Injection Of Betamethasone Research Articles

General health and social outcomes 50 years after exposure to antenatal betamethasone: follow-up of a randomised controlled trial

BackgroundAntenatal corticosteroids are recommended for women at risk of preterm birth from 24 to 34 weeks’ gestation as they reduce neonatal morbidity and mortality, but evidence regarding their long-term effects on offspring is limited. This study assessed general health and social outcomes 50 years after antenatal exposure to corticosteroids.MethodsWe assessed 424 adult offspring of women who participated in the first randomised, double-blind, placebo-controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome. The first 717 mothers received two intramuscular injections of betamethasone (6 mg betamethasone sodium phosphate and 6 mg betamethasone acetate) or placebo given 24 h apart and the subsequent 398 received two injections of double dose betamethasone (12 mg betamethasone sodium phosphate and 12 mg betamethasone acetate) or equivalent volume of placebo. Follow-up included a health questionnaire and consent for access to administrative data sources. Outcome categories included mental health (depression, anxiety, bipolar affective disorder, schizophrenia and treatment or hospital admission for any mental health disorder), general health (chronic kidney disease, cancer diagnosis, bone fracture, oral health, allergies, functional difficulties and physical activity) and social outcomes (educational attainment, employment and criminal convictions). Investigators remained blinded to treatment allocation. Analyses were adjusted for gestational age at entry, sex and clustering.ResultsWe assessed 424 adult offspring (46% of survivors; mean [SD] age 49.3 [1.0] years; 212 [50%] female). There was no difference in mental health, general health and social outcomes between those exposed to betamethasone and those exposed to placebo, with the exception that osteoporotic site fracture in adulthood was more likely to have occurred in the betamethasone group compared with placebo (adjusted relative risk 1.57, 95% CI 1.00, 2.48, p = 0.05). No dose–effect relationship was evident and there was no difference in the proportion with at least one fracture. Follow-up rate and lack of in-person assessments were the main limitations.ConclusionsThere is no evidence that antenatal corticosteroids have clinically important effects on general health and social outcomes up to 50 years of age.

Effect of ophthalmic preparation of methyldopa on induced ocular hypertension in rabbits.

Glaucoma is a type of ocular disorder with multifaceted etiologies characterized by progressive optic nerve damage and ultimately loss of visual field. Thisstudy aimed to evaluate the possible intraocular pressure (IOP) lowering effect of an ophthalmic preparation of methyldopa (MD) in corticosteroid-induced ocular hypertension in rabbits. Forty New Zealand white male rabbits were assigned to the experiment and then randomly divided into five groups (n = 8). Ocular hypertension was induced by weekly subconjunctival injection of betamethasone suspension in both eyes. Animal groups included the control (healthy) group, which received the ophthalmic vehicle only; the standard (timolol) group, which received 0.5% timolol eye drops (ED); and the MD groups, which received 0.5%, 1%, and 2% of methyldopa ophthalmic preparation. Treatments were applied to the right eye twice daily for 7 days, whereas the left eye served as a control and was given only distilled water. IOP was recorded and ocular reflexes were observed. Weekly subconjunctival injections of betamethasone resulted in a significant elevation in the IOP (P ≤ 0.001) that was reduced after treatments with timolol 0.5% and MD at different concentrations. Timolol showed the highest reduction (P ≤ 0.001) in the mean IOP with a 30% reduction. MD showed a concentration-dependent reduction with the highest reduction (P ≤ 0.01) observed at 2% compared to the induced/distilled water (DW) eyes and no significant difference compared to the timolol 0.5% (P ≥ 0.05) with a 24.2% reduction in the mean IOP. Methyldopa managed to reduce the IOP in the chronic model of glaucoma, making MD a promising addition to the anti-glaucoma medications.

