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At least 1,297 records · Page 72Linked to original sources
PubMed2002

Medetomidine-ketamine in reindeer (Rangifer tarandus tarandus): effective immobilization by hand- and dart-administered injection.

Twelve reindeer (Rangifer tarandus tarandus) were immobilized by hand injection in indoor stalls with established optimal hand-injection doses of medetomidine-ketamine and then moved to outside paddocks where they were immobilized again with the same dose by dart. The reindeer in paddocks were immobilized a second time with a 50% higher dose, hereafter referred to as the optimal darting dose. Mean time to first sign of sedation was longer and mean induction time was significantly longer (55% and 79%, respectively) when the optimal hand-injection dose was dart injected versus hand injected. Mean time to first sign of sedation was not significantly shorter (although 21% shorter, numerically) but mean induction time was significantly shorter (30%) when animals were darted with the optimal darting dose versus darted with the optimal hand-injection dose. There were no significant differences in respiratory rate, rectal temperature, and relative arterial oxygen saturation in animals injected with different doses and by different routes. but there was a significantly lower heart rate in animals dart injected with the optimal darting dose versus dart injected with the optimal hand-injection dose. All animals responded at similar rates to atipamezole injection.

Adrenergic alpha-Antagonists↗
PubMed1998

Effects of injection rates of contrast material on arterial phase hepatic CT.

OBJECTIVE: Our goal was to assess the effects of the i.v. injection rate of contrast material on arterial phase hepatic CT. SUBJECTS AND METHODS: One hundred patients were randomly divided into four groups of 25 with different injection rates of 90 ml of contrast material: 2, 3, 4, or 5 ml/sec. Single-level serial CT was performed at the level of the middle section of the main portal vein before injection and every 2 sec from 12 sec to 60 sec after injection of contrast material. The enhancement value was calculated as the difference in attenuation value between the unenhanced and contrast-enhanced images for the aorta and liver parenchyma. The duration of the arterial phase was defined as the interval beginning when the enhancement value for the aorta reached 100 H and ending when the value for the liver parenchyma reached 20 H. RESULTS: Faster injection rates increased the maximum enhancement of the aorta. Although faster injection rates decreased the time from injection to the beginning and the end of the arterial phase, faster injection rates did not decrease the duration of the arterial phase itself. CONCLUSION: A faster injection rate increases arterial enhancement of the liver, and the duration of the arterial phase remains the same as that occurring with a slower injection rate. We hypothesize that faster injection rates can provide better results using CT to reveal hypervascular liver tumors.

Adult↗
PubMed1999

Aortic enhancement during abdominal CT angiography: correlation with test injections, flow rates, and patient demographics.

OBJECTIVE: The goal of our study was to determine the effect of contrast material injection rate and patient demographic variables on vascular enhancement for abdominal CT angiography and compare test injection results with actual patterns of vascular enhancement. SUBJECTS AND METHODS: One hundred twenty-five patients underwent abdominal CT angiography. For each patient, CT attenuation values (Hounsfield units) of the aorta were determined before and after IV contrast administration, every 3 sec between 21 and 60 sec. A peak aortic enhancement value and the time needed to reach peak and aortic enhancement thresholds of 150 and 200 H were determined. All patients received 150 ml of nonionic contrast material at 3 ml/sec in 25 patients and 4 ml/sec in 100 patients. A test injection of 15 ml was used to compute a scan delay in 46 patients. Patient age, sex, weight, injection rate, and test injection results were compared with vascular enhancement patterns. RESULTS: For the 125 patients, the mean aortic enhancement at each time point was greater than 150 H. Patient weight was inversely correlated (r2 = -.62) with aortic enhancement. The test injection did not accurately predict actual aortic enhancement peak value or time. Test injection delay time was significantly correlated with time to reach aortic enhancement thresholds of 150 and 200 H. The 4 ml/sec rate resulted in a higher peak aortic enhancement (320+/-58 H versus 281+/-49 H) (mean +/- SD, p < .01) that was reached quicker than with the 3 ml/sec injection rate (45+/-5 sec versus 52+/-5 sec) (p < .01). Injecting at 4 ml/sec resulted in greater aortic enhancement values at 24-45 sec, whereas 3 ml/sec produced significantly better aortic enhancement at 54-60 sec. CONCLUSION: The test injection correlated better with time to reach specific aortic enhancement thresholds than with time to peak aortic enhancement. For a given amount of contrast material, faster injection rates resulted in greater vascular enhancement that occurred earlier.

