Intramuscular Injection of Combined Calf Blood Compound (CFC) and Homeopathic Drug Tr14 Accelerates Muscle Regeneration In Vivo.

Skeletal muscle injuries in competitive sports cause lengthy absences of athletes from tournaments. This is of tremendous competitive and economic relevance for both the athletes and their respective clubs. Therapy for structural muscle lesions aims to promote regeneration and fast-track return-to-play. A common clinical treatment strategy for muscle injuries is the intramuscular injection of calf blood compound and the homeopathic drug, Tr14. Although the combination of these two agents was reported to reduce recovery time, the regulatory mechanism whereby this occurs remains unknown. In this in vivo study, we selected a rat model of mechanical muscle injury to investigate the effect of this combination therapy on muscle regeneration. Gene expression analysis and histological images revealed that this combined intramuscular injection for muscle lesions can enhance the expression of pro-myogenic genes and proteins and accelerate muscle regeneration. These findings are novel and depict the positive effects of calf blood compound and the homeopathic drug, Tr14, which are utilized in the field of Sports medicine.

Low-dose methotrexate-induced vulvar edema: A case report.

RATIONALE: Methotrexate (MTX) is an antimetabolite of folic acid, which is used for management of ectopic pregnancy. MTX-related toxicity may include cutaneous mucosal damage, bone marrow suppression, gastrointestinal disorders (gastritis, diarrhea, hematitis), liver and kidney function damage, pulmonary toxicity, cardiac toxicity, and nerve toxicity. However, it is not usual for vulvar edema induced by low-dose methotrexate. PATIENT CONCERNS: In this case report, we described a patient with severe vulvar edema and oral cavity ulceration and scalp ulceration induced by low-dose MTX treatment for ectopic pregnancy. Her presenting complaints were pain in the vulva, oral cavity, and scalp. DIAGNOSES: The patient was diagnosed based on clinical findings for MTX toxic reactions. INTERVENTIONS: Vulva was disinfectioned with iodide and Kangfuxin solution, her mouth was rinsed with mouthwash. Three compound glycyrrhizin tablets were orally administered (3 times/day). After 10 days, the broken skin and mucous membrane healed. OUTCOMES: The vulvar edema and oral cavity ulceration and scalp ulceration healed. LESSONS: Our study demonstrated that even low-dose MTX can be induced skin and mucosal injury, patients and doctors should timely detection of drug toxicity reactions, immediately rescue, prompt discontinuation of medication, and symptomatic treatment to avoid accidental occurrence.

[The body's responsiveness and the efficiency of antihomotoxic therapy for chronic opisthorchiasis: 2. Therapy].

The authors propose a new treatment policy for opisthorchiasis, which is intended for the body's self-regulation and based on the use of antihomotoxic therapy. Forty patients with the verified diagnosis of chronic opisthorchiasis were examined. Antihomotoxic therapy was found to have high clinical (85%) and parasitological (75%) effects, The application of an aggregate clinical estimate showed a positive role of episodes of development of acute inflammatory reactions, fever, and reversion of prior diseases, which favors the restoration of the body's responsiveness and the particular efficiency of the therapy performed. The results of helminthoovoscopy are interpreted in the context of clinical data. There was a significant increase in the count of HLA DR monocytes and in the level of IgA and a reduction in IgE and IL-4 with a substantial rise in the cellular production of other cytokines.

A role for anabolic steroids in the rehabilitation of patients with COPD? A double-blind, placebo-controlled, randomized trial.

