prednisolone-hemisuccinate and Acute-Disease

Topics: Acute Disease; Addison Disease; Adenoma; Adrenal Cortex Diseases; Adrenal Cortex Neoplasms; Adrenal Insufficiency; Adrenalectomy; Adrenergic Agents; Adrenocortical Adenoma; Adrenocortical Hyperfunction; Anti-Inflammatory Agents; Antineoplastic Agents; Cushing Syndrome; Dexamethasone; Fludrocortisone; Humans; Hydrocortisone; Hyperaldosteronism; Mineralocorticoids; Prednisolone

The aim of the present study was to investigate the efficacy of i.v. immune globulin (IVIG) therapy combined with corticosteroids for additional treatment of acute Kawasaki disease (KD) unresponsive to initial IVIG treatment.. In 50 prospective KD patients, six IVIG non-responders without clinical improvement within 24-48 h after completion of initial IVIG, received 2 g/kg IVIG concurrently with 2 mg/kg i.v. prednisolone sodium succinate (PSL) until normalization of C-reactive protein level. Treatment was then changed to oral PSL, which was tapered over time. Clinical and coronary artery lesion (CAL) outcomes were compared with those of 13 IVIG non-responders who received additional heterogeneous therapies in 125 retrospective KD patients. In addition, the scoring system of Kobayashi et al. for prediction of non-responsiveness to initial IVIG treatment was retrospectively verified in 175 KD subjects, consisting of 50 prospective and 125 retrospective patients in order to evaluate the efficacy of the re-treatment regimen.. Incidence of CAL in the study patients was lower than in the control patients, although differences were not significant both in the acute stage (within 1 month: 1/6, 16.7% vs 7/13, 53.8%; P= 0.177) and in the convalescent stage (after 1 month: 0/6, 0.0% vs 4/13, 30.8%; P= 0.255). According to the non-responder prediction system, the scores of six study and 13 control patients before initial IVIG treatment were similar (7.2 ± 1.9 vs 5.3 ± 3.1; P= 0.200). No serious adverse effects related to each treatment were noted in patients of either group.. Additional IVIG combined with concurrent PSL appears to be safe and worth evaluation for the treatment of acute KD unresponsive to initial IVIG treatment.

Topics: Acute Disease; Child, Preschool; Drug Administration Schedule; Drug Therapy, Combination; Female; Glucocorticoids; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Infant; Male; Mucocutaneous Lymph Node Syndrome; Prednisolone

Hemorrhagic shock was induced in nonsplenectomized dogs by removing 41% of their blood volume over a 15-minute period. Hemodynamic and metabolic variables were determined prior to and for 3 hours after completion of hemorrhage. One group of 5 dogs was not treated. After the 30-minute sample was collected, a second group of 5 dogs was given lactated Ringer solution (LRS) at 88 ml/kg of body weight, IV. A third group of 5 dogs was given LRS (88 ml/kg, IV) and prednisolone sodium succinate (11 mg/kg, IV) 30 minutes after hemorrhage. The IV administration of LRS was completed within 15 minutes. The glucocorticoid was administered as an IV bolus after 500 ml of LRS had been given. The large volume and administration of LRS significantly (P = 0.05) improved many of the hemodynamic and metabolic effects of acute hemorrhage and hemorrhagic shock. At one time or another during the 2.5-hour observation period after the initiation of treatment, mean arterial pressure, cardiac index, systemic vascular resistance, heart rate, respiratory rate, lactate, glucose, and arterial and venous blood gas values were significantly (P = 0.05) improved, compared with baseline values. The addition of prednisolone sodium succinate to the treatment regimen improved the effectiveness of LRS alone only in some dogs at random sampling times. Significant trends were not observed except, possibly, the improvement of venous pH and A-V pH and PCO2 differences.

Topics: Acute Disease; Animals; Blood Glucose; Blood Pressure; Carbon Dioxide; Cardiac Output; Chemotherapy, Adjuvant; Dog Diseases; Dogs; Heart Rate; Hemoglobins; Hydrogen-Ion Concentration; Infusions, Intravenous; Isotonic Solutions; Lactates; Oxygen; Prednisolone; Respiration; Ringer's Solution; Shock, Hemorrhagic; Vascular Resistance

A case of cortical blindness developed in an infant who suffered from congenital adrenal hyperplasia and was hospitalized for enteritis is reported. The severe but transient hypertension recorded raises the possibility that the increased doses of steroid administered may have contributed to the pathogenesis of visual impairment.

Topics: Acute Disease; Adrenal Hyperplasia, Congenital; Blindness; Cerebral Cortex; Drug Synergism; Evoked Potentials, Visual; Fludrocortisone; Humans; Hypertension; Infant; Male; Prednisolone

The intravenous pulsed treatment with prednisone hemisuccinate of severe forms of systemic lupus erythematosus influences favorably the basic clinical manifestations of the disease--polyarthritis, fever, vasculitis, myocarditis, sialoadenitis. Prednisolone is as efficient as methylprednisolone in the pulsed treatment of patients with systemic lupus erythematosus.

Topics: Acute Disease; Administration, Oral; Drug Evaluation; Humans; Infusions, Intravenous; Lupus Erythematosus, Systemic; Prednisolone

Corticosteroid esters have been encapsulated into intact erythrocytes and used as an intravenous treatment for adjuvant induced arthritis in the rat. The treatment consisted of injections of the encapsulated steroids with the effects monitored for up to 14 days. On an equivalent weight basis both encapsulated cortisol-21-phosphate and prednisolone-21-sodium hemisuccinate proved superior to the free steroid esters administered in solution by injection.

Topics: Acute Disease; Animals; Arthritis; Arthritis, Experimental; Chronic Disease; Erythrocytes; Hydrocortisone; Male; Prednisolone; Rats; Rats, Inbred Strains