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1.
Pharm Res ; 38(7): 1179-1186, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34244893

ABSTRACT

PURPOSE: Pharmaceutical buffer systems, especially for injectable biologics such as monoclonal antibodies, are an important component of successful FDA-approved medications. Clinical studies indicate that buffer components may be contributing factors for increased injection site pain. METHODS: To determine the potential nociceptive effects of clinically relevant buffer systems, we developed an in vitro multi-electrode array (MEA) based recording system of rodent dorsal root ganglia (DRG) sensory neuron cell culture. This system monitors sensory neuron activity/firing as a surrogate of nociception when challenged with buffer components used in formulating monoclonal antibodies and other injectable biologics. RESULTS: We show that citrate salt and citrate mannitol buffer systems cause an increase in mean firing rate, burst frequency, and burst duration in DRG sensory neurons, unlike histidine or saline buffer systems at the same pH value. Lowering the concentration of citrate leads to a lower firing intensity of DRG sensory neurons. CONCLUSION: Increased activity/firing of DRG sensory neurons has been suggested as a key feature underlying nociception. Our results support the utility of an in vitro MEA assay with cultured DRG sensory neurons to probe the nociceptive potential of clinically relevant buffer components used in injectable biologics.


Subject(s)
Biological Products/administration & dosage , Injection Site Reaction/prevention & control , Injections/adverse effects , Nociception/drug effects , Pain/prevention & control , Animals , Biological Products/chemistry , Buffers , Cells, Cultured , Drug Evaluation, Preclinical/instrumentation , Electrodes , Ganglia, Spinal/cytology , Pain/etiology , Primary Cell Culture , Rats , Sensory Receptor Cells/drug effects
2.
Plast Reconstr Surg ; 147(1): 112-125, 2021 01 01.
Article in English | MEDLINE | ID: mdl-33002980

ABSTRACT

BACKGROUND: Lateral epicondylitis is a common overuse injury affecting approximately 1 to 3 percent of the population. Although symptoms may disappear spontaneously within 1 year, the clinical guidelines for conservative treatment are not clear. The authors' objective was to examine the outcomes of nonsurgical treatments for lateral epicondylitis through a meta-analysis and provide a treatment recommendation using the available evidence. METHODS: The authors searched the PubMed, EMBASE, Scopus, and Web of Science databases to identify primary research articles studying conservative treatments (electrophysiotherapy, physical therapy, and injections) for lateral epicondylitis. The authors included randomized controlled trials published in peer-reviewed journals. Data related to outcomes (pain, grip strength, Patient-Rated Tennis Elbow Evaluation score, and Disabilities of the Arm, Shoulder and Hand score) and complications were extracted. RESULTS: Fifty-eight randomized controlled trials were included in the meta-analysis. Electrophysiotherapy was effective in improving pain [mean difference, -10.0 (95 percent CI, -13.8 to -6.1)], Patient-Rated Tennis Elbow Evaluation score [mean difference, -10.7 (95 percent CI, -16.3 to -5.0)], and Disabilities of the Arm, Shoulder and Hand score [mean difference, -11.9 (95 percent CI, -15.8 to -7.9)]; and physical therapy improved pain [mean difference, -6.0 (95 percent CI, -9.7 to -2.3)] and Patient-Rated Tennis Elbow Evaluation scores [mean difference, -7.5 (95 percent CI, -11.8 to -3.2)] compared to placebo. Injections did not improve any outcome measures. Patients who received electrophysiotherapy and injections reported higher adverse effects than physical therapy patients. CONCLUSIONS: Patients who received electrophysiotherapy and physical therapy reported statistically and clinically improved scores in pain and function compared to placebo. Injections may put patients at higher risk for adverse effects compared to other conservative treatments. When managing lateral epicondylitis conservatively, electrophysiotherapy and physical therapy should be prioritized before other interventions. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.