STUDY OBJECTIVES: Skeletal muscle weakness commonly occurs in patients with COPD. Long-term use of systemic glucocorticosteroids further contributes to muscle weakness. Anabolic steroids could be an additional mode of intervention to improve outcome of pulmonary rehabilitation by increasing physiologic functioning, possibly mediated by increasing erythropoietic function. PATIENTS AND METHODS: We randomly assigned 63 male patients with COPD to receive on days 1, 15, 29, and 43 a deep IM injection of 50 mg of nandrolone decanoate (ND) [Deca-Durabolin; N.V. Organon; Oss, The Netherlands] in 1 mL of arachis oil, or 1 mL of arachis oil alone (placebo) in a double-blind design. All patients participated in a standardized pulmonary rehabilitation program. Outcome measures were body composition by deuterium and bromide dilution, respiratory and peripheral muscle function, incremental exercise testing, and health status by the St. George's Respiratory Questionnaire. RESULTS: Treatment with ND relative to placebo resulted in higher increases in fat-free mass (FFM; mean, 1.7 kg [SD, 2.5] vs 0.3 kg [SD, 1.9]; p = 0.015) owing to a rise in intracellular mass (mean, 1.8 kg [SD, 3.1] vs - 0.5 kg [SD, 3.1]; p = 0.002). Muscle function, exercise capacity, and health status improved in both groups to the same extent. Only after ND were increases in erythropoietic parameters seen (erythropoietin: mean, 2.08 U/L [SD, 5.56], p = 0.067; hemoglobin: mean, 0.29 mmol/L [SD, 0.73], p = 0.055). In the total group, the changes in maximal inspiratory mouth pressure (PImax) and peak workload were positively correlated with the change in hemoglobin (r = 0.30, p = 0.032, and r = 0.34, p = 0.016, respectively), whereas the change in isokinetic leg work was correlated with the change in erythropoietin (r = 0.38, p = 0.013). In the patients receiving maintenance treatment with low-dose oral glucocorticosteroids (31 of 63 patients; mean, 7.5 mg/24 h [SD, 2.4]), greater improvements in PImax (mean, 6.0 cm H(2)O [SD, 8.82] vs - 2.18 cm H(2)O [SD, 11.08], p = 0.046), and peak workload (mean, 20.47 W [SD, 19.82] vs 4.80 W [SD, 7.74], p = 0.023) were seen after 8 weeks of treatment with ND vs placebo. CONCLUSIONS: In conclusion, a short-term course of ND had an overall positive effect relative to placebo on FFM without expanding extracellular water in patients with COPD. In the total group, the improvements in muscle function and exercise capacity were associated with improvements in erythropoietic parameters. The use of low-dose oral glucocorticosteroids as maintenance medication significantly impaired the response to pulmonary rehabilitation with respect to respiratory muscle function and exercise capacity, which could be restored by ND treatment.

Urofollitropin - Ferring: FERRING hFSH, hFSH - Ferring, human follicle-stimulating hormone - Ferring, Bravelle.

Ferring Pharmaceuticals (US) is developing a highly purified form of urofollitropin [human follicle-stimulating hormone, hFSH, FERRING hFSH, Bravelle] for use in ovarian stimulation in fertility treatments. The highly purified human-derived follicle-stimulating hormone (HP-FSH), administered by either intramuscular (IM) or subcutaneous (SC) injection, was in phase III trials in the US and in May 2002 the product received US FDA approval for use in conjunction with human chorionic gonadotropin for infertility patients undergoing ovulation induction. The product will be marketed as Bravelle. Ferring Pharmaceuticals has also submitted a New Drug Application for additional indications for Bravelle in infertility treatment, which is currently under review by the US FDA. Bravelle is produced from the urine of menopausal women and has been shown to be as effective as Organon's recombinant FSH product, Follistam. Preclinical studies have shown that Ferring Pharmaceuticals' hFSH can be mixed in the same syringe as purified human menopausal gonadotropin (hMG) to reduce the number of daily injections required in ovarian stimulation protocols without altering the bioactivity of FSH or luteinising hormone. In addition, Ferring Pharmaceuticals' hFSH administered SC or IM showed positive results compared with SC Repronex in a randomised, open-label study in patients undergoing in vitro fertilisation.Ferring Pharmaceuticals has teamed up with the American Infertility Association and RESOLVE: the National Infertility Association to improve access to infertility treatment in the US, with the recent launch of the 'Bravelle' HEART (Helping Expand Access to Reproductive Therapy) Programme. The programme is intended to provide urofollitropin treatment at significant cost savings to patients and their physicians. Serono is also developing a highly purified urofollitropin product.

A prospective, randomized study to assess the tolerance and efficacy of intramuscular and subcutaneous administration of recombinant follicle-stimulating hormone (Puregon).