Microneedle transdermal delivery of compound betamethasone in alopecia areata—A randomized controlled trial

BackgroundAlopecia areata (AA) places a considerable burden on patients. While intralesional glucocorticoid injection is an important therapy, it can cause severe pain. ObjectiveTo compare the efficacy and pain levels of microneedle transdermal delivery of compound betamethasone versus traditional intralesional injection in mild-to-moderate AA. MethodsWe conducted a randomized controlled trial in AA patients with a SALT score < 50. Both groups received monthly compound betamethasone injections: Group A via intralesional injections, and Group B via transdermal microneedle delivery. The primary outcome was the reduction in SALT score after three months. ResultsWith 80 patients enrolled, baseline SALT scores were similar between group A (9.250±5.300) and group B (10.65±9.445). After 3 months, the mean SALT reduction was 7.000±4.5017 in group A and 8.075±8.014 in group B, with no statistical difference. Remission rates for SALT30/50/75/90 were 92.50/90.00/57.50/42.50% in group A and 95.00/87.50/72.50/40% in group B, with no significant difference. Group B had a significantly lower Visual Analog Scale (VAS) pain score than group A (4.000±1.174 vs. 5.281±2.098, p=0.0047). LimitationsThe study focused on mild-to-moderate patchy AA, limiting insights into severe cases. ConclusionMicroneedle transdermal delivery of compound betamethasone in mild-to-moderate patchy AA demonstrates efficacy comparable to traditional intralesional injection, with reduced pain.

Results of a New Treatment Protocol for Sudden Sensorineural Hearing Loss Using Betamethasone for Intratympanic Therapy.

Introduction Sudden sensorineural hearing loss (SSNHL) is defined as a rapid sensation of hearing impairment in one or both ears. Based on its personal impact on patients, the present study advances the analysis of new treatments for the prompt recognition and management of SSNHL, with higher chances of improvements in terms of hearing recovery and quality of life of the patients. Objective To describe the intratympanic (IT) corticoid infiltration technique, to demonstrate the efficacy of betamethasone injection as a sequential treatment in patients whose initial systemic steroid treatment failed, as well as to compare its use in different treatment periods. Methods The present clinical trial was conducted with 37 patients referred to our office with the diagnosis of SSNHL, from September 2019 to May 2022, who provided informed consent to participate. Results Even dividing the analysis of increasing the pure tone average (PTA) or speech recognition threshold (SRT) between the difference into initiation of the salvage therapy in up to 15 days of the sudden deafness event, and between 15 days and 3 months of the event, we did not find any difference in hearing improvement. Conclusion Intratympanic corticosteroid therapy is prescribed when conventional therapy fails or when there is a limitation to the use of corticosteroids due to the presence of systemic disorders. As such, new drugs, such as bethametasone, are studied and show promising results.

Corticosteroid Injection With and Without Local Anesthetic for the Treatment of Trigger Finger: A Randomized Clinical Trial

This study aimed to report pain during and following injection for trigger finger as well as failure to resolve triggering. We hypothesized that a corticosteroid injection alone would be equally or less painful compared with the standard combination of corticosteroid and lidocaine for the treatment of trigger fingers, and there would be no difference in the resolution of triggering. Our study was a prospective, single-blinded, randomized controlled trial at a single institution, comprising 76 patients with a diagnosis of trigger finger. Each treatment group consisted of 38 patients. Patients were randomized to receive either a betamethasone (1 mL, 6 mg) injection without lidocaine or a betamethasone injection (1 mL, 6 mg) with 1% lidocaine (1 mL). Patients were assessed during injection and at 1 hour, 6 hours, 2 days, and 6 weeks after the injection. The primary outcome was pain measured using a numerical rating scale. The secondary outcome was the rate of failure to resolve symptoms at 6 weeks. There was a statistically significant difference in pain scores between the lidocaine and betamethasone versus betamethasone-only injections during administration (4.6 vs 6.2) and after 1 hour (1.3 vs 2.5). There was no statistically significant difference in pain scores after 6 hours (1.5 vs 2.0) and 2 days (0.7 vs 0.6) or in failure rate at the 6-week time point (21% vs 18%). This study showed that there is a statistically significant difference in pain during and shortly after injection when using a steroid with lidocaine versus steroid alone for the treatment of trigger finger, but that difference may not be clinically relevant. There was no significant difference in the failure rate between the treatments. Therapeutic II.