Subject(s)
Conservative Treatment/methods , Pain Management/methods , Pain/diagnosis , Tennis Elbow/therapy , Conservative Treatment/adverse effects , Electric Stimulation Therapy/adverse effects , Electric Stimulation Therapy/methods , Exercise Therapy/adverse effects , Exercise Therapy/methods , Humans , Injections/adverse effects , Injections/methods , Pain/etiology , Pain Management/adverse effects , Pain Measurement , Randomized Controlled Trials as Topic , Tennis Elbow/complications , Treatment Outcome
3.
Medicine (Baltimore) ; 99(45): e23086, 2020 Nov 06.
Article in English | MEDLINE | ID: mdl-33157977

ABSTRACT

BACKGROUND: Diabetic gastroparesis (DGP) is one of the common complications of diabetes. Accumulated evidences have shown that acupoint injection is beneficial for the clinical treatment of diabetic gastroparesis. However, there is currently no systematic review to assess this therapy. This program aims to evaluate the effectiveness and safety of this therapy for the patients with DGP. METHODS AND ANALYSIS: Literature search will be conducted via following electronic bibliographic databases from inception to Aug 2020: the Cochrane Library, PubMed, MEDLINE, Web of Science, EMBASE, Springer, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Chinese Scientific Journal Database (VIP), Wan-Fang Database. All randomized controlled trials published in English or Chinese related to acupoint injection for DGP will be included. The primary outcome is the total effective rate. The secondary outcomes are the change of motilin and gastrin levels before and after the treatment. Two researchers will be responsible for the selection of study, extraction of data, and assessment of study quality independently. RevMan V5.3 Software will be used for assessing the risk of bias and synthesizing data. RESULTS: This study will provide a high-quality synthesis of current available evidence for the treatment of DGP with this therapy clinically. CONCLUSION: The conclusions of our study will provide new evidence to judge whether acupoint injection is an effective intervention for patients suffered from DGP. OSF REGISTRATION NUMBER:: osf.io/ms58j.


Subject(s)
Acupuncture Points , Diabetes Complications/drug therapy , Gastroparesis/drug therapy , Meta-Analysis as Topic , Research Design , Systematic Reviews as Topic , Humans , Injections/adverse effects , Injections/methods , Randomized Controlled Trials as Topic , Treatment Outcome
4.
J Cosmet Dermatol ; 19(3): 566-569, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31490624

ABSTRACT

BACKGROUND: As the desire for beauty and youthful appearance has increased in recent years, cosmetic injections are getting more attention. However, patients discomfort during these injections is a challenging issue. AIM: This review explores common approaches to reduce pain and discomfort during cosmetic injections through the available literature. METHODS: The eligible studies through searching in PubMed have been entered to evaluate the common methods of pain reduction for cosmetic injections. RESULTS: According to reviewed studies, vibration, local anesthesia, and vapocoolant anesthesia are common methods applied in order to reduce pain and discomfort in patients. All of these methods are able to reduce pain through their affects on neuron fibers. CONCLUSION: It seems that all common approaches can result in some amount of pain reduction. Using a combination of these methods during injections, practitioners can successfully reduce the pain of injection.


Subject(s)
Anesthesia, Local/methods , Cosmetic Techniques/adverse effects , Injections/adverse effects , Pain, Procedural/prevention & control , Vibration/therapeutic use , Anesthetics, Local/administration & dosage , Botulinum Toxins, Type A/administration & dosage , Dermal Fillers/administration & dosage , Humans , Pain, Procedural/etiology , Treatment Outcome
5.
Sci Rep ; 9(1): 16721, 2019 11 13.
Article in English | MEDLINE | ID: mdl-31723184

ABSTRACT

The adverse drug reaction (ADR) of traditional Chinese medicine injection (TCMI) has become one of the major concerns of public health in China. There are significant advantages for developing methods to improve the use of TCMI in routine clinical practice. The method of predicting TCMI-induced ADR was illustrated using a nested case-control study in 123 cases and 123 controls. The partial least squares regression (PLSR) models, which mapped the influence of basic characteristics and routine examinations to ADR, were established to predict the risk of ADR. The software was devised to provide an easy-to-use tool for clinic application. The effectiveness of the method was evaluated through its application to new patients with 95.7% accuracy of cases and 91.3% accuracy of controls. By using the method, the patients at high-risk could be conveniently, efficiently and economically recognized without any extra financial burden for additional examination. This study provides a novel insight into individualized management of the patients who will use TCMI.


