Steroidne injekcije

    I started losing my sense of smell again in February, and by April I was anosmic again. I did get it back, partially and intermittently, for about ten days after I used a Nasacort inhaler from my stash (they no longer sell them), and then I became anosmic again. On the 16 th of June, 2004, I got another Kenalog injection, on the left side, in preparation for my trip to Austin, Texas, to visit my daughter Lotus. The Kenalog effected a restoration of my sense of smell more rapidly than usual this time. The very next day the grocery store was a scent carnival -- every few steps brought a new, intense odor (most pleasant, some not). Walking through my garden I brushed against the dill plants and the scent was delightfully intense. As I weeded my flower beds the next day I could smell the marigolds and several of the weeds I pulled. The Datura was stinky and the rosemary delightful. Getting one's sense of smell back after a period of anosmia is a real trip! My Seventh Kenalog Injection, June, 2005     Having been congested for a good while, I went in to see my doc on the 27 th of June, 2005.  He scoped my nose, found no polyps there, and ordered a Kenalog injection for me so I should be able to enjoy my July vacation.  He advised me that we can also try, once the Kenalog has worn off, Astelin , an antihistamine nasal spray which is prescribed for vasomotor rhinitis (including nasal congestion). June, 2007     My sense of smell is still good, two years after my last Kenalog injection.  I have been stuffy, but not anosmic.  I am using Astelin now during the pollen season.  It seems to help a bit, but I am still more congested than I'd like to be. The Down Side of Steroid Use     Although I have observed no undesirable side effects of my Kenalog injections, it is well known that there is a long list of such possible side effects, contraindications, and complications. One correspondent reported to me that he had suffered tissue loss at the site of the injection. Apparently he had successive injections in the same site. My nurse rotates the site of injection to reduce that possibility. Some physicians are reluctant to use steroid therapy, others not. Another of my correspondents, who is a practicing physician, wrote to me " The role of steroids in treatment of all types of respiratory inflammatory problems has really changed over the past 5-10 years with much earlier initiation and better/quicker resolution. There does not seem to be much long term down side to the use of a short course of systemic steroids."

Gonal-f ® is a potent gonadotropic substance capable of causing Ovarian Hyperstimulation Syndrome (OHSS) in women with or without pulmonary or vascular complications. Gonadotropin therapy requires a certain time commitment by physicians and supportive health professionals, and requires the availability of appropriate monitoring facilities (see PRECAUTIONS/Laboratory Tests ). Safe and effective use of Gonal-f ® in women requires monitoring of ovarian response with serum estradiol and vaginal ultrasound on a regular basis. The lowest effective dose should be used.

Ceftriaxone is a third-generation antibiotic from the cephalosporin family of antibiotics. [7] It is within β {\displaystyle \beta } -lactam family of antibiotics. Ceftriaxone selectively and irreversibly inhibits bacterial cell wall synthesis by binding to transpeptidases, also called transamidases, which are penicillin-binding proteins (PBPs) that catalyze the cross-linking of the peptidoglycan polymers forming the bacterial cell wall. [20] The peptidoglycan cell wall is made up of pentapeptide units attached to a polysaccharide backbone with alternating units of N-acetylglucosamine and N-acetylmuramic acid. [21] [22] PBPs act on a terminal D-alanyl-D-alanine moiety on a pentapeptide unit and catalyze the formation of a peptide bond between the penultimate D-alanine and a glycine unit on an adjacent peptidoglycan strand, releasing the terminal D-alanine unit in the process. [20] [22] The structure of ceftriaxone mimics the D-alanyl-D-alanine moiety, and the PBP attacks the beta-lactam ring in ceftriaxone as if it were its normal D-alanyl-D-alanine substrate. [20] The peptidoglycan cross-linking activity of PBPs is a construction and repair mechanism that normally helps to maintain bacterial cell wall integrity, so the inhibition of PBPs leads to damage and destruction of the cell wall and eventually to cell lysis. [20]

Steroidne injekcije

steroidne injekcije

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steroidne injekcije

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