Aorta, Abdominal↗
PubMed1997

The safety of injecting insulin through clothing.

OBJECTIVE: Many of the "antiseptic" practices recommended by health care professionals for insulin injection have been successfully challenged as unnecessary. Since people with diabetes have long been observed to inject their insulin through their clothing, this study was undertaken to determine the safety and perceived benefits of administering insulin by this "rogue" technique. RESEARCH DESIGN AND METHODS: Fifty people with insulin-treated diabetes were randomized into a 20-week single-blinded prospective crossover study comparing the conventional subcutaneous injection technique (with skin preparation) to an experimental injection technique through clothing. Skin assessment, glycated hemoglobin levels, and leukocyte count were determined before randomization, at 10 weeks (before crossover), and again at 20 weeks (at completion). The participants injected through a single layer of fabric, which ranged from nylon to denim. Problems, benefits, type of clothing, and other comments were recorded by the subjects in an injection log. RESULTS: Forty-two (84%) subjects completed the study. The mean age was 41 years (range, 23-63 years), 50% were women, 86% were Caucasian, and 80% had type I diabetes. The mean duration of diabetes was 14 years (range, 1-33 years). Fifty-one percent had > 16 years of education. The demographic characteristics of the dropouts were similar to those who completed the study. Over the 20-week period approximately 13,720 injections were performed by participants. None of the subjects experienced erythema, induration, or abscess at injection sites. Neither the glycated hemoglobin levels nor the leukocyte counts differed between the conventional and experimental regimens. During the injection-through-clothing phase of the study, only minor problems, such as blood stains on clothing and bruising, were recorded in the logbooks. However, subjects reported that injection through clothing offered benefits such as convenience and saving time. CONCLUSIONS: It is safe and convenient to inject insulin through clothing.

Adult↗
PubMed2002

Effects of florfenicol injection on the meat characteristics of the cervical muscles in cattle.

OBJECTIVE: To determine the effects of florfenicol injection on the meat characteristics of the cervical muscles in cattle. ANIMALS: 100 steers (mean weight, 380 kg). PROCEDURE: In 50 calves, florfenicol (25 ml, twice) was injected into the cervical muscles of 1 side of the neck, and saline (0.9% NaCI) solution (25 ml, twice) was injected into the cervical muscles of the other side of the neck. In the remaining 50 calves, florfenicol was injected into the cervical muscles of 1 side of the neck, and nothing was injected into the cervical muscles of the other side of the neck. Animals were slaughtered 132 days later, and samples of the cervical muscles were submitted for histologic evaluation and measurement of shear forces. RESULTS: 2 injection sites used in the present study had extensive lesions, and both of these were sites where florfenicol had been injected. However, histologic scores for the florfenicol injection sites were not significantly different from scores for the contralateral saline solution injection sites and uninjected control sites. In addition, shear force values were not significantly different between sites in which florfenicol had been injected and the contralateral sites. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that few reactions should be expected with injection of florfenicol into the cervical muscles in steers and that reactions that do occur will consist mainly of fibrosis and infiltration of adipose tissue. However, shear force values, a measure of tenderness of the meat, should not be affected.

Animals↗
PubMed2004

Effects of intracameral injection of preservative-free lidocaine on the anterior segment of the eyes in dogs.

OBJECTIVE: To evaluate effects of intracameral injection of preservative-free 1% and 2% lidocaine hydrochloride solution on the anterior segment of the eyes in dogs. ANIMALS: 16 adult healthy dogs (8 male and 8 female) judged to be free of ocular disease. PROCEDURE: Dogs were randomly assigned to 2 groups of 8 dogs each. Group 1 dogs received an intracameral injection of 0.10 mL of preservative-free 1% lidocaine solution in the designated eye, and group 2 dogs received 0.10 mL of preservative-free 2% lidocaine solution in the designated eye. After injection, intraocular pressure was measured every 12 hours for 48 hours and then every 24 hours until 168 hours after injection. Slit-lamp biomicroscopy was performed preceding intracameral injection, 8 hours after injection, and then every 24 hours until 168 hours after injection. Ultrasonic pachymetry and specular microscopy were performed preceding intracameral injection and 72 and 168 hours after injection. Corneal thickness and endothelial cell density and morphology were compared with baseline measurements. RESULTS: No significant differences were found in intraocular pressure, corneal thickness, endothelial cell density, and morphologic features in either group, compared with baseline. A significant difference in aqueous flare was found for treated and control eyes 8, 24, and 48 hours after injection, compared with baseline. No significant difference in aqueous flare was found between treated and control eyes within either group. CONCLUSIONS AND CLINICAL RELEVANCE: No adverse ocular effects were detected after intracameral injection of preservative-free 1% or 2% lidocaine solution; thus, its use would be safe for intraocular pain management in dogs.