Peri-levator Betamethasone Versus Triamcinolone Injection in Management of Thyroid Eye Disease-related Upper Eyelid Retraction Without Proptosis.

To compare the efficacy of peri-levator injection of both betamethasone and triamcinolone in the management of thyroid eye disease-related upper eyelid retraction without proptosis. This prospective, double-blind, randomized clinical trial was conducted at Assiut University Hospital, Upper Egypt in the period between December 2021 and October 2023. The study included 47 patients (56 eyes) and was divided into 2 groups. In group A, 1 ml betamethasone was injected into the peri-levator area, while in group B, 1 ml triamcinolone was injected. The injection was repeated every month for up to 5 injections if there was an improvement in margin reflex distance 1 (MRD1). The injection was stopped if MRD1 reached the normal value or if 2 successive injections caused no improvement in MRD1. The postinjection outcome was divided into: 1) effective if MRD1 reached the normal ≤4.5 mm; 2) partially effective if MRD1 was improved but did not reach the normal; and 3) ineffective if there was no improvement in MRD1. The follow up ranged from 6 to 20 months. In group A, the injection was effective in 26 eyes (92.9%) and partially effective in 2 eyes (7.1%). In group B, the injection was effective in 17 eyes (60.7%), partially effective in 6 eyes (21.4%), and ineffective in 5 eyes (17.9%). The mean number of injections was significantly lower in group A than in group B: 1.61 ± 0.50 versus 2.36 ± 1.16. This study results suggest that betamethasone is more effective with a smaller number of injections than triamcinolone in the management of thyroid eye disease-related upper eyelid retraction.

Clinical efficacy of CO2 fractional laser combined with compound betamethasone in treating vitiligo and its impact on inflammatory factors.

To analyze the clinical efficacy of CO2 fractional laser combined with compound betamethasone in treating vitiligo and its impact on inflammatory factors. The clinical treatment effects, levels of inflammatory factors [interleukin-17 (IL-17), interferon-gamma (IFN-γ), interleukin-10 (IL-10)], prognosis regarding repigmentation and relapse, psychological health (satisfaction). ① Clinical treatment effects: the total effective rate in Group A was 92.73%, Group B was 74.55%, and Group C was 67.27%, with Group A showing significantly higher effectiveness than Groups B and C (p < 0.05). ② Inflammatory factors: prior to treatment, there was no significant difference in IL-17, IFN-γ, and IL-10 levels among the three groups (p > 0.05); after 3 and 6 months of treatment, the levels of IL-17 and IFN-γ decreased significantly while IL-10 levels increased significantly across all three groups, with Group A showing a more pronounced change compared to Groups B and C (p < 0.05). ③ Prognosis regarding repigmentation and relapse: after 3 and 6 months of treatment, Group A exhibited significantly higher repigmentation rates compared to Groups B and C (p < 0.05); in terms of relapse, Group A had a relapse rate of 5.45%, Group B had 21.82%, and Group C had 23.64%, with Group A showing significantly lower relapse rates compared to Groups B and C (p < 0.05). ④ Quality of life and psychological health: at the end of the 6 month follow-up, the quality of life and psychological health of patients in Group A were significantly higher than those in Groups B and C (p < 0.05). ⑤ Occurrence of adverse reactions: the incidence of adverse reactions was 12.73% in Group A, 10.91% in Group B, and 9.09% in Group C, with no significant difference observed among the three groups (p > 0.05). The application of CO2 fractional laser combined with compound betamethasone in vitiligo patients demonstrates significant efficacy. Compared to sole treatment with CO2 fractional laser or compound betamethasone injections, this combined approach further improves the levels of inflammatory factors in vitiligo patients, reduces the risk of relapse, enhances skin repigmentation, improves quality of life, psychological well-being, without increasing the risk of related adverse reactions. This combined approach merits clinical promotion and application.

