Diprolene
Is 1-hour glucose screening test reliable after a short-term administration of antenatal betamethasone?

Gurbuz A, Karateke A, Ozturk G, Kabaca C.

Zeynep Kamil Women and Children Diseases Education and Research Hospital, Uskudar, Istanbul, Turkey.

This study was designed to determine whether betamethasone has any effect on 1-hour (50-g) glucose screening test in nongestational diabetic pregnancy, and if any exists, to determine if this effect is transient or permanent. If the effect is temporary, the study was designed to determine the duration of this glucose intolerance effect and to determine the timing of 1-hour glucose screening test after betamethasone usage. One hundred fourteen pregnant women with a diagnosis of preterm labor at 24 to 34 weeks gestation were enrolled into the prospective study. One-hour glucose screening test was performed before initiation of hydration treatment. Forty pregnant women with normal 1-hour glucose results, who also had responded to hydration therapy, made up our study group. Twenty-four hours, 72 hours, and 1 week after administration of betamethasone, 50-g glucose challenge tests were again performed. A 3-hour glucose tolerance test was performed in pregnant women, whose 1-hour screening test had been positive 1 week after corticosteroid administration. In the evaluation of data, one-way, variance analysis and Tukey's multiple comparison test were used. The mean value of 1-hour glucose results of 50-g challenge test at the 24 hours was significantly higher than the mean value of 1-hour glucose results of the test done initially before betamethasone administration and than those of the tests done at 72 hours and 1 week (p < 0.001 for these three groups). There was no statistically significant difference between the mean values of 1-hour glucose results of the test done before betamethasone administration and both the results of the tests done at 72 hours (p = 0.96) and 1 week (p = 0.99), separately. There was no significant difference between the mean 1-hour glucose results of the tests at 72 hours and 1 week (p = 0.99). The test results were positive in 42.5%, 10%, and 5% of the patients, respectively at 24 hours, 72 hours, and 1 week. The betamethasone administration significantly deteriorates 1-hour glucose screening test results in the nongestational diabetic patients but this effect of betamethasone is transient. Because of its high false-positivity at 24 hours (42.5%) and at 72 hours (10%) in women with initial negative 1-hour glucose screening test, we suggest that 1-hour glucose screening test in pregnant women be postponed at least 1 week after betamethasone administration or perform the test before administration of betamethasone.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15476133&dopt=Abstract betamethasone Diprolene AF



Diprolene
Pimecrolimus cream 1% vs. betamethasone 17-valerate 0.1% cream in the treatment of seborrhoeic dermatitis. A randomized open-label clinical trial.

Rigopoulos D, Ioannides D, Kalogeromitros D, Gregoriou S, Katsambas A.

National University of Athens Medical School, A. Syrgos Hospital, Athens, Greece. drigop hol.gr

BACKGROUND: Seborrhoeic dermatitis is a chronic inflammatory disease with remissions and exacerbations, characterized by erythema, scaling and pruritus primarily on the face, scalp and chest. Corticosteroids and antifungals are the mainstay of therapy. However, chronic use of corticosteroids is associated with side-effects such as skin atrophy and telangiectasia. Pimecrolimus, an inhibitor of calcineurin, has been used successfully in one patient with seborrhoeic dermatitis. OBJECTIVES: The objective of this randomized open-label clinical trial was to compare the efficacy and tolerability of pimecrolimus in comparison with a potent corticosteroid (betamethasone 17-valerate) in the treatment of seborrhoeic dermatitis. METHODS: Twenty patients with seborrhoeic dermatitis were included in this study, 11 patients in the pimecrolimus 1% cream group and nine patients in the betamethasone 17-valerate 0.1% cream group. Patients were instructed to use a thin layer of the study products twice daily at the lesional area and to discontinue treatment as soon as symptoms were absent. Clinical measures assessed were erythema, scaling and pruritus which were evaluated using a four-point scale (0-3). RESULTS: Both pimecrolimus and betamethasone were highly effective in the treatment of seborrhoeic dermatitis. Betamethasone reduced all three parameters, erythema, scaling and pruritus, faster than pimecrolimus, but the differences in reduction were not statistically significant. Relapses were observed more frequently and were more severe with betamethasone than with pimecrolimus. Moreover, pruritus was not observed after discontinuation of treatment from day 15 and beyond in the pimecrolimus group, whereas it was reported in most patients of the betamethasone group. This difference was statistically significant. CONCLUSIONS: It appears that pimecrolimus, a nonsteroidal topical treatment, may be an excellent alternative therapeutic modality for treating seborrhoeic dermatitis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15541087&dopt=Abstract betamethasone Diprolene AF



Diprolene
Calcipotriol/betamethasone dipropionate: a review of its use in the treatment of psoriasis vulgaris.