Analysis of Variance↗
PubMed1994

Effectiveness of zinc acetate injection in alleviating postweaning performance lag in pigs.

Four trials were conducted using crossbred pigs (n = 308) to determine the effects of Zn acetate injection near weaning on serum Zn concentrations and performance. In Trial 1, 78 pigs (BW of 5.1 kg and age of 18 d) were injected i.m. 3 d before weaning with either 3 mg of Zn from Zn acetate (in saline) per kilogram of BW or saline. Serum Zn concentrations were higher (P < .05) for Zn-injected pigs at 1 wk postweaning than for controls. In Trial 2, 96 pigs (BW of 7.2 kg and age of 26 d) were used to compare time of i.p. injection of Zn (weaning or 12 h postweaning) and amount of Zn injected (0, 3, or 4 mg of Zn/kg of BW). Serum Zn concentrations were higher (P < .01) in Zn-injected pigs 1 d after injections and remained higher than those in controls until after wk 2. In Trial 3 (n = 30, BW of 6.9 kg and 24 d of age), pigs that were injected with 3 mg of Zn/kg BW i.p. 3 d postweaning had lower (P < .05) ADG and ADFI and lower (P < .01) gain/feed from d 4 to d 7 postweaning than controls. Zinc-injected pigs had higher (P < .05) serum Zn concentrations at d 7. In Trial 4, 104 pigs (BW of 6.4 kg) were used in a 2 x 2 x 2 factorial arrangement of treatments: 1) regrouped 3 d before weaning or not regrouped, 2) Zn injections (3 mg i.p.) or placebo, and 3) time of injection, 2 d before or 1 d after weaning. All pigs were weaned at 23 d of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗
PubMed1999

Use of vitamin B12 injections among elderly patients by primary care practitioners in Ontario.

BACKGROUND: Excess use of parenteral vitamin B12 has been reported from audits of clinical practices. The authors assessed the use of vitamin B12 injections in patients aged 65 years and over in Ontario. METHODS: A cross-sectional analysis was conducted that included all elderly people covered by the Ontario Health Insurance Plan who received insured services from general practitioners or family physicians (GP/FPs). For each practice the proportion of elderly patients who received regular vitamin B12 injections between July 1996 and June 1997 was calculated. The frequency of injections was determined for each patient receiving regular B12 replacement. RESULTS: Of the 1,196,748 elderly patients (mean age 74.8 [standard deviation 6.8], 58.0% female) treated by 14,177 GP/FPs, 23,651 (2.0%) received regular B12 injections. The rate of B12 injections per patient, standardized for age and sex, varied between practices (range 0%-48.6%). Although no authoritative sources support the practice, 3303 (19.8%) of the 16,707 patients receiving long-term parenteral therapy had, on average, overly frequent injections (more than 1 injection every 4 weeks). For 76 (12.3%) of the 617 practices with 10 or more patients receiving regular vitamin B12 injections, the mean injection frequency was greater than once every 4 weeks. The proportion of patients in these 617 practices who received overly frequent injections varied extensively (0%-100%). INTERPRETATION: Our findings indicate that some primary care physicians in Ontario administer unnecessary vitamin B12 injections to elderly patients.

Aged↗
PubMedDate not supplied

The Wand vs. traditional injection: a comparison of pain related behaviors.