OBJECTIVE: To compare local tolerance and clinical efficacy after i.m. or s.c. injection of recombinant FSH (Puregon; NV Organon, Oss, The Netherlands). DESIGN: An open-label, prospective, randomized, group-comparative, multicenter study. SETTING: Twelve IVF clinics in 10 countries. PATIENT(S): Two hundred eighteen infertile pituitary-suppressed women undergoing IVF-ET were randomized, of whom 195 (i.m., n = 77; s.c., n = 118) received recombinant FSH. INTERVENTION(S): One cycle of controlled ovarian hyperstimulation induced by either i.m. or s.c. injection of recombinant FSH, followed by IVF-ET. MAIN OUTCOME MEASURE(S): Local tolerance symptoms, number of oocytes retrieved, ongoing pregnancy rate. RESULT(S): The incidences after i.m. injection of bruising, pain, redness, swelling, and itching were 37.7%, 31.2%, 13.0%, 7.8%, and 6.5%; after s.c. injection, the corresponding figures were 54.2%, 28.0%, 16.1%, 5.9%, and 3.4%. Only bruising was significantly lower in the i.m. group, which could be attributed to the more visible superficial injection site with s.c. administration. The overall occurrence of local symptoms were 63.6% after i.m. injection and 68.6% after s.c. injection. The mean numbers of oocytes recovered were 9.8 (i.m) and 10.4 (s.c.) and the ongoing pregnancy rates per attempt were 27.1% (i.m.) and 26.1% (s.c.), respectively. CONCLUSION(S): There were no marked differences in local tolerance symptoms and clinical efficacy between i.m. and s.c. administration of recombinant FSH.

Instability of pancuronium in postmortem blood and liver taken after a fatal intramuscular Pavulon injection.

The present study was designed to determine the stability of pancuronium in postmortem blood and liver during storage. Results were obtained using the method by Kerskes et al. [C.H.M. Kerskes, K.J. Lusthof, P.G.M. Zweipfenning, J.P. Franke, The detection and identification of quaternary nitrogen muscle relaxants in biological fluids and tissues by ion-trap LC-ESI-MS, J. Anal. Toxicol. 26 (2002) 29-34.], modified and validated in our laboratory. Target analytes were isolated after enzymatic hydrolysis followed by solid phase extraction (BondElut C18 column). Internal standardisation was carried out using laudanosine and the target ions were monitored by LC-ESI-MS (monitoring ions m/z 358 for IS and 286 for pancuronium). Materials were taken from a 46-year-old woman, who had been found dead. A syringe (2 ml) and an empty ampoule of Pavulon (4 mg/2 mL) were found in her hand. The residual volume of fluid in the syringe was 0.7 ml. An autopsy was performed six days after death. It revealed a needle mark on the left thigh. Postmortem materials (muscle from the injection site, blood and liver) and the syringe with fluid were stored for four months in a freezer at -20 degrees C. The initial pancuronium concentrations were 81 ng/mL in blood and 532 ng/g in liver. The analyte was stable when stored at -20 degrees C in blood even up to seven months. In liver samples its concentrations were variable. Pancuronium in blood stored at 20 degrees C underwent degradation very rapidly. After three months of storage these blood samples had concentrations not greater about 10% of the initial value. The degradation patterns of pancuronium depended on temperature and the biological matrix.

Use of pancuronium bromide to inhibit fetal movement during magnetic resonance imaging. A case report.

Magnetic resonance imaging has been of limited value in fetal evaluation due to the prolonged duration of image construction and uncontrolled fetal movement. This limitation can be overcome safely by immobilizing the fetus with an intramuscular injection of pancuronium bromide.

When do patients given intrathecal morphine need postoperative systemic opiates?

A prospective, randomised study has compared the requirements for intramuscular papaveretum after cholecystectomy in patients given either 0.8 mg intrathecal morphine preoperatively or intravenous papaveretum peroperatively. Patients given intrathecal morphine required significantly less papaveretum during the first 48 hours after operation, but no significant difference in analgesic requirements was observed by 72 hours due to a continuing demand for papaveretum by these patients.

Cytogenetical effects of sonication in mice and their modulations by actinomycin D and a homeopathic drug, Arnica 30.

