Objective:To determine and compare the abilities of Shot Blocker and cryotherapy for reducing pain and anxiety associated with subcutaneous injections.Subcutaneous injection has been used excessively for continuous,lo...Objective:To determine and compare the abilities of Shot Blocker and cryotherapy for reducing pain and anxiety associated with subcutaneous injections.Subcutaneous injection has been used excessively for continuous,low-dose administration of drugs.Considering that these drugs may require prolonged administration,new devices and methods of injection are needed to decrease pain and anxiety associated with repeated drug injections.Methods:A quasi-experimental study design on a purposive sample of 54 patients comprised of both sexes has been utilized.The subjects were divided into 2 equal groups(group 1,Shot Blocker;group 2,cryotherapy),and 3 tools were used,namely the sociodemographic and medical data sheet,Verbal Descriptor Scale for measuring pain,and Beck Anxiety Inventory.Results:A significant reduction in pain and anxiety mean scores was observed after using cryotherapy and Shot Blocker techniques during subcutaneous injection.In addition,the Shot Blocker group exhibited significantly lower pain and anxiety mean scores compared with the cryotherapy group.Conclusions:Our findings revealed that Shot Blocker and cryotherapy were effective non-pharmacological methods for reducing pain and anxiety levels associated with repeated subcutaneous injections.展开更多
Adjuvanted vaccines are recommended for administration through an intramuscular route. The Centers for Disease Control and Prevention (CDC) has recommended the anterolateral thigh using a 22 - 25-G 25-mm (1 inch) need...Adjuvanted vaccines are recommended for administration through an intramuscular route. The Centers for Disease Control and Prevention (CDC) has recommended the anterolateral thigh using a 22 - 25-G 25-mm (1 inch) needle for infants, injected at a 90° into the skin surface, and using a 16 mm (5/8 inch) for newborns. Appropriate needle lengths may differ depending on racial backgrounds. In the present study, the thickness of the epidermis and lengths from the skin surface to the muscle fascia and bone were measured using ultrasonic echograms in order to determine suitable needle lengths for Japanese infants aged 2, 3, 4, 5, 6, and 12 - 15 months old. The thickness of the epidermis was 1.44 - 1.54 mm (95% CI), and the lengths from the skin surface to the muscle fascia and bone were 11.52 - 12.28 mm (95% CI), and 25.66 - 26.93 mm (95% CI), respectively, at the anterolateral thigh. At the center of the deltoid muscle, skin thickness was similar to that at the thigh, furthermore the lengths from the skin surface to the muscle fascia and bone were 8.49 - 9.10 mm (95% CI), and 17.38 - 18.31 mm (95% CI), respectively. The lengths from the skin surface to the muscle fascia and bone were 1 - 2 mm shorter in 2-month-old infants than those in older generations. Therefore, the appropriate needle length for intramuscular injections in Japanese infants was 16 mm (5/8 inch) at any age and sites, and with 25 mm (1 inch) needles at a 90° angle being associated with the risk of over-penetration.展开更多
BACKGROUND Vitamin K1(phytomenadione)is a fat-soluble naturally occurring vitamin that is widely used to treat certain coagulation disorders.Adverse cutaneous reactions to vitamin K1 can occur;however,owing to its low...BACKGROUND Vitamin K1(phytomenadione)is a fat-soluble naturally occurring vitamin that is widely used to treat certain coagulation disorders.Adverse cutaneous reactions to vitamin K1 can occur;however,owing to its low incidence and considerable variability in presentation and morphology,its diagnosis can be easily overlooked.Managing these reactions may be challenging for patients and clinicians.Therefore,reviewing the adverse cutaneous reactions to vitamin K1 is important.CASE SUMMARY Here we report the case of a 50-year-old woman with no pre-existing hepatic disease who developed a cutaneous allergic reaction to subcutaneous vitamin K1 that presented as localized eczematous plaques at the vitamin K1 injection site.The eruption developed within 5 d of the injection and persisted for 32 mo despite treatment with topical and intralesional steroids.Eczema was diagnosed based on the results of the pathological examination,immunohistochemical staining,and a skin biopsy.The patient was advised to take herbal medicines orally twice daily.After treatment and follow-up,the patient’s eczematous urticarial plaques improved and her condition stabilized.CONCLUSION Here we present the first case of a cutaneous allergic reaction to subcutaneous vitamin K1 that was successfully treated with Chinese medicine.展开更多