Short-term effects of antenatal betamethasone on fetal cardiovascular and circulation status: A quasi-experimental observational (before-after) study.

The administration of antenatal corticosteroid is a standard treatment to reduce the rate of perinatal mortality and morbidity; however, there is limited evidence regarding the potential effects of betamethasone on the constriction of the ductus arteriosus (DA). This study aimed to investigate the short-term effects of antenatal betamethasone on fetal cardiovascular and circulation status. This quasi-experimental observational (before-after) study was conducted on 32 singleton fetuses. The participants were healthy pregnant women with a diagnosis of placenta accreta spectrum who were eligible for 2 doses of betamethasone and referred to prenatal care clinic, Vali-E-Asr hospital, Tehran, Iran from January 2021-May 2022. The results of fetal echocardiography and Doppler sonography were compared before and after the administration of antenatal corticosteroid therapy. Following betamethasone injection, significant increases were observed in peak systolic and diastolic velocity of the DA without constriction of the DA (p 0.001, p = 0.002 respectively). However, no significant changes were observed in right ventricular function, tricuspid valve function, Doppler of ductus venous, and peak systolic velocity of the aortic isthmus (p 0.05). Doppler examination of the uterine, umbilical, and middle cerebral arteries also showed no significant changes (p 0.05). Considering the benefits of antenatal corticosteroid therapy, its administration seems reasonable in preterm births. The transient changes in ductal blood flow are not prohibitive.

Dual-wavelength dye laser combined with betamethasone injection for treatment of keloids: protocol of a randomised controlled trial

IntroductionKeloids, benign fibroproliferative tumours characterised by excessive fibroblast proliferation and over-deposition of extracellular matrix, pose a therapeutic challenge with high recurrence rates. Betamethasone (diprospan) injection (BI) is one of the...

Comparison of the therapeutic effects of photodynamic therapy, transpupillary thermotherapy, and their combination on circumscribed choroidal haemangioma

ObjectiveTo characterize the clinical and imaging features of circumscribed choroidal hemangioma (CCH), and to evaluate individualized treatment efficiency of photodynamic therapy (PDT), transpupillary thermotherapy (TTT), or their combination, followed by retrobulbar injection of betamethasone on CCH resolvement. MethodsForty-nine patients with CCHs who underwent PDT, TTT or PDT+TTT treatments were retrospectively analyzed. Their treatment efficacy was compared by analyzing the change of best corrected visual acuity (BCVA), subretinal fluid (SRF) and CCH lesion characteristics. ResultsPDT, TTT and PDT+TTT were respectively administrated in 17, 11 and 21 patients. No significant difference in age, gender, affected eyes and tumor location across the three groups. Baseline BCVA were 0.41 ± 0.28, 0.62 ± 0.30 and 0.24 ± 0.24 for PDT, TTT and PDT+TTT groups, respectively (F = 6.572, P = 0.003). CCH treated by three strategies showed significant difference in maximum tumor basal diameter, SRF areas and macula involvement prior to the treatment (P < 0.05). Patients receiving PDT+TTT exhibited larger tumor basal diameter, more SRF, higher ratio of macular involvement than other groups. A total of 38 (77.6 %) cases had good visual acidity with final BCVA ≥0.5 after treatments. PDT and PDT+TTT treatment groups acquired more vision improvement (0.27 ± 0.23 and 0.31 ± 0.26) in BCVA than TTT group (0.09 ± 0.13). All SRF were resolved within two weeks of treatment and no recurrent SRF were found. ConclusionThe three treatments showed good performance in improving visual function and controlling SRF, and individualized treatment should be selected primarily by the tumor location, and then the tumor size and presence of SRF.