Experiments were designed to examine if Actinomycin D, an antibiotic, and Amica 30, a homeopathic drug used against shock and injury, can ameliorate cytogenetic damage induced by single or multiple exposures to ultrasonication. Separate sets of healthy mice were directly exposed to sonication for two minutes either once or they received multiple exposures at an interval of 20 days. The mice were then assessed at different intervals, against suitable controls, using parameters like chromosome aberrations (CA), mitotic index (MI), sperm head anomaly (SHA) and micronucleated erythrocytes (MNE). Separate groups of sonicated mice were either orally administered with Arnica 30 (alcohol 30 in control) or injected intramuscularly with Actinomycin-D (AMD). Elevated frequencies of CA, MI, MNE and SHA were noted in sonicated series. AMD had genotoxic effects of its own and also had additive effects on sonication induced genotoxicity. Sonicated mice fed with Arnica 30 showed appreciably reduced genotoxicity as against alcohol 30 and distilled water fed controls, thereby showing ameliorating effect which may have human application.

Myotoxicity of injections for acute muscle injuries: a systematic review.

BACKGROUND: Injection therapies are widely used for muscle injuries. As there is only limited evidence of their efficacy, physicians should be aware of the potential harmful effects of these injected preparations. OBJECTIVES: The purpose of this review was to systematically review the literature on the myotoxic effects of intramuscular injection preparations commonly used for acute muscle injuries. DATA SOURCES: The databases of PubMed, Embase, Web of Science, Cochrane Library, CINAHL and SportDiscus were searched in March 2013. STUDY ELIGIBILITY CRITERIA: Studies reporting histological evaluation or creatine kinase activity after intramuscular injection with local anaesthetics, corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), platelet-rich plasma (PRP), Traumeel(®) and Actovegin(®), or combination preparations were eligible for inclusion. DATA ANALYSIS: Two authors independently screened the search results and assessed the risk of bias. A best-evidence synthesis was used to identify the level of evidence. RESULTS: Forty-nine studies were included in this systematic review. There is strong to moderate evidence that intramuscularly injected local anaesthetics and NSAIDs are myotoxic, and there is conflicting evidence of the myotoxicity of PRP. There is limited evidence that single corticosteroid injections are not myotoxic but have a synergistic myotoxic effect when used together with local anaesthetics. There is no information to assess whether Actovegin(®) and Traumeel(®) are myotoxic. CONCLUSION: Local anaesthetics and NSAID injections are not recommended for the treatment of muscle injuries in athletes, as they are myotoxic. The possible myotoxic effects of corticosteroids, PRP, Traumeel(®) and Actovegin(®) should be assessed in future research.

Autologous blood therapy for common cold--a randomized, double-blind, placebo-controlled trial.

BACKGROUND: In Germany autologous blood therapy (ABT) is a widespread therapy for infectious diseases in complementary medicine. Clinical data for its use for common cold is lacking. METHODS: In a double-blind randomized controlled trial 139 patients with common cold were enrolled either to ABT (gluteal intramuscular reinjection of venous blood three times a week) or to placebo (sterile sodium chloride solution). Main criterion was time period of illness after initiation of treatment, measured by a modified symptom diary adapted from Jackson. RESULTS: 58 and 56 patients completed therapy. In both groups illness duration was 7 days (5.0-10.0 for verum and 5.25-9.0 for placebo). CONCLUSIONS: This trial found no effect of ABT as treatment for common cold. Because of a rather highly selected patient sample another RCT on this topic is reasonable. Further research to analyse the effect of other doses or of autologous blood therapy in addition to homeopathic preparations or vitamin preparations is needed.

Premedication for fibreoptic bronchoscopy.

A randomised, double-blind trial of atropine, atropine plus papaveretum, and atropine plus diazepam given intramuscularly as premedication for fibreoptic bronchoscopy in 60 patients showed no difference between the three regimens as assessed by bronchoscopist or patient. Bronchoscopists frequently attributed a sedative action to atropine alone and their assessment of tolerance and sedation was more optimistic than that of the patients. In a second study comparing intravenous diazepam (10 mg) with saline, after prior intramuscular atropine (0.6 mg), both the bronchoscopists and the patients noted a significant sedative effect of diazepam, and coughing was reduced by diazepam.