AIM:To compare the difference between tumorinduced lymph node enlargement and inflammation-induced lymph node enlargement by contrast-enhanced ultrasonography and pathological findings. METHODS:A model of tumor-induce...AIM:To compare the difference between tumorinduced lymph node enlargement and inflammation-induced lymph node enlargement by contrast-enhanced ultrasonography and pathological findings. METHODS:A model of tumor-induced lymph node metastasis was prepared by embedding a VX2 tumor into the hind paws of white rabbits.A model of inflammation-induced enlargement was prepared by injecting a suspension of Escherichia coli into separate hind paws of white rabbits.Then,a solution of SonazoidTM(GE Healthcare,Oslo,Norway)was injected subcutaneously in the proximity of the lesion followed by contrast-enhanced ultrasonography of the enlarged popliteal lymph nodes. RESULTS:In the contrast-enhanced ultrasonography of the tumor-induced metastasis model,the sentinel lymph node was imaged.An area of filling defect was observed in that enlarged lymph node.In the histology examination,the area of filling defect corresponded to the metastatic lesion of the tumor.Contrast-enhanced ultrasonography of the model on inflammation-induced lymph node enlargement,and that of the acute inflam-mation model performed 3-7 d later,revealed dense staining that was comparatively uniform.The pathological findings showed acute lymphadenitis mainly due to infiltration of inflammatory cells.Contrast-enhanced ultrasonography that was performed 28 d post-infection in the acute inflammation model showed speckled staining.Inflammation-induced cell infiltration and fiberization,which are findings of chronic lymphadenitis, were seen in the pathological findings. CONCLUSION:Sentinel lymph node imaging was made possible by subcutaneous injection of SonazoidTM.Contrast-enhanced ultrasonography was suggested to be useful in differentiating tumor-induced enlargement and inflammation-induced enlargement of lymph nodes.展开更多
Background:Echinococcosis is a serious,zoonotic,parasitic disease with worldwide distribution.According to a epidemiological survey in 2012 in China,there are 20,000 infected patients and more than 50 million people a...Background:Echinococcosis is a serious,zoonotic,parasitic disease with worldwide distribution.According to a epidemiological survey in 2012 in China,there are 20,000 infected patients and more than 50 million people at the risk.As the dog is the main,definitive host,the Government of China encourages monthly praziquantel treatment of every dog.However,this is difficult to achieve in geographically challenging areas,such as the Tibetan plateau,where there are also many dogs without owners.To overcome these problems,we investigated the transmission blocking capacity of a slow-release formulation of praziquantel administered by subcutaneous injection.Methods:The impact of a slow-release preparation of two pharmacokinetically stereoselective praziquantel enantiomers,i.e.,R-(−)-praziquantel(R-PZQ)and S-(+)-praziquantel(S-PZQ)absorbed into a biodegradable polymer was studied in beagle dogs(N=6).The preparation was given by subcutaneous injection using a single dose of 100 mg/kg.Chiral-selective,high-performance liquid chromatography(HPLC)and high-resolution mass spectrometry(HRMS)were applied to measure the praziquantel enantiomers in the plasma of the dogs.The lower limit for estimating plasma concentrations accurately for R-PZQ was 4 ng/ml and for S-PZQ 20 ng/ml.The pharmacokinetic parameters were calculated by a noncompartmental analysis model using Drug Analyze System(DAS)software 2.0.The SPSS 19.0 software was used for statistical analysis,and the statistical comparison between enantiomers was assessed using the two-tailed t-test.Results:Two hours after administration,peak concentrations of R-PZQ and S-PZQ:321±26 and 719±263 ng/ml,respectively,were achieved.After 180 days,the average plasma concentration of R-PZQ in the six dogs had decreased to 13 ng/ml.The average concentration value of S-PZQ was higher than that of R-PZQ in the first 90-day period but fell afterwards and could not be accurately estimated when dropping below 20 ng/ml(the lower methodological limit for this enantiomer).Taking all the dogs into account,the average maximum concentration(Cmax)of S-PZQ in plasma over the first 3 months was higher than that of R-PZQ by 114.0%(P<0.05),while the average mean retention time(MRT)of R-PZQ in plasma was higher than that of S-PZQ by 96.3%(P<0.05).Conclusions:Praziquantel given as an in situ slow-release formulation by subcutaneous injection resulted in concentrations of the active principle in beagle dogs,which should be capable of resisting new Echinococcus infections for at least 6 months.The new formulation of praziquantel represents a potential,alternative way of presenting medication against tapeworm infections in dogs.展开更多