Comparison of the Effect of Ketorolac and Betamethasone Injection on Post Complications of Third Molar Surgery (A Clinical Trial)

BACKGROUND: The aim of this study was to evaluate the effect of preoperative ketorolac and betamethasone injections on reducing postoperative complications mandibular third molar surgery. MATERIALS AND METHODS: In this randomized clinical trial, 134 patients at the age group of 18-40 years who required mandibular molars surgery were studied. Patients were randomly divided into two groups. In A group, 1 mL of betamethasone LA was injected into the master muscle before surgery, and in the A group, 30 mg of ketorolac per 1 mL was injected before surgery. On the second and seventh days after surgery, patients were evaluated for the variables of maximum mouth opening, pain, swelling, and general satisfaction with the surgery through telephone calls on the second and seventh days. Independent t-test and Mann-Whitney test were used to evaluate the variables. RESULTS: The mean of pain intensity and the swelling variables in the betamethasone group were lower than the ketorolac group in second and seventh days (P&lt;0.05). The mean of maximum mouth opening and the patient satisfaction variables in the betamethasone group were higher than the ketorolac group in second day (P&lt;0.05). There was no statistically significant difference in the patient satisfaction and maximum mouth opening variables on the seventh day (P&gt;0.05). CONCLUSION: This study concluded that betamethasone performed significantly better in reducing swelling, pain, maximum mouth opening limitation, and general satisfaction.

Serum cytokine profiles predict response to systemic glucocorticoid in active vitiligo.

Vitiligo is an immune-related skin disease. Cytokines regulate immune response and inflammation and are involved in the pathogenesis of vitiligo. To assess the serum levels of pro-inflammatory cytokines pre- and post- systemic glucocorticoid treatment in patients with active vitiligo. We measured serum cytokine levels using the enzyme-linked immunosorbent assay in 31 patients with active vitiligo before and after treatment. All patients received systemic glucocorticoid (compound betamethasone injection) in combination with topical halometasone cream and tacrolimus ointment for 3 months. Twenty healthy controls were also examined. The cytokines measured included TNF-α, IL-1β, IL-6, IFN-γ, IL-2, IL-17, IL-10, IL-8, and CXCL10. The serum levels of TNF-α, IL-1β, IL-6, IFN-γ, IL-2, IL-17, IL-8, and CXCL10 were significantly higher, and levels of IL-10 were lower in vitiligo patients compared to controls. Additionally, serum IFN-γ (r = 0.378; p = 0.036), IL-17 (r = 0.426; p = 0.017), and CXCL10 (r = 0.514; p = 0.003) showed a positive correlation with affected body surface area in vitiligo patients. After 3 months of systemic glucocorticoid treatment, the levels of IL-1β, IFN-γ, IL-2, IL-17, and CXCL10 in responders were significantly decreased and nearly restored to normal levels. The IL-10 level was also increased in response to treatment. In contrast, the non-responder group had persistently high IL-6, IL-17, IL-8, and CXCL10 levels, and negligible changes in TNF-α, IL-1β, IFN-γ, IL-2, and IL-10. Our study indicated that the levels of inflammatory cytokines were significantly ameliorated in the glucocorticoid responder group. Altered cell-mediated immunity may contribute to the resistance in vitiligo. The cytokines such as TNF-α, IL-1β, IFN-γ and IL-2 could serve as therapeutic targets for managing glucocorticoid-resistant vitiligo.