The need for analgesic cover after ENT surgery--comparison of nefopam and papaveretum.

Intra-operative intramuscular injections of either papaveretum 0.3 mg/kg or nefopam 0.4 mg/kg were given to alternate patients to promote smooth emergence from ENT anaesthesia in a consecutive series of 40 children. Observations over a period of 30 minutes following completion of surgery showed that emergence was satisfactory in 19 out of 20 children given papaveretum, and in 15 out of 20 children given nefopam. The study confirms that this indication for papaveretum is justifiably popular and that nefopam is a useful alternative mainly because it does not cause respiratory depression. There are no previous reports of the use of nefopam in children.

A comparison of rectal diclofenac with intramuscular papaveretum or placebo for pain relief following tonsillectomy.

A controlled investigation was conducted to compare the effectiveness of diclofenac and papaveretum in the prevention of pain and restlessness after tonsillectomy in children. Sixty children between 3 and 13 years of age were randomly allocated to receive rectal diclofenac 2 mg/kg, intramuscular papaveretum 0.2 mg/kg or no medication immediately after induction of anaesthesia. Pain and appearance were assessed 1, 3 and 6 hours postoperatively, and the following morning. The assessments were double-blind and performed by the same observer. No significant differences in postoperative pain were found between the groups at any time. The use of diclofenac was associated with a significantly more rapid return to calm wakefulness and had significantly less effect upon respiratory rate. Consumption of paracetamol on the day of operation was significantly less in the diclofenac group. Diclofenac may offer advantages compared to papaveretum with regard to safety and convenience for use in the treatment of pain after tonsillectomy in children.

Prevention of fetal movement during invasive procedures with pancuronium bromide.

The use of fetal intramuscular pancuronium (0.5 mg) to temporarily arrest fetal movement during antenatal intervention in six instances is reported. Successful arrest of movement without adverse side effects was observed. The use of this technique eliminates the need for the excessive and potentially dangerous maternal sedation currently used to minimize fetal movement.

[Effectiveness of Formica rufa and autologous blood injection in patients with ankylosing spondylitis: a double-blind randomized study]. / Wirksamkeit von Formica rufa und Eigenblut-Injektionen bei Patienten mit ankylosierender Spondylitis: eine doppelblinde, randomisierte Studie.

While complementary medicine and homeopathy is becoming an increasingly prominent part of the health care practices, there is a lack of controlled studies concerning their effectiveness. In our study, we wanted to answer the question whether a combination of Formica rufa D6 and reinjection of the patient's own blood is superior to injection of placebo. 104 patients with ankylosing spondylitis entered a prospective, randomized, double-blind study. During four weeks they received twice weekly either 1 ml of Formica rufa D6 in combination with 0.5 ml of blood or 1.5 ml NaCl intramuscular. Before and after therapy, mobility, thoracic excursion and doctor's overall assessment were measured in addition to patient's health status, using a German version of the Arthritis Impact Measurement Scales, before and after therapy as well as four, twelve, and twenty-four weeks later. We were not able to detect any statistical difference between treatment and placebo group in any of the parameters measured. Therefore, the therapy under study may not be regarded effective.

Pain relief after tonsillectomy in adults: intramuscular diclofenac and papaveretum compared.

A wide variety of surgical and pharmacological methods have been described in an attempt to reduce pain after tonsillectomy, with conflicting results. Opiates are still widely used, despite unwanted side-effects. Recently the non-steroidal anti-inflammatory drugs have been shown to be effective against a variety of post-operative pains. Diclofenac is effective in both children and adults in the relief of pain after tonsillectomy when administered rectally, but absorption is variable, and suppositories are not widely accepted in the UK. The present double-blind study compared a single intramuscular dose of diclofenac with papaveretum in adults undergoing tonsillectomy. Post-operatively, the patients who received diclofenac had less pain and started drinking significantly sooner than the control group. There were no undesirable side-effects. Intramuscular diclofenac is superior to papaveretum in the relief of pain in adults undergoing tonsillectomy.