文摘Objective:To determine and compare the abilities of Shot Blocker and cryotherapy for reducing pain and anxiety associated with subcutaneous injections.Subcutaneous injection has been used excessively for continuous,low-dose administration of drugs.Considering that these drugs may require prolonged administration,new devices and methods of injection are needed to decrease pain and anxiety associated with repeated drug injections.Methods:A quasi-experimental study design on a purposive sample of 54 patients comprised of both sexes has been utilized.The subjects were divided into 2 equal groups(group 1,Shot Blocker;group 2,cryotherapy),and 3 tools were used,namely the sociodemographic and medical data sheet,Verbal Descriptor Scale for measuring pain,and Beck Anxiety Inventory.Results:A significant reduction in pain and anxiety mean scores was observed after using cryotherapy and Shot Blocker techniques during subcutaneous injection.In addition,the Shot Blocker group exhibited significantly lower pain and anxiety mean scores compared with the cryotherapy group.Conclusions:Our findings revealed that Shot Blocker and cryotherapy were effective non-pharmacological methods for reducing pain and anxiety levels associated with repeated subcutaneous injections.
文摘Adjuvanted vaccines are recommended for administration through an intramuscular route. The Centers for Disease Control and Prevention (CDC) has recommended the anterolateral thigh using a 22 - 25-G 25-mm (1 inch) needle for infants, injected at a 90° into the skin surface, and using a 16 mm (5/8 inch) for newborns. Appropriate needle lengths may differ depending on racial backgrounds. In the present study, the thickness of the epidermis and lengths from the skin surface to the muscle fascia and bone were measured using ultrasonic echograms in order to determine suitable needle lengths for Japanese infants aged 2, 3, 4, 5, 6, and 12 - 15 months old. The thickness of the epidermis was 1.44 - 1.54 mm (95% CI), and the lengths from the skin surface to the muscle fascia and bone were 11.52 - 12.28 mm (95% CI), and 25.66 - 26.93 mm (95% CI), respectively, at the anterolateral thigh. At the center of the deltoid muscle, skin thickness was similar to that at the thigh, furthermore the lengths from the skin surface to the muscle fascia and bone were 8.49 - 9.10 mm (95% CI), and 17.38 - 18.31 mm (95% CI), respectively. The lengths from the skin surface to the muscle fascia and bone were 1 - 2 mm shorter in 2-month-old infants than those in older generations. Therefore, the appropriate needle length for intramuscular injections in Japanese infants was 16 mm (5/8 inch) at any age and sites, and with 25 mm (1 inch) needles at a 90° angle being associated with the risk of over-penetration.
文摘BACKGROUND Vitamin K1(phytomenadione)is a fat-soluble naturally occurring vitamin that is widely used to treat certain coagulation disorders.Adverse cutaneous reactions to vitamin K1 can occur;however,owing to its low incidence and considerable variability in presentation and morphology,its diagnosis can be easily overlooked.Managing these reactions may be challenging for patients and clinicians.Therefore,reviewing the adverse cutaneous reactions to vitamin K1 is important.CASE SUMMARY Here we report the case of a 50-year-old woman with no pre-existing hepatic disease who developed a cutaneous allergic reaction to subcutaneous vitamin K1 that presented as localized eczematous plaques at the vitamin K1 injection site.The eruption developed within 5 d of the injection and persisted for 32 mo despite treatment with topical and intralesional steroids.Eczema was diagnosed based on the results of the pathological examination,immunohistochemical staining,and a skin biopsy.The patient was advised to take herbal medicines orally twice daily.After treatment and follow-up,the patient’s eczematous urticarial plaques improved and her condition stabilized.CONCLUSION Here we present the first case of a cutaneous allergic reaction to subcutaneous vitamin K1 that was successfully treated with Chinese medicine.