Effect of betamethasone injection into the pterygomandibular space on the neurosensory disturbance after bilateral sagittal split ramus osteotomy: a pilot study

AimThe aim of this study was to evaluate the effect of local betamethasone injection into the pterygomandibular space on postoperative neurosensory deficits.Materials and methodsA prospective controlled clinical study was conducted on 16 patients (6 male, 10 female; mean age, 24.95 ± 9.22 years) who underwent bilateral sagittal ramus osteotomy for mandibular discrepancies. One side of each patient’s mandible was randomly selected as the control side, and the opposite side as the experimental side. On the experimental side, a solution of betamethasone (6 mg/1 ml) was injected into the pterygomandibular space after the completion of wound closure. Neurosensory tests, including light touch, two-point discrimination, direction of movement, thermal sensitivity, and pin-prick discrimination, were performed. The follow-up period ranged between 6 and 12 months, according to the particular sensory test. The Fisher exact test was used to analyse the data.ResultsThe light touch sensation was abnormal in 75% of the control side and 31% of the study side, with the difference being significant (p = 0.03). However, at 6 months, all the study cases regained touch sensation, compared to 69% of the control side. No significant difference in direction movement discrimination was seen; however, at 3 months, the study side showed significantly less direction sensation (19%) compared to the control side (56%) (p = 0.02). There was no significant difference in the two-point discrimination; however, at 3 months, the study side had a significantly less abnormal two-point sensation (13%) than the control side (56%) (p = 0.02). In addition, no significant difference was noted in thermal sensitivity or pin-prick sensation.ConclusionBetamethasone injection into the pterygomandibular space reduces neurosensory disturbances after bilateral sagittal split ramus osteotomies nd leads to faster recovery of sensations.

Bladder neck contracture following transurethral surgery of prostate: a retrospective single-center study.

Bladder neck contracture (BNC) is a rare but intolerant complication after transurethral surgery of prostate. The present study aims to investigate the incidence and risk factors of BNC in patients diagnosed benign prostate hyperplasia (BPH) and following transurethral resection or enucleation of the prostate (TURP/TUEP). This retrospective study included 1008 BPH individuals who underwent transurethral surgery of the prostate between January 2017 and January 2022. Patients' demographics, medical comorbidities, urologic characteristics, perioperative parameters, and the presence of BNC were documented. Univariate and multivariate analyses were conducted to identify the risk factors. A total of 2% (20/1008) BPH patients developed BNC postoperatively and the median occurring time was 5.8months. Particularly, the incidences of BNC were 4.7% and 1.3% in patients underwent Bipolar-TURP and TUEP respectively. Preoperative urinary tract infection (UTI), elevated PSA, smaller prostate volume (PV), bladder diverticulum (BD), and B-TURP were significantly associated with BNC in the univariate analysis. Further multivariate logistic regression demonstrated preoperative UTI (OR 4.04, 95% CI 2.25 to 17.42, p < 0.001), BD (OR 7.40, 95% CI 1.83 to 31.66, p < 0.001), and B-TURP (OR 3.97, 95% CI 1.55 to 10.18, p = 0.004) as independent risk factors. All BNC patients were treated with transurethral incision of the bladder neck (TUIBN) combined with local multisite injection of betamethasone. During a median follow-up of 35.8months, 35% (7/20) of BNC patients recurred at a median time of 1.8months. BNC was a low-frequency complication following transurethral surgery of prostate. Preoperative UTI, BD, and B-TURP were likely independent risk factors of BNC. TUIBN combined with local multisite injection of betamethasone may be promising choice for BNC treatment.

The Impact of Intramuscular Depot Betamethasone Injection (Diprospan) on Patients with Fibromyalgia and Normal C-Reactive Protein Levels

The Impact of Intramuscular Depot Betamethasone Injection (Diprospan) on Patients with Fibromyalgia and Normal C-Reactive Protein Levels

Comparing the Intensity of Pain and Incidence of Flare Reaction Following Trigger Finger Injections Using Betamethasone and Methylprednisolone: A Double-Blinded, Randomized Controlled Trial.

