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Latest & greatest articles for methylprednisolone
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Randomized clinical trial of prevention of seroma formation after mastectomy by local methylprednisolone injection Seroma formation, the most prevalent postoperative complication after mastectomy, is an inflammatory process that is potentially preventable via local steroid administration. This study investigated the effect of local steroid administration on seroma formation.This was a double-blind randomized placebo-controlled intervention study of a single dose of 80 mg methylprednisolone (...) and complications.A total of 212 women scheduled for mastectomy for primary breast cancer were included. After M + SLNB, 32 (46 per cent) of 69 women developed a seroma in the methylprednisolone group, compared with 52 (78 per cent) of 67 in the saline group (P < 0.001). The mean cumulative seroma volume in the intention-to-treat population for the first 10 and 30 days was significantly lower in the methylprednisolone group (24 ml versus 127 ml in the saline group, and 177 versus 328 ml respectively) (P < 0.001
Efficacy of Triamcinolone Hexacetonide versus Methylprednisolone Acetate Intraarticular Injections in Knee Osteoarthritis: A Randomized, Double-blinded, 24-week Study Intraarticular (IA) corticosteroid injections are broadly used in knee osteoarthritis (OA); however, the best corticosteroid agent is not well defined. The aim of the present study was to compare the efficacy of triamcinolone hexacetonide (TH) and methylprednisolone acetate (MA) injections in knee OA.Patients with symptomatic knee
Effect of Timing and Route of Methylprednisolone Administration During Pediatric Cardiac Surgical Procedures We compared the antiinflammatory and cardioprotective effects of the two most common regimens of corticosteroid administration in pediatric cardiac surgical procedures: a single dose delivered either at anesthesia induction or by cardiopulmonary bypass (CPB) prime.Forty-five children, aged between 1 and 18 months and undergoing ventricular septal or atrioventricular septal defect (...) correction, were randomized in double-blind fashion into three groups. The anesthesia induction group received 30 mg/kg methylprednisolone intravenously after anesthesia induction, and the CPB-prime group received 30 mg/kg methylprednisolone by CPB circuit. The placebo group received saline solution. Plasma concentrations of methylprednisolone, interleukin (IL)-6, IL-8 and IL-10, and troponin were measured at anesthesia induction before the study drug, 30 minutes on CPB, after patients were weaned from
Meta-analysis of methylprednisolone pulse therapy for Graves' ophthalmopathy Meta-analysis of methylprednisolone pulse therapy for Graves' ophthalmopathy Meta-analysis of methylprednisolone pulse therapy for Graves' ophthalmopathy Gao G, Dai J, Qian Y, Ma F CRD summary The review concluded that intravenous glucocorticoid therapy (steroids injected into the bloodstream) were more efficient in treating people with active and moderate-to-severe Graves’ ophthalmopathy (eye disease linked (...) up. Most of the included trials compared intravenous with oral glucocorticoids. Most included patients had not received any prior treatment. The authors stated that methylprednisolone doses ranged from 4.5g to 12g (but no further details for individual trials were provided). Treatment durations ranged from three to 13 months. Three-quarters of patients were female and most had moderate-to-severe disease (patients had severe disease in one trial). Mean ages ranged from 32 to 56 years. The trials
Clinical findings for fungal infections caused by methylprednisolone injections. Since September 18, 2012, public health officials have been investigating a large outbreak of fungal meningitis and other infections in patients who received epidural, paraspinal, or joint injections with contaminated lots of methylprednisolone acetate. Little is known about infections caused by Exserohilum rostratum, the predominant outbreak-associated pathogen. We describe the early clinical course of outbreak