PURPOSE: The purpose of this study was to evaluate the efficacy of a computerized anesthesia delivery system (e.g., Wand) compared to a traditional anesthesia administration, with respect to reducing disruptive pain related behavior during injections. METHODS: Subjects consisted of 62 patients between the ages of 5 and 13 requiring local anesthesia for dental restorations in the maxilla. Patients were randomly assigned to either the Wand or the traditional anesthetic delivery system. A palatal approach to the anterior and middle superior alveolar nerves and the anterior superior alveolar nerve was used with the Wand injections. Buccal infiltration and palatal injections were used for the traditional method. Pain behavior was observed and coded. Pain ratings were obtained. Subjects also rated their satisfaction with treatment. RESULTS: Results of chi-square tests found that the Wand injections produced significantly fewer patients who exhibited disruptive behavior during the initial 15 seconds of an injection when compared with those who received a traditional palatal injection. Wand patients were significantly less likely to cry, to exhibit disruptive body movements, and to require physical restraint. In contrast, there were no significant differences in disruptive behavior when comparing the Wand with the traditional buccal injection. Pain ratings showed no statistical difference between the Wand and the traditional injections. CONCLUSION: Wand injections can deliver proper anesthesia, utilizing one palatal injection site, while significantly reducing the likelihood of disruptive behaviors during the initial moments of an injection.

Adolescent↗
PubMed1975

Accumulation of mononuclear cells in tumors with growth slowing and elevation in host splenic histidine decarboxylase activity following repeated tumor injections with bradykinin.

Repeated intratumor injections of SV-40 virus-induced and transplaned syngenic fibrosarcomsa in hamsters with bradykinin (BK) has produced markded slowing of tumor growth in comparison with control saline injections. Growth slowing was greatest when the injections were daily, with a decrease in growth slowing as injections became less frequent. The growth slowing also was dose dependent (greater with 250 mug BK injections than with 50 mug BK injections). BK-injected tumors, on histological study, were found to have marked infiltration with mononuclear cells. This was not encountered in noninjected or saline-injected tumors. Significant mononuclear cell infiltration of noninjected tumors was found in two tumor animals which had had one tumor injectecd with BK. Splenic histidine decarboxylase (HDC) activity was higher in BK tumor-injected animals than in saline tumor-injected animals. Splenic HDC activity was higher when studed nearer the period of daily intratumor injections. The findings of this study suggest a potential role of inportance for inter-related vasoactive substances which act as mediators of inflammation in the study and therapy of neoplasia.

Animals↗
PubMed2004

Traditional versus automated injection contrast system in diagnostic and percutaneous coronary interventional procedures: comparison of the contrast volume delivered.

UNLABELLED: Contrast injection with a manual stopcock-manifold system is the standard technique during diagnostic coronary angiography or percutaneous coronary intervention (PCI). The ACIST Injection System is a new automatic injection device that allows online hemodynamic monitoring, as well as control of injection rate and amount of contrast to be delivered. The aim of the study was to compare the amount of contrast media delivered using the two methods, i.e., the traditional (manual injection plus standard power injection for the left ventriculography using the ANGIOMAT-6000) versus the ACIST System programmed injector. A total of 453 consecutive patients underwent diagnostic cardiac catheterization and/or PCI at our institution. Patients were randomly assigned to either automated contrast injection with the ACIST device (n = 253) or to conventional contrast injection using a stopcock-manifold system and contrast injection by hand syringe (n = 200). In the diagnostic catheterization group, the mean quantity of contrast volume was significantly lower in the ACIST group compared to the control group (130 +/- 60 ml versus 257 +/- 64 ml, respectively; 97.4% more contrast media; p < 0.001). When the data were analyzed for patients who underwent diagnostic catheterization plus PCI, the mean quantity of contrast volume was 228 +/- 90 ml versus 350 +/- 94 ml, respectively (53.8% more contrast media; p < 0.001). For patients who underwent PCI alone, the mean quantity of contrast volume was 175 +/- 76 ml versus 275 +/- 100 ml, respectively (57.3% more contrast media; p = 0.009). When only the total volume of contrast media delivered to the patient was considered (not including the contrast wasted outside), the results were very similar. CONCLUSION: There was a significant reduction in the total volume of contrast media used (amount injected to the patient as well as the amount wasted) and in the net amount of contrast delivered to the patient with the ACIST power device when compared to the traditional method of manual contrast injection.

Angioplasty, Balloon, Coronary↗
PubMed2002

A comparison of intraoral injection discomfort produced by plain and epinephrine-containing lidocaine local anesthetic solutions: a randomized, double-blind, split-mouth, volunteer investigation.

