Evaluation of the function of polymorphonuclear neutrophilic leukocytes in healthy dogs given a high dose of methylprednisolone sodium succinate

2010 ◽  
Vol 71 (5) ◽  
pp. 541-546 ◽  
Author(s):  
Shunsuke Shimamura ◽  
Kozue Kanayama ◽  
Takuya Shimada ◽  
Kenichi Maeda ◽  
Ruriko Nakao ◽  
...  
Keyword(s):  
Sodium Succinate ◽  
High Dose ◽  
Methylprednisolone Sodium Succinate ◽  
Neutrophilic Leukocytes ◽  
Healthy Dogs

Treatment of Graves' ophthalmopathy with high-dose intravenous methylprednisolone pulse therapy

1987 ◽  
Vol 116 (4) ◽  
pp. 513-518 ◽  
Author(s):  
Yuji Nagayama ◽  
Motomori Izumi ◽  
Takeshi Kiriyama ◽  
Naokata Yokoyama ◽  
Shigeki Morita ◽  
...  
Keyword(s):  
Sodium Succinate ◽  
Total Duration ◽  
Pulse Therapy ◽  
Methylprednisolone Pulse Therapy ◽  
High Dose ◽  
Methylprednisolone Pulse ◽  
Methylprednisolone Sodium Succinate ◽  
Graves Ophthalmopathy ◽  
Preliminary Study ◽  
Intravenous Methylprednisolone Pulse

Abstract. This preliminary study was undertaken to investigate the efficacy of high-dose iv methylprednisolone pulse therapy in 5 patients with Graves' ophthalmopathy. One gram of methylprednisolone sodium succinate was given iv daily for 3 successive days. The 3-day infusion was repeated 3 to 7 times at intervals of 1 week; total duration of pulse therapy was 3 to 7 weeks. The clinical improvement of eye involvements by pulse therapy was assessed immediately after the last pulse therapy. The clinical assessment of the effect of pulse therapy for Graves' ophthalmopathy showed a good response in 3 patients, a fair response in one, and no response in one. However, in one patient, who was judged to show no response, complete improvement of the enlarged extraocular muscle was observed on orbital computed tomography. Moreover, two patients, who have been followed without any other therapies, showed no relapse of eye involvements for 32 and 10 months, respectively. Although it is impossible to determine whether pulse therapy is more effective than other immunosuppressive therapies, the results of this preliminary study suggest that pulse therapy may be a good immunosuppressive therapy for Graves' ophthalmopathy too. Controlled studies are desired.

scholarly journals A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Use of Methylprednisolone Sodium Succinate

2017 ◽  
Vol 7 (3_suppl) ◽  
pp. 203S-211S ◽  
Author(s):  
Michael G. Fehlings ◽  
Jefferson R. Wilson ◽  
Lindsay A. Tetreault ◽  
Bizhan Aarabi ◽  
Paul Anderson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Practice ◽  
Sodium Succinate ◽  
Acute Spinal Cord Injury ◽  
Adult Patients ◽  
High Dose ◽  
Methylprednisolone Sodium Succinate ◽  
Cord Injury

Introduction: The objective of this guideline is to outline the appropriate use of methylprednisolone sodium succinate (MPSS) in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to the use of MPSS in acute SCI. A multidisciplinary Guideline Development Group used this information, in combination with their clinical expertise, to develop recommendations for the use of MPSS. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as “we recommend,” whereas a weaker recommendation is indicated by “we suggest.” Results: The main conclusions from the systematic review included the following: (1) there were no differences in motor score change at any time point in patients treated with MPSS compared to those not receiving steroids; (2) when MPSS was administered within 8 hours of injury, pooled results at 6- and 12-months indicated modest improvements in mean motor scores in the MPSS group compared with the control group; and (3) there was no statistical difference between treatment groups in the risk of complications. Our recommendations were: (1) “We suggest not offering a 24-hour infusion of high-dose MPSS to adult patients who present after 8 hours with acute SCI”; (2) “We suggest a 24-hour infusion of high-dose MPSS be offered to adult patients within 8 hours of acute SCI as a treatment option”; and (3) “We suggest not offering a 48-hour infusion of high-dose MPSS to adult patients with acute SCI.” Conclusions: These guidelines should be implemented into clinical practice to improve outcomes and reduce morbidity in SCI patients.