Methylprednisolone injections for the carpal tunnel syndrome: a randomized, placebo-controlled trial. Steroid injections are used in idiopathic carpal tunnel syndrome (CTS), but evidence of efficacy beyond 1 month is lacking.To assess the efficacy of local methylprednisolone injections in CTS.Randomized, placebo-controlled trial. (ClinicalTrials.gov: NCT00806871).Regional referral orthopedic department in Sweden.Patients aged 18 to 70 years with CTS but no previous steroid injections.Three (...) groups (37 patients each) received 80 mg of methylprednisolone, 40 mg of methylprednisolone, or placebo. The patients and treating surgeons were blinded.Primary end points were the change in CTS symptom severity scores at 10 weeks (range, 1 to 5) and rate of surgery at 1 year. Three patients had missing 10-week data. All patients had 1-year data.Improvement in CTS symptom severity scores at 10 weeks was greater in patients who received 80 mg of methylprednisolone and 40 mg of methylprednisolone than
Relapse of Fungal Meningitis Associated with Contaminated Methylprednisolone. 23718153 2013 07 16 2018 12 03 1533-4406 368 26 2013 Jun 27 The New England journal of medicine N. Engl. J. Med. Relapse of fungal meningitis associated with contaminated methylprednisolone. 2535-6 10.1056/NEJMc1306560 Smith Rachel M RM Tipple Margaret M Chaudry Muddasar N MN Schaefer Melissa K MK Park Benjamin J BJ eng Case Reports Letter 2013 05 29 United States N Engl J Med 0255562 0028-4793 0 Antifungal Agents 0 (...) Pyrimidines 0 Triazoles 43502P7F0P Methylprednisolone Acetate JFU09I87TR Voriconazole X4W7ZR7023 Methylprednisolone AIM IM Aged, 80 and over Antifungal Agents administration & dosage Drug Administration Schedule Drug Contamination Humans Injections, Epidural adverse effects Male Meningitis, Fungal drug therapy etiology Methylprednisolone adverse effects analogs & derivatives Methylprednisolone Acetate Pyrimidines administration & dosage Recurrence Saccharomycetales Triazoles administration & dosage
Cyclophosphamide versus methylprednisolone for treating neuropsychiatric involvement in systemic lupus erythematosus. Neuropsychiatric involvement in systemic lupus erythematosus (SLE) is complex and it is an important cause of morbidity and mortality. Management of nervous system manifestations of SLE remains unsatisfactory. This is an update of a Cochrane review first published in 2000 and previously updated in 2006.To assess the benefits and harms of cyclophosphamide and methylprednisolone (...) in the treatment of neuropsychiatric manifestations of SLE.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, SCOPUS and WHO up to and including June 2012. We sought additional articles through handsearching in relevant journals as well as contact with experts. There were no language restrictions.We included all randomised controlled trials that compared cyclophosphamide to methylprednisolone in patients with SLE of any age and gender and presenting with any kind
Long-term follow-up of a randomised controlled trial of azathioprine/methylprednisolone versus cyclophosphamide in patients with proliferative lupus nephritis The objectives of this study are to analyse the long-term follow-up of a randomised controlled trial of induction treatment with azathioprine/methylprednisolone (AZA/MP) versus high-dose intravenous cyclophosphamide (ivCY) in patients with proliferative lupus nephritis (LN) and to evaluate the predictive value of clinical, laboratory
Fungal Infections Associated with Contaminated Methylprednisolone in Tennessee. We investigated an outbreak of fungal infections of the central nervous system that occurred among patients who received epidural or paraspinal glucocorticoid injections of preservative-free methylprednisolone acetate prepared by a single compounding pharmacy.Case patients were defined as patients with fungal meningitis, posterior circulation stroke, spinal osteomyelitis, or epidural abscess that developed after (...) amphotericin B. Eight patients (12%) died, seven of whom had stroke.We describe an outbreak of fungal meningitis after epidural or paraspinal glucocorticoid injection with methylprednisolone from a single compounding pharmacy. Rapid recognition of illness and prompt initiation of therapy are important to prevent complications. (Funded by the Tennessee Department of Health and the Centers for Disease Control and Prevention.).