Considerable evidence supports corticosteroid injection as an effective treatment for trigger finger. One common side effect, the flare reaction, is a well-documented phenomenon of increased pain following steroid injections. Its incidence and intensity may be related to steroid composition. The purpose of this study was to determine whether betamethasone and methylprednisolone injections for trigger fingers have differing intensity of pain or incidence flare reaction. Patients with symptomatic trigger finger were recruited during their hand surgery visits. Patients were randomized into 2 treatment groups: betamethasone (40 mg) and methylprednisolone (6 mg) mixed with lidocaine 1%. Treatment group assignment was blinded to the patients and investigators. Visual analog scale pain measurements were taken prior to injection, 5 minutes postinjection, and daily thereafter for 7 days. Sixty-four patients were randomized into the 2 treatment groups. Patients in the betamethasone group reported slightly higher baseline pain compared with the methylprednisolone group, but lower pain on day 1. None of the following days showed a statistically significant difference. The incidence of flare and severe flare reactions of betamethasone injections for trigger finger management was roughly double that of methylprednisolone, but this difference was not statistically significant. Further studies are required to evaluate the relative course of nonflare postinjection pain for different corticosteroid injections for trigger finger injections.

Periprosthetic Joint Infection Risk After Primary Total Knee Arthroplasty: Are All Preoperative Corticosteroid Injections the Same?

BackgroundPrevious evidence has demonstrated an increased risk of periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) in patients receiving corticosteroid injection (CSI) within 3 months of surgery. The study aimed to determine if PJI risk after TKA varied among different corticosteroid agents. MethodsA total of 85,073 patients undergoing primary TKA from 2009 to 2019 were identified from a large national database. Of these, 1,092 (1.3%) received an ipsilateral, intra-articular CSI within 90 days of TKA. These patients were compared to those not receiving CSI using multivariate logistic regressions following 1:4 propensity score matching, with PJI development as the primary outcome. ResultsPatients given an injection of any corticosteroid within 90 days of TKA had significantly higher PJI rates compared to controls (1.6 versus 0.41%; P < .001). This finding was driven by patients receiving methylprednisolone acetate (n = 543) or betamethasone (n = 153), with prevalence rates of 1.7 and 2.6%, respectively (P = .003 and P = .01, respectively). No significant increase in the rate of PJI was observed for patients receiving triamcinolone (1.2%; P = .08; n = 342) or dexamethasone (0.0%; P = 1; n = 54) within 90 days preceding TKA. PJI risk for all agents, administered more than 90 days preoperatively normalized to control levels (0.51 versus 0.34%). ConclusionsThese results suggest that PJI risk varies with CSI type. In this large database study, only patients given methylprednisolone acetate or betamethasone injections within 90 days of surgery had significantly higher PJI rates compared to controls.

Intralesional betamethasone versus oral propranolol for localized infantile hemangiomas of the lip

Infantile hemangiomas (IHs) of the lips are associated with an increased risk of incomplete involution and ulceration, causing disfigurement. Treatment with oral propranolol (OPT) has credible efficacy but takes months to complete. Thus, this study aimed to investigate the efficacy of intralesional betamethasone injection (IBI) as an alternative treatment for protruding localized IHs of the lips. To investigate the efficacies of OPT and IBI, we designed a prospective, noninferiority, parallel-group study. The primary outcome assessed was treatment response rate. Secondary outcome assessments included lesion size changes and surgical rate. Additionally, complication rates and treatment durations of OPT and IBI were compared. The treatment response rate of IBI was not inferior to that of OPT (95.7% vs. 76.0%, respectively; a difference of 19.7%, 95% confidence interval [CI], -4.4% to 41.6%). The average surgical rate in the IBI group was significantly lower than that in the OPT group (8.7% vs. 40%, respectively; p=0.012), and the average duration of treatment for IBI was shorter than that of OPT (2.1 months vs. 6.3 months, respectively; p<0.001). There were no severe adverse drug events in either group. If not managed properly, small, localized lip IHs may cause disfigurement in a child. Our study demonstrated that IBI is as effective as OPT in treating protruding localized lip IHs. Moreover, IBI treatment has a shorter duration and lower surgical rate than OPT. With proper care, IBI is an effective treatment modality for small and localized lip IHs.