文摘AIM:To compare the difference between tumorinduced lymph node enlargement and inflammation-induced lymph node enlargement by contrast-enhanced ultrasonography and pathological findings. METHODS:A model of tumor-induced lymph node metastasis was prepared by embedding a VX2 tumor into the hind paws of white rabbits.A model of inflammation-induced enlargement was prepared by injecting a suspension of Escherichia coli into separate hind paws of white rabbits.Then,a solution of SonazoidTM(GE Healthcare,Oslo,Norway)was injected subcutaneously in the proximity of the lesion followed by contrast-enhanced ultrasonography of the enlarged popliteal lymph nodes. RESULTS:In the contrast-enhanced ultrasonography of the tumor-induced metastasis model,the sentinel lymph node was imaged.An area of filling defect was observed in that enlarged lymph node.In the histology examination,the area of filling defect corresponded to the metastatic lesion of the tumor.Contrast-enhanced ultrasonography of the model on inflammation-induced lymph node enlargement,and that of the acute inflam-mation model performed 3-7 d later,revealed dense staining that was comparatively uniform.The pathological findings showed acute lymphadenitis mainly due to infiltration of inflammatory cells.Contrast-enhanced ultrasonography that was performed 28 d post-infection in the acute inflammation model showed speckled staining.Inflammation-induced cell infiltration and fiberization,which are findings of chronic lymphadenitis, were seen in the pathological findings. CONCLUSION:Sentinel lymph node imaging was made possible by subcutaneous injection of SonazoidTM.Contrast-enhanced ultrasonography was suggested to be useful in differentiating tumor-induced enlargement and inflammation-induced enlargement of lymph nodes.
基金This work was supported by grants from the Program for National Key Research and Development Program of China(Grant No.2016YFC1202000)National S and T Major Program(Grant No.2012ZX10004-220)from the 4th Three Years Action Plan for the Construction of Shanghai Public Health System(GWIV-29)and Hydatid workstation in Ganzi Tibetan Autonomous Region.
文摘Background:Echinococcosis is a serious,zoonotic,parasitic disease with worldwide distribution.According to a epidemiological survey in 2012 in China,there are 20,000 infected patients and more than 50 million people at the risk.As the dog is the main,definitive host,the Government of China encourages monthly praziquantel treatment of every dog.However,this is difficult to achieve in geographically challenging areas,such as the Tibetan plateau,where there are also many dogs without owners.To overcome these problems,we investigated the transmission blocking capacity of a slow-release formulation of praziquantel administered by subcutaneous injection.Methods:The impact of a slow-release preparation of two pharmacokinetically stereoselective praziquantel enantiomers,i.e.,R-(−)-praziquantel(R-PZQ)and S-(+)-praziquantel(S-PZQ)absorbed into a biodegradable polymer was studied in beagle dogs(N=6).The preparation was given by subcutaneous injection using a single dose of 100 mg/kg.Chiral-selective,high-performance liquid chromatography(HPLC)and high-resolution mass spectrometry(HRMS)were applied to measure the praziquantel enantiomers in the plasma of the dogs.The lower limit for estimating plasma concentrations accurately for R-PZQ was 4 ng/ml and for S-PZQ 20 ng/ml.The pharmacokinetic parameters were calculated by a noncompartmental analysis model using Drug Analyze System(DAS)software 2.0.The SPSS 19.0 software was used for statistical analysis,and the statistical comparison between enantiomers was assessed using the two-tailed t-test.Results:Two hours after administration,peak concentrations of R-PZQ and S-PZQ:321±26 and 719±263 ng/ml,respectively,were achieved.After 180 days,the average plasma concentration of R-PZQ in the six dogs had decreased to 13 ng/ml.The average concentration value of S-PZQ was higher than that of R-PZQ in the first 90-day period but fell afterwards and could not be accurately estimated when dropping below 20 ng/ml(the lower methodological limit for this enantiomer).Taking all the dogs into account,the average maximum concentration(Cmax)of S-PZQ in plasma over the first 3 months was higher than that of R-PZQ by 114.0%(P<0.05),while the average mean retention time(MRT)of R-PZQ in plasma was higher than that of S-PZQ by 96.3%(P<0.05).Conclusions:Praziquantel given as an in situ slow-release formulation by subcutaneous injection resulted in concentrations of the active principle in beagle dogs,which should be capable of resisting new Echinococcus infections for at least 6 months.The new formulation of praziquantel represents a potential,alternative way of presenting medication against tapeworm infections in dogs.