Fungal Infections Associated with Contaminated Methylprednisolone Injections - Preliminary Report. 23083312 2013 07 16 2014 11 20 1533-4406 368 26 2013 Jun 27 The New England journal of medicine N. Engl. J. Med. Fungal infections associated with contaminated methylprednisolone injections. 2495-500 10.1056/NEJMra1212617 Kauffman Carol A CA Division of Infectious Diseases, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, Ann Arbor, MI 48105, USA. ckauff (...) @umich.edu Pappas Peter G PG Patterson Thomas F TF eng Journal Article Review 2012 10 19 United States N Engl J Med 0255562 0028-4793 0 Antifungal Agents 0 Pyrimidines 0 Triazoles JFU09I87TR Voriconazole X4W7ZR7023 Methylprednisolone AIM IM Antifungal Agents administration & dosage adverse effects therapeutic use Aspergillus fumigatus isolation & purification Cerebrospinal Fluid microbiology Disease Outbreaks Drug Compounding Drug Contamination Drug Monitoring Humans Injections, Spinal adverse effects
A Comparison Between Dexamethasone and Methylprednisolone for Vomiting Prophylaxis After Tonsillectomy in Inpatient Children: A Randomized Trial The frequent incidence of postoperative vomiting in children undergoing tonsillectomy, in addition to the occurrence of severe pain, may delay postoperative oral intake and lead to increased risk of dehydration. Thus, prophylactic therapy is indicated in this high-risk group. Glucocorticoids, such as dexamethasone and methylprednisolone, have anti (...) -inflammatory and antiemetic properties with dexamethasone being frequently used. We hypothesized that methylprednisolone should be noninferior to dexamethasone for the prevention of vomiting in children after tonsillectomy.We designed a randomized double-blind trial to compare the efficacy of a single prophylactic dose of 0.5 mg/kg dexamethasone with a dose of 2.5 mg/kg methylprednisolone on the incidence of postoperative vomiting during the first 24 hours (primary outcome) in children undergoing total
Perioperative methylprednisolone and outcome in neonates undergoing heart surgery Recent studies have called into question the benefit of perioperative corticosteroids in children undergoing heart surgery, but have been limited by the lack of placebo control, limited power, and grouping of various steroid regimens together in analysis. We evaluated outcomes across methylprednisolone regimens versus no steroids in a large cohort of neonates.Clinical data from the Society of Thoracic Surgeons (...) Database were linked to medication data from the Pediatric Health Information Systems Database for neonates (≤30 days) undergoing heart surgery (2004-2008) at 25 participating centers. Multivariable analysis adjusting for patient and center characteristics, surgical risk category, and within-center clustering was used to evaluate the association of methylprednisolone regimen with outcome.A total of 3180 neonates were included: 22% received methylprednisolone on both the day before and day of surgery
Oral Methylprednisolone in Pediatric Acute Pyelonephritis Alleviates Renal Scarring To determine if glucocorticoids can prevent renal scar formation after acute pyelonephritis in pediatric patients.Patients younger than 16 years diagnosed with their first episode of acute pyelonephritis with a high risk of renal scar formation (ie, inflammatory volume ≥ 4.6 mL on technetium-99m-labeled dimercaptosuccinic acid scan [DMSA] or abnormal renal ultrasonography results) were randomly assigned (...) to receive either antibiotics plus methylprednisolone sodium phosphate (1.6 mg/kg per day for 3 days [MPD group]) or antibiotics plus placebo (placebo group) every 6 hours for 3 days. Patients were reassessed by using DMSA 6 months after treatment. The primary outcome was the development of renal scars.A total of 84 patients were enrolled: 19 in the MPD group and 65 in the placebo group. Patient characteristics were similar between the 2 groups, including the acute inflammatory parameters and the initial
Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis: a double-blind, placebo-controlled randomized trial The place of systemic corticosteroids in the treatment of children with chronic rhinosinusitis (CRS) remains unclear.We sought to assess the effectiveness and tolerability of oral methylprednisolone as an anti-inflammatory adjunct in the treatment of CRS in children.Forty-eight children (age, 6-17 years) with clinically (...) and radiologically proved CRS were included. Patients were randomly assigned to either oral amoxicillin/clavulanate (AMX/C) and methylprednisolone or AMX/C and placebo twice daily for 30 days. Oral methylprednisolone was administered for the first 15 days with a tapering schedule. Primary parameters were mean change in symptom and sinus computed tomographic (CT) scan scores after treatment. Secondary study parameters were mean changes in individual symptom scores after treatment, relapse rate
Efficacy of periarticular injection of bupivacaine, fentanyl, and methylprednisolone in total knee arthroplasty:a prospective, randomized trial We evaluated the efficacy of periarticular infiltration of corticosteroid, opioid, and a local anesthetic by comparing pain scores, knee flexion, and quadriceps function on the day of surgery, first postoperative day, day of discharge, and 2 and 4 weeks after surgery between the infiltrated and the noninfiltrated knee in 40 patients undergoing
Methylprednisolone in combination with interferon beta-1a for relapsing-remitting multiple sclerosis (MECOMBIN study): a multicentre, double-blind, randomised, placebo-controlled, parallel-group trial Interferon beta is commonly used to treat patients with relapsing-remitting multiple sclerosis; however, the treatment is only partially effective in reducing relapses and progression of disability. Corticosteroids are used to treat relapses in patients with multiple sclerosis. We therefore aimed (...) to investigate the combination of cyclic methylprednisolone and interferon beta for the treatment of relapsing-remitting multiple sclerosis.In 2001, we designed a multicentre, double-blind, randomised, parallel-group trial, termed the methylprednisolone in combination with interferon beta-1a for relapsing-remitting multiple sclerosis (MECOMBIN) study. Patients were recruited between October, 2002, and March, 2005 from 50 neurology departments in eight countries. We included treatment-naive patients
A double-blind randomised controlled study comparing subacromial injection of tenoxicam or methylprednisolone in patients with subacromial impingement We have carried out a prospective double-blind randomised controlled trial to compare the efficacy of a single subacromial injection of the non-steroidal anti-inflammatory drug, tenoxicam, with a single injection of methylprednisolone in patients with subacromial impingement. A total of 58 patients were randomly allocated into two groups. Group (...) A received 40 mg of methylprednisolone and group B 20 mg of tenoxicam as a subacromial injection along with lignocaine. The Constant-Murley shoulder score was used as the primary outcome measure and the Disability of Arm, Shoulder and Hand (DASH) and the Oxford Shoulder Score (OSS) as secondary measures. Six weeks after injection the improvement in the Constant-Murley score was significantly greater in the methylprednisolone group (p = 0.003) than in the tenoxicam group. The improvement in the DASH score
A short-term randomized MRI study of high-dose oral vs intravenous methylprednisolone in MS To compare the efficacy, tolerability, and safety of IV methylprednisolone (IV MP) vs oral methylprednisolone (oMP) at equivalent high doses in patients with multiple sclerosis (MS) experiencing a recent relapse.Patients with a clinical relapse within the previous 2 weeks and at least 1 gadolinium (Gd)-enhancing lesion on a screening brain MRI scan were included. Forty patients with MS were randomized (...) profiles of the 2 routes of administration.The 2 groups showed a reduction of Gd-enhancing lesions over time (p = 0.002 for oMP and p = 0.001 for IV MP) with a "non-inferiority effect" between the 2 routes of administration at week 1. Both groups showed an improvement of EDSS over time (p < 0.001) without between-group difference at week 4. Both treatments were well-tolerated and adverse events were minimal and occurred similarly in the 2 treatment arms.Oral methylprednisolone (oMP) is as effective