Subject(s)
Drug-Related Side Effects and Adverse Reactions/diagnosis , Injections/adverse effects , Medicine, Chinese Traditional/adverse effects , Software , Case-Control Studies , Drug-Related Side Effects and Adverse Reactions/etiology , Humans
6.
J Plast Reconstr Aesthet Surg ; 72(12): 1979-1985, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31519504

ABSTRACT

BACKGROUND: The administration of local anesthetics is considered the most unpleasant part of office-based surgery. Many procedural and pharmacological strategies have been developed to minimize pain. In children and adolescents, distraction has been demonstrated to be an effective way of minimizing pain during local anesthesia. We present a randomized controlled trial of the effect of distraction on pain during local anesthesia in adults. MATERIAL AND METHODS: We have included 115 patients undergoing small office-based surgery to either the face, wrist, or hand. We randomized these patients between two groups: a control group and an intervention group. The intervention group watched a distractive video during the administration of the local anesthetic; for the rest the surgical procedures were performed in an equal fashion in both groups. Preoperative anxiety was scored from 0 to 10 and pain experienced during the injection of local anesthetic was measured on the visual analogue scale of pain (VAS), ranging from 0 to 10. Patient satisfaction was measured on the Patient Satisfaction Questionnaire (PSQ-18), ranging from 18 to 90. RESULTS: Patients had an equal anticipated pain score in control and intervention group. In the intervention group, a reduction of pain scores of 1 point was observed (p = 0.01). There was no difference in patient satisfaction scores between both groups. DISCUSSION: In this study, we demonstrate the pain minimizing effect of distraction during the administration of local anesthesia. Less experienced pain did not result in improved patient satisfaction in our study. We encourage physicians to seek ways to actively distract patients during unpleasant procedures.


Subject(s)
Anesthesia, Local/adverse effects , Anesthetics, Local/administration & dosage , Attention , Pain/prevention & control , Anxiety/etiology , Face/surgery , Female , Hand/surgery , Humans , Injections/adverse effects , Male , Middle Aged , Pain Management , Pain Measurement , Patient Satisfaction , Preoperative Care
7.
BMJ Open ; 9(7): e029460, 2019 07 02.
Article in English | MEDLINE | ID: mdl-31270121

ABSTRACT

INTRODUCTION: A current non-pharmacological mean for attaining painless local anaesthesia (LA) is presented by vibrotactile devices. Their concept is to reduce injection pain due to distraction by applying physical stimuli which interfere with pain signals. The aim of this study is to determine the efficacy of the DentalVibe (DV) device in reducing pain and anxiety associated with LA in paediatric patients. METHODS AND ANALYSIS: The proposed study is a randomised controlled clinical trial with split-mouth design. Included are positive patients aged 8-12 years, requiring buccal infiltration for extraction of two bilateral primary maxillary molars. After dental fear measurement, eligible patients undergo two single-visit treatments with DV device allocated to either first or second LA via computer-generated randomisation sequence. Outcome measures will be self-reported pain felt during LA on Visual Analogue Scale; self-reported anxiety on Facial Image Scale; pain-related behaviour according to Faces, Legs, Activity, Cry, Consolability Scale; heart rate; patient preference to LA technique.Data will be analysed with intention-to-treat concept by Student's t-test for paired samples, Wilcoxon signed-rank test, p<0.05. Pretest on 20 subjects resulted in n=41 patients sample size. ETHICS AND DISSEMINATION: This study protocol has been approved by the Committee for Scientific Research Ethics, Medical University - Plovdiv, Bulgaria (Reference number P-8604, Protocol of approval No. 6/23.11.2017) and registered on a publicly accessible database. This research received institutional funding from the Medical University - Plovdiv, Bulgaria, under project SPD-03/2017. Findings will be reported in scientific publications and at research conferences, and in project summary papers for participants. TRIAL REGISTRATION NUMBER: NCT03445182; Pre-results.