Fenton C, Plosker GL.

Adis International Limited, Yardley, Pennsylvania 19067, USA. demail adis.com

The two-compound product containing calcipotriol 50 microg/g plus betamethasone dipropionate 0.5 mg/g (Dovobet, Daivobet) [referred to here as calcipotriol/betamethasone dipropionate], is a topical treatment for psoriasis vulgaris, combining a vitamin D analog and a corticosteroid. For most adult patients with psoriasis vulgaris on the trunk and limbs, up to 4 weeks of therapy with calcipotriol/betamethasone dipropionate provides an effective and well tolerated treatment. In clinical trials, patients with a mean baseline psoriasis area and severity index (PASI) of 9.5-10.9 experienced a mean 65.0-74.4% PASI improvement within 4 weeks, significantly better than improvements with calcipotriol 50 microg/g monotherapy, betamethasone dipropionate 0.5 mg/g monotherapy, or placebo. In addition, in 6.4%-20.1% of patients, lesions cleared. In patients who were subsequently treated with calcipotriol maintenance therapy, benefits were retained for at least 4 weeks. The safety of calcipotriol/betamethasone dipropionate in patients treated for up to 1 year was generally good; fewer than 5% of patients experienced adverse events possibly associated with long-term corticosteroid use.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15663344&dopt=Abstract betamethasone Diprolene AF



Diprolene
Effects into adulthood of single or repeated antenatal corticosteroids in sheep.

Moss TJ, Doherty DA, Nitsos I, Sloboda DM, Harding R, Newnham JP.

School of Women's and Infants' Health, The University of Western Australia, Crawley, Australia. tmoss cyllene.uwa.edu.au

OBJECTIVE: To determine effects of maternal or fetal injections of betamethasone on postnatal growth and arterial pressure. STUDY DESIGN: We measured body weight, arterial pressure, and heart rate serially in sheep born after single or repeated maternal or fetal betamethasone injections. At approximately 3.5 years, organ weights were measured. RESULTS: Repeated maternal betamethasone injections caused intrauterine growth restriction, and low body weight and blood pressure at 3 months. From 6 months to 3 years, body weight, blood pressure, and heart rate were not affected by treatment. At approximately 3.5 years, brain weight was reduced after single or repeated maternal betamethasone by 13% and 18%, respectively (P = .001). Fetal betamethasone reduced brain weight by 7% to 8% (P = .018). Weights of other organs were not affected by treatment. Brain weight was unrelated to body weight at approximately 3.5 years (P = .649) but was related to birth weight (P = .029). CONCLUSION: Prenatal betamethasone does not have long-term effects on blood pressure but causes a persistent deficit in brain weight.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15672017&dopt=Abstract betamethasone Diprolene AF



Diprolene
Short-Term (0-48 h) Effects of Maternal Betamethasone Administration on Fetal Heart Rate and Its Variability.

Lunshof MS, Boer K, Wolf H, Koppen S, Velderman JK, Mulder EJ.

Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, 1100 DE, Amsterdam, The Netherlands, Department of Perinatology and Gynecology, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3584 EA, Utrecht, The Netherlands.

The short-term (0-48 h) effects of maternal betamethasone administration on computerized fetal heart rate (FHR) parameters were studied in 36 pregnancies at increased risk for preterm delivery. FHR was recorded for 90 min immediately before the start of betamethasone treatment and again at 6-h intervals during the next 48 h. Multiple linear regression models were used to assess the possible effects on FHR parameters of gestational age, time of day, clinical indication for treatment, and use of tocolytic drugs. Within 12 h after the start of treatment, significant increases occurred in FHR accelerations, and short- and long-term FHR variability (36%, 28%, and 22%, respectively), whereas basal FHR showed a 5% decrease. FHR variability was decreased by 10% at 42-48 h. The observed changes were more pronounced in older (29-33 wk of gestation) compared with younger fetuses (25-28 wk of gestation). Decelerations occurred only in 4 out of 11 compromised fetuses during betamethasone therapy. We conclude that there are significant changes in FHR parameters during the first 48 h after betamethasone administration. These changes are transient in normal fetuses. However, the compromised fetus may be adversely affected by betamethasone.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15695600&dopt=Abstract betamethasone Diprolene AF