The authors report a clinical trial designed to compare the discomfort produced by plain and epinephrine-containing lidocaine solutions during local anesthesia in the maxilla. Twenty-four healthy volunteers were recruited; each received buccal and palatal infiltrations on each side of the maxilla in the premolar region. The solutions were 2% lidocaine and 2% lidocaine with 1:80,000 epinephrine. Allocation to side was randomized and operator and volunteer were blinded to the identity of the solutions. Volunteers recorded injection discomfort on a 100-mm visual analogue scale (VAS). Volunteers were included in the trial if a score of at least 30 mm was recorded for at least 1 of the matched pair of injections. Differences between treatments were measured using Student's paired t test. Twelve volunteers recorded a VAS score of at least 30 mm for 1 or both buccal injections, and 17 volunteers reached this score for palatal injections. Buccal injection pain was less when the plain solution was used (P = .04) and was not influenced by the order of the injection. Palatal injection discomfort did not differ between the solutions; however, the second palatal injection was more uncomfortable than the first palatal injection (P = .046). These results suggest that plain lidocaine produces less discomfort than lidocaine with epinephrine when administered into the maxillary premolar buccal sulcus in individuals who report moderate pain during this injection. Palatal injection discomfort does not differ between these solutions.

Administration, Buccal↗
PubMed2004

Pain and anxiety reduction using a manual stimulation distraction device when administering local analgesia oro-dental injections: a multi-center clinical investigation.

OBJECTIVE: This study was designed to assess the effects of a manual stimulating distraction device (Isoflex referred to as Manual Stimulation Distraction Device or MSDD) for reducing pain and anxiety experienced with standard dental local anesthetic injections. Additionally, the memory recall effects on injection pain and anxiety were also explored. METHODOLOGY: Patients from different dental clinics were identified by their practitioners as requiring dental procedures under local anesthesia, in the same area on both sides of the mouth. A local anesthetic solution was injected on either the left or right side at different times by random selection; one side using MSDD, while the opposite side used a solution without MSDD. Each patient acted as his or her own symmetrical split-mouth control. The same dentist administered both injections, using identical technique and equipment for each side. Forty-six patients used the MSDD first with the injection, while 54 used MSDD second when they received the injection. Using 10-point visual analogue nominal and ordinal scales, pain and stress were recorded by the patient each time after receiving the injection. The results were pooled and subjected to statistical analysis. Student's paired t-test was employed to test for significant differences in pain and anxiety (stress) when injections were administered with and without MSDD. RESULTS: Results showed significant reductions in perceived pain and stress from local analgesia injections (p < 0.001) when MSDD was used. There was no correlation of pain reduction with age, gender, upper or lower jaw, with or without MSDD. There was a trend for pain and stress to be scored higher for those subjects who had a lower period since the first injection (POFI) scores. This was attributed to recent memory of pain, as POFI scores over one week were significantly lower (p < 0.05). Stress reduction for POFI scores greater than one week proved to be non-significant (p = 0.099). CONCLUSION: In this study, MSDD was effective at reducing pain and stress experienced with local regional analgesic injections.

Adolescent↗
PubMed1992

Permanent acceptance of liver allografts by intraportal injection of donor spleen cells in rats.

Antigen pretreatment through the oral or intraportal route has been reported to suppress antibody formation or delayed-type hypersensitivity (DTH) response to the same antigens. However, this effect on allografted organs has not been well studied. In this study we evaluated the efficacy for suppression of antibody formation and DTH response to the allogeneic antigens and tried to prolong liver allograft survival in rats. Male ACI (RT1a) rats were used as donors and male BUF (RT1b) rats as recipients. Intraportal or intravenous injection of spleen cells (SPCs) (5 x 10(7)) was performed through the mesenteric vein or the tail vein, respectively. The anti-ACI DTH response was tested by ear challenge of ACI SPCs. Cytotoxic antibody was assessed by complement-dependent cytotoxicity assay. ACI rat liver was transplanted orthotopically to BUF rat by the cuff technique 10 days after SPC injection. Cytotoxic antibody titer rose to X2(6) to X2(8) at 7 to 10 days after intravenous injection of SPCs. However, intraportal injection of the cells rarely caused a rise in antibody titer and even strongly suppressed subsequent antibody formation induced by intravenous injection when given 10 days before. The DTH response was also suppressed by intraportal injection of SPCs, with a mean value of 0.18 +/- 0.13 mm versus 0.67 +/- 0.19 mm for controls or 0.46 +/- 0.04 mm with intravenous injection. Liver-allografted rats died between 9 and 11 days, averaging 10.1 +/- 0.7 days in the control group. All seven transplants injected intraportally with donor SPCs survived more than 100 days, whereas six of eight rats injected intravenously with donor SPCs died of bleeding from the surface of the liver grafts within 12 hours after grafting, with signs similar to those of hyperacute rejection. Four of five rats injected intraportally with F344 (third-party) SPCs died of acute rejection in the same way the control rats died. The liver allograft-bearing rats had permanently accepted ACI skin grafts when tested 60 days after liver transplantation but rejected F344 skin grafts in the normal fashion. Intraportal injection of donor SPCs markedly suppressed the antibody formation, as well as the DTH response, and completely blocked liver allograft rejection. Moreover, the liver allograft-bearing rats proved to be fully tolerant of the donor antigen. This method might be a promising modality for inducing donor-specific tolerance in liver transplantation.