Subject(s)
Anesthesia, Local/methods , Anxiety/prevention & control , Dental Care , Injections/adverse effects , Pain, Procedural/etiology , Pain, Procedural/prevention & control , Randomized Controlled Trials as Topic/methods , Vibration/therapeutic use , Child , Equipment and Supplies , Humans , Treatment Outcome
8.
J Pediatr Health Care ; 33(5): 509-519, 2019.
Article in English | MEDLINE | ID: mdl-30898499

ABSTRACT

INTRODUCTION: Holistic comfort is an essential component of pediatric procedural care. However, a main gap in the literature is the ability to measure this. In this study, researchers report the feasibility of implementing a newly developed psychosocial measurement instrument in clinical practice. METHOD: This mixed methods study was guided by Kolcaba's holistic comfort theory. Descriptive and inferential statistics and a qualitative descriptive approach to cognitive interviewing were used. Children aged 4 to 8 years (n = 16) experiencing a nonurgent needle procedure and registered nurses (n = 14) who administered the instrument were recruited. RESULTS: Eight qualitative themes of feasibility and comprehensibility were identified. Perspectives of children and nurses were not significantly associated with any demographic variable. The Pediatric Procedural Holistic Comfort Assessment is a feasible instrument to implement but will benefit from minor revisions. DISCUSSION: This study has implications for nursing practice, research methodology, and future research. The Pediatric Procedural Holistic Comfort Assessment can be successfully implemented by nurses in health care settings.


Subject(s)
Holistic Nursing , Patient Comfort , Child , Child, Preschool , Feasibility Studies , Female , Humans , Injections/adverse effects , Injections/methods , Male , Pain, Procedural/nursing , Pain, Procedural/prevention & control , Patient Comfort/methods
9.
J Dairy Sci ; 102(4): 3431-3438, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30772020

ABSTRACT

Dairy calves are routinely administered medicines, vaccines, and anesthesia via injection. Although injections are painful, little is known about methods to alleviate this pain. The aim of this study was to determine whether lidocaine-prilocaine cream, a topical anesthetic, reduced calves' pain response to a subcutaneous injection around the cornual nerve. Calves were assigned 1 of 2 treatments: lidocaine-prilocaine cream at the sites of injection (n = 10) or no cream (n = 9). Thirty minutes after treatment, calves received a subcutaneous injection of 2% buffered lidocaine hydrochloride around the left and right cornual nerves. Contrary to our hypothesis, calves that received anesthetic cream beforehand displayed more escape behaviors during the injections than control calves. Both treatments had similarly low amounts of head-related behaviors afterward. Maximum eye temperature did not differ between the calves that received anesthetic cream and control calves, although eye temperature increased over time for both treatments. Heart rate increased during the 30 s following the first injection in both treatments. There were no treatment differences for any heart rate measures over the 5-min period after the first injection (mean heart rate, root mean square of successive differences, high-frequency power, and the ratio of low-frequency power to high-frequency power). These results suggest that cornual nerve blocks with buffered lidocaine are painful and that a lidocaine-prilocaine cream was not only ineffective in reducing this pain but that it may also worsen it.


Subject(s)
Acute Pain , Anesthetics, Local , Cattle Diseases , Lidocaine, Prilocaine Drug Combination , Lidocaine , Nerve Block , Animals , Cattle , Female , Male , Acute Pain/etiology , Acute Pain/prevention & control , Acute Pain/veterinary , Administration, Topical , Anesthesia, Local , Anesthetics, Local/pharmacology , Cattle Diseases/etiology , Cattle Diseases/prevention & control , Heart Rate , Injections/adverse effects , Injections/veterinary , Lidocaine/pharmacology , Lidocaine, Prilocaine Drug Combination/pharmacology , Nerve Block/veterinary , Pain Measurement
11.
Biomed Pharmacother ; 109: 1523-1531, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30551404

