamcinolone given for subretinal neovascularization is associated with an ocular pressure rise. METHODS: A total of 113 patients with angiographically proven subretinal neovascularization were enrolled into a prospective study of the effects of intravitrea triamcinolone. Intraocular pressure was one of the parameters studied. RESULTS: Approximately 30% of the study group developed a significant rise (> or =5 mm Hg) in intraocular pressure above baseline during the first 3 months. CONCLUSIONS: Patients considering this form of treatment should be fully informed of the known risks of intraocular injections of steroids.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10641903&dopt=Abstract triamcinolone Kenalog