Can progesterone be a better alternative to dexamethasone for use in routine brain surgery？ Surgical brain injury （SBI） is a form of brain trauma caused by various forms of neurosurgical interventions including bra...Can progesterone be a better alternative to dexamethasone for use in routine brain surgery？ Surgical brain injury （SBI） is a form of brain trauma caused by various forms of neurosurgical interventions including brain tumor excision, evacuation of intracere- bral hemorrhage and brain lobectomv （e.g., in epililepsv surger）.展开更多
Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported i...Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported in medical literature but not common and corticosteroids are often cited. This report involved 2 male patients who developed persistent hiccups following use of oral dexamethasone for inflammatory conditions. The hiccups were severe and intolerable and could not stop despite use of metoclopramide and chlorpromazine. The hiccups only stopped following discontinuation of the dexamethasone. It should be noted that low dose of dexamethasone was used. Management of dexamethasone induced hiccups involves discontinuation of the drug, steroid rotation if the patient is steroid dependent and use of metoclopramide and chlorpromazine. Clinicians should be aware of this known but rare adverse effect of dexamethasone as it could be severe, distressful and negatively impart patients care. There is a need for a high index of suspicion whenever a patient develops hiccups while taking dexamethasone.展开更多
目的:探讨地塞米松(DEX)对大鼠中央髓鞘溶解症(CPM)的预防作用及机理。方法:通过皮下注射长效尿崩停针和腹腔注射2.5%葡萄糖液诱导大鼠低钠血症3 d,第4天腹腔注射1 m o l/L氯化钠液(高渗盐水)快速补钠的方法诱导大鼠CPM模型。DEX早期治...目的:探讨地塞米松(DEX)对大鼠中央髓鞘溶解症(CPM)的预防作用及机理。方法:通过皮下注射长效尿崩停针和腹腔注射2.5%葡萄糖液诱导大鼠低钠血症3 d,第4天腹腔注射1 m o l/L氯化钠液(高渗盐水)快速补钠的方法诱导大鼠CPM模型。DEX早期治疗组大鼠在注射高渗盐水同时肌注5 m g/kg DEX;DEX延迟治疗组大鼠在注射高渗盐水后24 h肌注5 m g/kg DEX;生理盐水治疗组大鼠在注射高渗盐水同时肌注生理盐水;另设正常对照组。观察大鼠脑组织脱髓鞘病变发生情况;测定脑内伊文思兰(EB)的含量变化;W estern b lot印迹法测定脑内一氧化氮合酶(iN-OS)的表达变化。结果:通过诱导低钠血症、快速补钠的方法成功建立了大鼠CPM模型。DEX早期治疗组、DEX延迟治疗组、生理盐水治疗组3组大鼠在快速补钠后0 h时点,脑内EB含量与正常对照组无明显差异(P>0.05)。生理盐水治疗组大鼠在快速补钠后6 h,脑内EB含量比0 h时点明显增加(P<0.05),24 h达高峰,同时脑内iNOS在快速补钠后3 h开始表达增强,36 h仍呈较强表达,脱髓鞘发生率为66.7%。DEX早期治疗组大鼠快速补钠后脑内EB含量及iNOS表达,均较同时点生理盐水治疗组明显下降,未见明显脱髓鞘病变。DEX延迟治疗组脱髓鞘病变发生率为75%,与生理盐水治疗组无明显差异(P>0.05)。结论:早期应用DEX能够通过保护血脑屏障和抑制脑内iN-OS表达,起到预防CPM的作用。展开更多
文摘Can progesterone be a better alternative to dexamethasone for use in routine brain surgery？ Surgical brain injury （SBI） is a form of brain trauma caused by various forms of neurosurgical interventions including brain tumor excision, evacuation of intracere- bral hemorrhage and brain lobectomv （e.g., in epililepsv surger）.
文摘Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported in medical literature but not common and corticosteroids are often cited. This report involved 2 male patients who developed persistent hiccups following use of oral dexamethasone for inflammatory conditions. The hiccups were severe and intolerable and could not stop despite use of metoclopramide and chlorpromazine. The hiccups only stopped following discontinuation of the dexamethasone. It should be noted that low dose of dexamethasone was used. Management of dexamethasone induced hiccups involves discontinuation of the drug, steroid rotation if the patient is steroid dependent and use of metoclopramide and chlorpromazine. Clinicians should be aware of this known but rare adverse effect of dexamethasone as it could be severe, distressful and negatively impart patients care. There is a need for a high index of suspicion whenever a patient develops hiccups while taking dexamethasone.
文摘目的:探讨地塞米松(DEX)对大鼠中央髓鞘溶解症(CPM)的预防作用及机理。方法:通过皮下注射长效尿崩停针和腹腔注射2.5%葡萄糖液诱导大鼠低钠血症3 d,第4天腹腔注射1 m o l/L氯化钠液(高渗盐水)快速补钠的方法诱导大鼠CPM模型。DEX早期治疗组大鼠在注射高渗盐水同时肌注5 m g/kg DEX;DEX延迟治疗组大鼠在注射高渗盐水后24 h肌注5 m g/kg DEX;生理盐水治疗组大鼠在注射高渗盐水同时肌注生理盐水;另设正常对照组。观察大鼠脑组织脱髓鞘病变发生情况;测定脑内伊文思兰(EB)的含量变化;W estern b lot印迹法测定脑内一氧化氮合酶(iN-OS)的表达变化。结果:通过诱导低钠血症、快速补钠的方法成功建立了大鼠CPM模型。DEX早期治疗组、DEX延迟治疗组、生理盐水治疗组3组大鼠在快速补钠后0 h时点,脑内EB含量与正常对照组无明显差异(P>0.05)。生理盐水治疗组大鼠在快速补钠后6 h,脑内EB含量比0 h时点明显增加(P<0.05),24 h达高峰,同时脑内iNOS在快速补钠后3 h开始表达增强,36 h仍呈较强表达,脱髓鞘发生率为66.7%。DEX早期治疗组大鼠快速补钠后脑内EB含量及iNOS表达,均较同时点生理盐水治疗组明显下降,未见明显脱髓鞘病变。DEX延迟治疗组脱髓鞘病变发生率为75%,与生理盐水治疗组无明显差异(P>0.05)。结论:早期应用DEX能够通过保护血脑屏障和抑制脑内iN-OS表达,起到预防CPM的作用。