ABSTRACT

AIMS: To determine the causes of adverse reactions associated with Xuebijing injection and provide medical evidence for its safe and rational post-marketing use in clinical practice. MATERIALS AND METHODS: We used prospective nested case-control and prescription sequence analysis designs. Using data from the Hospital Information System, patients exhibiting trigger signals after receiving Xuebijing injection were classified as suspected allergic patients. Logistic regression analysis was performed on the risk factors associated with Xuebijing-induced allergic reactions. Randomized controlled and cohort studies on adverse drug reactions to Xuebijing injection were screened from databases and the results were subjected to meta-analysis. RESULTS: The overall incidence of allergic reactions or anaphylaxis tended to increase with dosage and patient's age. Moreover, compared with Xuebijing alone, co-administration of Xuebijing with other drugs or agents (including Ringer's sodium acetate solution, reduced glutathione, aspirin-DL-lysine, and torasemide) increased the risk of adverse reactions. The use of glucose as a vehicle also provoked a greater incidence of allergic reactions than that by the use of 0.9% w/v sodium chloride as a vehicle. Adverse reactions occurred more frequently in patients receiving indicated dosages than in those receiving off-label dosages. CONCLUSIONS: Adverse reactions to Xuebijing injections were correlated with vehicle type, dosage, age, and drug combination. There was no clear association between patient's condition at admission and suspected adverse reactions to Xuebijing injection. Factors influencing the adverse reactions to Xuebijing injection must be fully considered in clinical practice.


Subject(s)
Drug-Related Side Effects and Adverse Reactions/etiology , Drugs, Chinese Herbal/administration & dosage , Drugs, Chinese Herbal/adverse effects , Hypersensitivity/etiology , Injections/adverse effects , Product Surveillance, Postmarketing/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Male , Middle Aged , Prospective Studies , Young Adult
12.
Orv Hetil ; 159(52): 2212-2216, 2018 12.
Article in Hungarian | MEDLINE | ID: mdl-30582357

ABSTRACT

Dental anaesthesia is one of the most frequently performed medical procedures. Although the frequency of ocular complications is low, these can be alarming and can potentially give rise to medicolegal issues. Dentists and oral surgeons should be well-informed of these adverse reactions. Ophthalmologists and emergency physicians might be required for appropriate care of these patients. Fortunately, most ocular complications related to dental anesthesia are transient. Differential diagnosis includes stroke and intracranial hemorrhage and so vital signs are to be closely monitored. The planned surgical procedure can be carried out once the patient is fully informed and gave consent. The psychological aspect of such unexpected complication must be managed appropriately. We report a case with diplopia and ophthalmoplegia of a reversible and temporary nature. We also include a literature review of ophthalmologic complications after intraoral local anaesthesia in this paper. Orv Hetil. 2018; 159(52): 2212-2216.


Subject(s)
Anesthesia, Dental/adverse effects , Anesthesia, Local/adverse effects , Diplopia/etiology , Ophthalmoplegia/etiology , Anesthesia, Dental/methods , Anesthesia, Local/methods , Humans , Injections/adverse effects , Tooth Extraction
13.
Zhongguo Zhong Yao Za Zhi ; 43(21): 4347-4351, 2018 Nov.
Article in Chinese | MEDLINE | ID: mdl-30583639

ABSTRACT

As a modern dosage form drug with rapid effect, traditional Chinese medicine (TCM) injection has been more and more used in clinical practice. Meanwhile the safety of TCM injection has attracted more and more attention. The retrospective analysis on 74 cases of adverse reaction of TCM injections collected from 2007 to 2016 in the Third Affiliated Hospital of Beijing University of Chinese Medicine showed that the proportion of men and women with adverse reactions was 0.54:1; the average age was 62.5 years old; 21 kinds of TCM injections were involved. Among them, the most reported were blood-regulating agents. The top four kinds of TCM injections with highest adverse drug reactions (ADRs) were Tanreqing injection, Danhong Injection, Shuxuening Injection and Xuesaitong for injection. The top three clinical manifestations of adverse reactions were lesions of skin and its appendages, damage of circulatory system and damage of nervous system. The potential causes of the adverse reactions of TCM injections were analyzed, and it was believed that individual difference, medicine, pharmaceutical excipients, solvent and TCM syndrome differentiation may be the main five causes for the adverse reactions of TCM injections. In order to reduce the adverse reactions of TCM injections, it is suggested that the clinical pharmacists should participate in the application management of TCM injections in the hospital; the production enterprises shall strengthen the whole life cycle management of the drugs; and at the same time, the drug control and administration authorities should improve the drug management methods constantly and encourage the development of TCM injections to the high quality level.