Does Betamethasone Injection Into the Pterygomandibular Space Affect the Postoperative Outcomes of Impacted Lower Third Molar Surgery?

Pain, swelling, and trismus are common outcomes following impacted lower third molar surgery. The purpose of the study was to evaluate the effect of betamethasone injection into the pterygomandibular space on the aforementioned sequelae of third molar surgery. A split-mouth, double-blind, randomized clinical trial was conducted on 40 patients with symmetrical bilateral impacted lower third molars. The surgeries were performed at an outpatient clinic under local anesthesia. The predictor variable is the steroid treatment. The experimental group received a 1mL (6mg) betamethasone injection into the pterygomandibular space, while the control group received a normal saline. The primary outcome variable was postoperative pain assessed using a visual analog scale. The secondary outcome variables were the number of analgesic tablets consumed, facial swelling, and trismus. The age and sex of the patients, the direction of impaction, and the duration of surgery were recorded. Comparisons between the groups were carried out using an unpaired t test. An analysis of variance test was used to assess intragroup differences. The significance was considered at P≤.05. Of the 265 patients initially screened for study enrollment, the final sample included 40 subjects, with a mean age of 28.3years (±7.4), 28 (70%) were mal and 12 (30%) were female. There was no significant difference between the two groups concerning postoperative pain or the number of consumed analgesic tablets. However, the betamethasone group exhibited significantly reduced facial swelling and increased mouth opening. On the first postoperative day, the visual analog scale pain score did not significantly differ between the betamethasone group (6.0±1.7) and the control group (6.8±1.4), with a P value of 0.112. On the first postoperative day, facial swelling measured 4.2±1.3mm in the betamethasone group compared to 6.0±0.9mm in the control group (P<.001). Mouth opening in the betamethasone group was 30.8±6.7mm, while in the control group, it measured 21.9±5.5mm(P<.001). Local betamethasone has no effect on pain after third molar surgery, but facial swelling and trismus are significantly reduced.

A prospective study of 100 patients with rotator cuff tendinopathy showed no correlation between subacromial bursitis and the efficacy of ultrasound-guided corticosteroid injection.

The objective of this study was to determine whether the presence of subacromial bursitis in patients with rotator cuff tendinopathy (RCT) was associated with a better outcome after ultrasound (US)-guided subacromial corticosteroid injection. A single-center prospective study was performed including patients referred for subacromial injection to manage RCT. At baseline, all patients received an US-guided intra-bursal injection of betamethasone (1ml). The primary endpoint was reduced pain 3months (M3) after the procedure: a good responder was defined by a decrease in Visual Analogue Scale pain of more than 30%. Secondary endpoints included functional recovery assessed by the Oxford Shoulder Score (OSS) and clinical success at 6weeks (W6). We also explored the association between good clinical response and other factors, such as US or X-ray features. One hundred patients were included and 49 presented with subacromial bursitis. At M3, 60% of patients (54/100) were considered good responders. The rate of good responders did not differ between the bursitis and non-bursitis groups (p = 0.6). During follow-up, OSS improved over time whether bursitis was present or not. We did not find any US or X-ray features significantly associated with a favorable clinical outcome. The presence of subacromial bursitis did not influence clinical outcomes at 3months post-subacromial injection in patients suffering from RCT. The presence of subacromial bursitis did not influence clinical outcomes at 3months post-subacromial corticosteroid injection in patients with rotator cuff tendinopathy. For patient management, looking for ultrasonographic signs of bursitis does not appear relevant for the indication of the injection. • Ultrasound-guided subacromial corticosteroid injections led to a significant improvement in 60% of patients suffering from rotator cuff tendinopathy. • The presence of subacromial bursitis was not associated with better improvement at 3months post-injection. • Except for the Minnesota score referring to job satisfaction, we did not find any baseline clinical, X-ray, or ultrasound characteristics associated with a successful outcome.