High Dose Glucocorticoids in the Management of Severe Head Injury

Neurosurgery ◽  
1984 ◽  
Vol 15 (4) ◽  
pp. 497-501 ◽  
Author(s):  
Steven L. Giannotta ◽  
Martin H. Weiss ◽  
Michael L.J. Apuzzo ◽  
Evangeline Martin
Keyword(s):  
Dose Group ◽  
Low Dose ◽  
Sodium Succinate ◽  
Assisted Ventilation ◽  
High Dose Group ◽  
High Dose ◽  
Monitoring And Control ◽  
Methylprednisolone Sodium Succinate ◽  
Significant Difference ◽  
And Control

Abstract Eighty-eight patients with a Glasgow coma score of 8 or less 6 hours after nonpenetrating head trauma were given either high dose methylprednisolone sodium succinate (30 mg/kg q6h ×2, then 250 mg q6h ×6, then tapering over 8 days), low dose methylprednisolone (1.5 mg/kg q6h ×2, then 25 mg q6h ×6, then tapering over 8 days), or placebo. Standard care including the removal of traumatic hematomas, assisted ventilation, and intracranial pressure monitoring and control was carried out. Follow-up assessments were performed on all surviving patients at 6 months and were graded according to the Glascow outcome scale. No statistically significant difference in outcome was seen between the low dose group and the placebo group. The high dose group experienced a mortality of 39% as compared to a 52% mortality in the low dose and placebo groups (P < 0.05). Mortality differences were most marked in patients less than 40 years old, with the high dose group experiencing a mortality of 6% as compared to a 43% mortality for the low dose and placebo groups (P < 0.05). For patients under 50 years old, the incidence of recovery of speech was 62% compared to 36% in the low dose and placebo groups (P < 0.5). The increased survival in those treated with high dose corticoids, however, was associated with an increase in the poorer outcome categories.

scholarly journals Lessons learned from administration of high-dose methylprednisolone sodium succinate for acute pediatric spinal cord injuries

2017 ◽  
Vol 20 (6) ◽  
pp. 567-574 ◽  
Author(s):  
Michelle C. Caruso ◽  
Margot C. Daugherty ◽  
Suzanne M. Moody ◽  
Richard A. Falcone ◽  
Karin S. Bierbrauer ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Benefit ◽  
Spinal Cord Injuries ◽  
Sodium Succinate ◽  
Pediatric Trauma ◽  
Penetrating Trauma ◽  
High Dose ◽  
Steroid Use ◽  
Methylprednisolone Sodium Succinate ◽  
Cord Injury

OBJECTIVEMethylprednisolone sodium succinate (MPSS) has been studied as a pharmacological adjunct that may be given to patients with acute spinal cord injury (ASCI) to improve neurological recovery. MPSS treatment became the standard of care in adults despite a lack of evidence supporting clinical benefit. More recently, new guidelines from neurological surgeon groups recommended no longer using MPSS for ASCI, due to questionable clinical benefit and known complications. However, little information exists in the pediatric population regarding MPSS use in the setting of ASCI. The aim of this paper was to describe steroid use and side effects in patients with ASCI at the authors’ Level 1 pediatric trauma center in order to inform other hospitals that may still use this therapy.METHODSA retrospective chart review was conducted to determine adherence in ordering and delivery according to the guideline of the authors’ institution and to determine types and frequency of complications. Inclusion criteria included age < 17 years, blunt trauma, physician concern for ASCI, and admission for ≥ 24 hours or treatment with high-dose intravenous MPSS. Exclusion criteria included penetrating trauma, no documentation of ASCI, and incomplete medical records. Charts were reviewed for a predetermined list of complications.RESULTSA total of 602 patient charts were reviewed; 354 patients were included in the study. MPSS was administered in 59 cases. In 34 (57.5%) the order was placed correctly. In 13 (38.2%) of these 34 cases, MPSS was administered according to the recommended timeline protocol. Overall, only 13 (22%) of 59 patients received the therapy according to protocol with regard to accurate ordering and administration.Among the patients with ASCI, 20 (55.6%) of the 36 who received steroids had complications, which was a significantly higher rate than in those who did not receive steroids (8 [24.2%] of 33, p = 0.008). Among the patients without ASCI, 10 (43.5%) of the 23 who received steroids also experienced significantly more complications than patients who did not receive steroids (50 [19.1%] of 262, p = 0.006).CONCLUSIONSHigh-dose MPSS for ASCI was not delivered to pediatric patients according to protocol with a high degree of reliability. Patients receiving steroids for pediatric ASCI were significantly more likely to experience complications than patients not receiving steroids. The findings presented, including complications of steroid use, support removal of high-dose MPSS as a treatment option for pediatric ASCI.

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