Subject(s)
Drugs, Chinese Herbal/adverse effects , Medicine, Chinese Traditional/adverse effects , Female , Humans , Injections/adverse effects , Male , Middle Aged , Retrospective Studies
14.
J Indian Soc Pedod Prev Dent ; 36(3): 296-300, 2018.
Article in English | MEDLINE | ID: mdl-30246753

ABSTRACT

BACKGROUND: Injection of local anesthesia is one of the most important reasons for avoidance behavior in children. Applying a topical anesthetic before injection is the most popular way to control pain; however, topical anesthetics have some shortcomings such as longer duration of action, displeasing taste, and spread of the anesthetic agent to noninjection site areas. Cryoanesthesia using refrigerant as a topical anesthesia is being studied as an alternative to overcome the shortcomings of topical anesthetics and has shown promising results. MATERIALS AND METHODS: In this split-mouth design study, 50 children of aged 8-10 years who required bilateral mandibular local anesthesia administration were selected. In the first visit, application of topical anesthetic spray (lidocaine) on one side and during the second appointment cryoanesthetic tetrafluorethane on the other side was used before local anesthetic administration. Patients were asked to report their discomfort and pain using visual analog scale (VAS) (subjective method). Patients' pain perception during injection is assessed by sound, eye, and motor (SEM) scale by the dentist (objective method). RESULTS: The results were statistically analyzed using paired Wilcoxon signed-rank test and Mann-Whitney tests. In VAS scale (subjective method), pain scores were significantly lower in tetrafluorethane group when compared with lidocaine group. In SEM scale (objective method), pain scores were lower in tetrafluorethane group when compared with lidocaine group, but it was statistically insignificant. CONCLUSION: Precooling the injection site using refrigerant tetrafluorethane spray has shown to be effective in eliminating pain before local anesthesia administration in children when compared with topical anesthetic lidocaine spray.


Subject(s)
Anesthesia, Dental/methods , Anesthesia, Local/methods , Cryoanesthesia/methods , Fluorocarbons/administration & dosage , Pain Perception/drug effects , Aerosols , Anesthetics, Local/administration & dosage , Child , Facial Pain/prevention & control , Humans , Injections/adverse effects , Lidocaine/administration & dosage , Pain Measurement , Pain, Postoperative/prevention & control , Pulpectomy/adverse effects , Tooth Extraction/adverse effects
15.
Anesth Prog ; 65(2): 95-99, 2018.
Article in English | MEDLINE | ID: mdl-29952639

ABSTRACT

Intraoral local anesthesia injection is often perceived as a painful and anxiety-causing dental procedure. Vibration stimulus is one of the nonpharmacologic methods used to reduce unwanted sensations of local anesthesia injection. This clinical study evaluated the effectiveness of a recently introduced vibratory stimulation device in intraoral local anesthesia administration. Thirty-two subjects underwent 2 maxillary local anesthesia injections in 2 different sessions: 1 with conventional techniques and 1 with the aid of a vibratory stimulation device (DentalVibe). The pain levels were evaluated with a visual analog scale and the Wong-Baker FACES Pain Rating Scale. The subjects were asked to choose the preferred method for future injections. The data were evaluated statistically. There were no significant differences between the 2 injection methods with regard to either pain evaluation method. The preference of the subjects regarding future injection technique was evenly distributed between the groups. The vibratory stimulation device used in this study did not provide any reduction in pain level associated with maxillary infiltration local anesthesia administration.


