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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
Intravenous injection of methylprednisolone reduces the incidence of postextubation stridor in intensive care unit patients PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Treatment of early rheumatoid arthritis: A randomized magnetic resonance imaging study comparing the effects of methotrexate alone, methotrexate in combination with infliximab, and methotrexate in combination with intravenous pulse methylprednisolone. OBJECTIVE: To compare the effects of methotrexate (MTX), alone or in combination with intravenous (IV) methylprednisolone (MP) or infliximab, on magnetic resonance imaging (MRI)-detected synovitis, bone edema, and erosive changes in patients
12-h pretreatment with methylprednisolone versus placebo for prevention of postextubation laryngeal oedema: a randomised double-blind trial. The efficacy of corticosteroids in reducing the incidence of postextubation laryngeal oedema is controversial. We aimed to test our hypothesis that methylprednisolone started 12 h before a planned extubation could prevent postextubation laryngeal oedema.We did a placebo-controlled, double-blind multicentre trial in 761 adults in intensive-care units (...) . Patients who were ventilated for more than 36 h and underwent a planned extubation received intravenous 20 mg methylprednisolone (n=380) or placebo (381) 12 h before extubation and every 4 h until tube removal. The primary endpoint was occurrence of laryngeal oedema within 24 h of extubation. Laryngeal oedema was clinically diagnosed and deemed serious if tracheal reintubation was needed. Analyses were done on a per protocol and intention-to-treat basis. This trial is registered at ClinicalTrials.gov
2007LancetControlled trial quality: predicted high
Cyclophosphamide versus methylprednisolone for treating neuropsychiatric involvement in systemic lupus erythematosus. Neuropsychiatric involvement in systemic lupus erythematosus is complex and several clinical presentations are related to this disease such as: convulsions, chronic headache, transverse myelitis, vascular brain disease, psychosis and neural cognitive dysfunction. This systematic review is an update of a review performed in 2000.To assess the efficacy and safety (...) of cyclophosphamide and methylprednisolone in the treatment of neuropsychiatric manifestations of systemic lupus erythematosus.We searched EMBASE, LILACS, Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE up to and including May 2005. Additional articles were sought through handsearching in relevant journals. There were no language restrictions.All randomised controlled trials that compared cyclophosphamide to methylprednisolone were included. Patients of any age and gender were included
Methylprednisolone, valacyclovir, or the combination for vestibular neuritis. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo. Its assumed cause is a reactivation of herpes simplex virus type 1 infection. Therefore, corticosteroids, antiviral agents, or a combination of the two might improve the outcome in patients with vestibular neuritis.We performed a prospective, randomized, double-blind, two-by-two factorial trial in which patients with acute vestibular (...) neuritis were randomly assigned to treatment with placebo, methylprednisolone, valacyclovir, or methylprednisolone plus valacyclovir. Vestibular function was determined by caloric irrigation, with the use of the vestibular paresis formula (to measure the extent of unilateral caloric paresis) within 3 days after the onset of symptoms and 12 months afterward.Of a total of 141 patients who underwent randomization, 38 received placebo, 35 methylprednisolone, 33 valacyclovir, and 35 methylprednisolone plus