Animals↗
PubMedDate not supplied

Effect of a single botulinum toxin injection on bone development in growing rabbits.

Intramuscular injections with botulinum toxin A (BTX-A) lead to a rapid decrease in muscle mass and force, but the effect of this drug on bone development is unclear. In the present pilot study we evaluated the effect of a one-time injection of BTXA in growing rabbits. Twelve young (weight 1.5 kg) New Zealand rabbits were randomly assigned to receive either BTX-A (total dose 8 units per kg body weight) or sodium chloride 0.9% injections into the left quadriceps and gastrocnemius muscles. Both groups continued to gain weight in a similar manner following the injection. However, when the animals were sacrificed at five weeks after the injection, the group receiving BTX-A had a significant deficit (of 10%) in gastrocnemius muscle mass on the injected side, whereas no significant side-difference was found for the quadriceps. BTX-A injections did not affect the length of the tibia. Nevertheless, bone mineral content of the whole tibia, as measured by dual-energy X-ray absorptiometry, was 7% lower in the BTX-A injected side than on the contralateral side. Peripheral quantitative computed tomography showed that this bone mass deficit was larger in the metaphysis than in the epiphysis or diaphysis. In the diaphysis, the bone mass deficit was due to a reduction in cross-sectional bone dimensions, which equally affected the cross-section of the entire bone, the cortical compartment and the marrow space. BTX-A injections did not have a detectable effect on cortical bone mineral density. The bone mass deficit in the diaphysis thus appeared to be caused by a lack of periosteal bone apposition rather than increased endocortical or intracortical resorption. These preliminary data suggest that intramuscular BTX-A injections can have a deleterious effect on the development of bones that are loaded by the injected muscles.

Animals↗
PubMed2006

Injection practices in the formal & informal healthcare sectors in rural north India.

BACKGROUND & OBJECTIVES: Unsafe injections in health settings contribute to a large burden of preventable blood-borne diseases. Current strategies to enhance injection safety in India almost exclusively target the formal health sector. However, injections are provided not only by doctors and nurses in the formal sector, but also by practitioners from the informal sector, such as traditional healers, who are not necessarily trained or authorized to administer these. The present study was undertaken to determine the extent to which patients using formal healthcare services also consult and receive injections in the informal sector, quantify the injections received by these patients and their relatives, and assess knowledge and attitudes in relation to injections. METHODS: A cross-sectional survey of 280 in patients and 120 of their relatives was undertaken between November 2004 and February 2005 in two rural hospitals in Bihar and Jharkhand states. RESULTS: Sixty one per cent of patients had consulted a healthcare practitioner in the month prior to admission, and 39 per cent of these had consulted in the informal sector at least once. Forty three per cent had received at least one injection in the month prior to admission, and 43 per cent of these were given by informal practitioners. About 13 per cent of relatives had received at least one injection in the last three months, 69 per cent of which were given by informal practitioners. Thirty per cent did not know that unsafe injections can spread diseases. INTERPRETATION & CONCLUSION: The findings of this survey highlight the fact that informal practitioners in India are commonly administering injections with clear implications for patient safety. There is a need to promote strategies for injection safety among both formal and informal practitioners.

Adolescent↗
PubMedDate not supplied

Subacromial injections of corticosteroids and xylocaine for painful subacromial impingement syndrome.

