[EMBOLISM OF THE CENTRAL RETINAL ARTERY AFTER THERAPEUTIC CORTISONE INJECTION INTO THE SCALP. MECHANISM OF PRODUCTION].
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Fifty-six patients with rheumatoid arthritis were treated continuously with cortisone for periods ranging between 4 and 38 months, in daily doses of 15 to 100 mg. Concomitant therapy included periods of rest, physical therapy, and salicylates. The incidence of subjective improvement exceeded that of objective improvement. The incidence of objective improvement was higher in females; also, in those patients whose disease was in an early stage and of short duration at the time therapy was begun, and who required relatively smaller maintenance doses of cortisone. Therapeutic results were not affected by the age of the patient or by the presence of spondylitis. Despite precautions, the long-term administration of cortisone was, in some patients, productive of serious undesirable side-effects. Although cortisone usually suppressed the symptoms and signs of rheumatoid arthritis, progression of the disease was frequently noted during its long-term administration.
The authors present their study on interleukin-2 receptors (IL-2R), transferrin receptors (R-Tr), CD-4/CD-8 ratio, T-lymphocytes after therapy with a corticosteroid (125 mg/die), in 7 female geriatric patients suffering from rheumatoid arthritis. The study was performed with conjugated monoclonal antibody marking the lymphocytes with fluorescein (FITC) and phycoerythrin (PE). Using the considered parameters a depressant effect was presumed on T-lymphocytes and on the immune defences in the first 6 hours after starting therapeutic cortisone infusion. The proliferative effect on T-lymphocytes, CD4 and on the receptor state of the membrane, for IL-2R and Tr-R, was already evident in the 11-12th hour with a peak at 24 hours. It is therefore useful to follow the evolution of the immune state, even using the above parameters, in order to evaluate the correct therapeutic course.
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