BACKGROUND: Subacromial impingement syndrome, with pain and limited motion, is a common disease encountered daily in clinics. This study determined the efficacy of subacromial injections of corticosteroids and local anesthesia for treatment of painful subacromial impingement syndrome. METHODS: A total of 238 shoulders in 209 patients, with regular follow-up, were enrolled in this study. Mean patient age was 51 years (range 31-72 years). Each patient complained of shoulder pain with progressive motion limitation present for more than one month, which was not relieved by various nonsurgical treatments. The mean duration of symptoms before injection was five months (range 1-12 months). Each patient had a positive Neer impingement sign, Hawkins impingement sign, painful tendon sign, limited range of motion and did not show clinical evidence of a rotator cuff tear. Each patient was administered an injection of 1 ml of 2% Xylocaine and 1 ml of Rinderon suspension. A second injection was administered one week later for patients without obvious improvement. Following injections, patients were instructed to perform a home rehabilitation program for four weeks. Follow-up examinations were scheduled for one, two and four weeks, and three, six, nine and 12 months after injection. Outcome measures included the Constant-Murley score and shoulder range of motion. RESULTS: At follow-up four weeks after the first injection, 216 shoulders (91%) had satisfactory improvement in amount of pain and range of motion: mean improvements in the active range of motion of forward elevation, abduction, internal rotation and external rotation were 56 degrees, 48 degrees, 18 degrees and 22 degrees, respectively. However, at the first year follow-up, the satisfaction rate was slightly down at 88%, and 19 shoulders (8%; 16 patients) had recurrent pain and motion limitation after an average of 5.4 months (range 3-12 months). Each of these patients received another injection. Surgery was recommended for 22 shoulders (9%; 18 patients) that did not have satisfactory improvement. Of these patients, eight shoulders (seven patients) had a partial tear of the rotator cuff and 10 shoulders (eight patients) had complete rotator cuff tears. CONCLUSION: Subacromial injection of corticosteroids and local anesthesia is an effective therapy for the treatment of symptomatic subacromial pathology, such as impingement pain, tendonitis and bursitis. The injection can substantially reduce pain and increase range of motion of the shoulder. If there is no improvement following injections, a rotator cuff tear should be suspected.

Adrenal Cortex Hormones↗
PubMed1991

Effect of low frequency low energy pulsing electromagnetic fields on mice injected with cyclophosphamide.

C3H mice have been used to investigate the effect of a combination of cyclophosphamide (CY) and electromagnetic fields (PEMF). Mice were injected i.p. with a single dose of 200 mg/kg body weight of CY and then exposed to PEMF 24 h per day. In an initial series of experiments immediately after CY injection mice were exposed to PEMF until sacrifice. WBC counts in the peripheral blood demonstrated a quicker decline in WBC at days 1 and 2 in mice exposed to PEMF. Groups of mice were sacrificed at days 1, 4, 6, 8, and 10 after CY injection. In mice exposed to PEMF the spleen weight was less than in controls at days 6, 8, and 10. Autoradiographic studies demonstrated that the labeling index of bone marrow smears did not significantly differ between controls and experimental mice exposed to PEMF, whereas the spleen labeling index proved to be higher among control mice versus mice exposed to PEMF at day 6, and higher among mice exposed to PEMF versus controls at day 8. In a second series of experiments mice were exposed to PEMF only over the 24 h following CY injection. We found that the spleens of mice exposed to PEMF weighed less than those of controls at days 6 and 8. The labeling index of bone marrow did evidence a slight decrease among mice exposed to PEMF at days 8 and 10 after CY injection versus control mice. The spleen labeling index proved to be lower in experimental mice exposed to PEMF than in controls at days 4, 6, and 8. Mice were then injected with CY, half were exposed to PEMF, and 24 h later bone marrow was recovered from both groups of animals. The same number of bone marrow cells was injected via the tail vein into recipient mice irradiated to 8.5 Gy. The grafting efficiency of the bone marrow was evaluated by examining the number of spleen colonies and the spleen and bone marrow labeling indices at day 8; all parameters proved to be significantly lower among mice grafted with the bone marrow of mice injected with CY and exposed to PEMF than among controls injected with CY only. Finally, we found th at the effect of PEMF is evident only if mice are exposed during the 24 h following CY injection. The data reported here indicates that PEMF exposure after CY injection increases the damage induced in mice by CY.

Animals↗