Subject(s)
Anesthesia, Local/methods , Facial Pain/prevention & control , Maxillary Nerve , Vibration/therapeutic use , Adolescent , Adult , Anesthesia, Local/adverse effects , Cross-Over Studies , Facial Pain/diagnosis , Facial Pain/etiology , Female , Humans , Injections/adverse effects , Male , Pain Measurement , Pain Threshold , Prospective Studies , Treatment Outcome , Turkey , Young Adult
17.
J Clin Ultrasound ; 46(2): 129-131, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29205374

ABSTRACT

Ultrasound-guided injections such as steroid injections are common procedures involving the musculoskeletal system. They are usually performed after a subcutaneous injection of local anesthetic (LA), which can be painful. In 126 consecutive patients, local anesthesia was performed using ethyl chloride spray prior to a therapeutic ultrasound-guided injection in joints, tendons, or bursae. Ninety-nine (78.5%) patients found the use of ethyl chloride spray helpful. The use of ethyl chloride spray is an effective, patient-friendly alternative to the standard injection of local aesthetic for ultrasound-guided therapeutic musculoskeletal injections with the advantage of a lower cost of $0.18 per procedure.


Subject(s)
Anesthesia, Local/methods , Anesthetics, Local/administration & dosage , Ethyl Chloride/administration & dosage , Pain/prevention & control , Ultrasonography, Interventional , Adult , Aged , Aged, 80 and over , Anesthetics, Local/therapeutic use , Ethyl Chloride/therapeutic use , Female , Humans , Injections/adverse effects , Injections, Subcutaneous , Male , Middle Aged , Musculoskeletal System/diagnostic imaging , Prospective Studies
18.
Clin Infect Dis ; 66(1): 11-19, 2018 01 06.
Article in English | MEDLINE | ID: mdl-29020202

ABSTRACT

Background: To better monitor patients on outpatient parenteral antimicrobial therapy (OPAT), we need an improved understanding of risk factors for and timing of OPAT-associated adverse drug events (ADEs). Methods: We analyzed a prospective cohort of patients on OPAT discharged from 2 academic medical centers. Patients underwent chart abstraction and a telephone survey. Multivariable analyses estimated adjusted incident rate ratios (aIRR) between clinical and demographic risk factors and clinician-determined clinically significant ADEs. Descriptive data were used to present patient-reported ADEs. Results: Of 339 patients enrolled in the study, 18.0% experienced an ADE (N = 65), of which 49 were significant (14.5%, 2.24/1000 home-OPAT days). Patients with longer courses of therapy had lower rates of ADEs compared with patients treated for 0-13 days (14-27 days: aIRR, 0.44; 95% confidence interval [CI], 0.20-0.99; at least 28 days: aIRR, 0.11; 95% CI, 0.056-0.21). Risk factors for ADEs included female gender and receipt of daptomycin or vancomycin, while treatment for uncomplicated bacteremia and empiric treatment were associated with lower rates of ADEs. Conclusions: OPAT-related ADEs were common and often occurred within 2 weeks of hospital discharge. Patients on OPAT should be monitored more closely for ADEs, including clinical assessment and laboratory monitoring, especially within the first weeks after hospital discharge and particularly among women and patients who receive vancomycin.


Subject(s)
Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/adverse effects , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug-Related Side Effects and Adverse Reactions/pathology , Injections/adverse effects , Outpatients , Adult , Aged , Aged, 80 and over , Female , Humans , Interviews as Topic , Male , Middle Aged , Prospective Studies , Risk Factors
19.
J Evid Based Complementary Altern Med ; 22(4): 897-901, 2017 10.
Article in English | MEDLINE | ID: mdl-28776413

ABSTRACT

The aim of this study was to describe application of a static Qigong program to decrease needle pain in Korean adolescents with type 1 diabetes and its pilot test results. The pilot study was a randomized crossover design including 26 adolescents randomized to Qigong or rest group. Participants received a 60-minute Qigong program consisted of warm up, deep breathing, imaginary, and a closing warm up. After 24-hour washout period, treatment assignments were switched. We collected before and after intervention using a self-administered questionnaire, which included the faces pain scale to assess expected and perceived pain during blood sugar testing and insulin injection and the Positive and Negative Affect Schedule. Only expected pain on insulin injection was significantly lower after intervention ( P = .025). The results suggested that the devised static Qigong program was feasible intervention to decrease at least expected pain on insulin injection of adolescents with type 1 diabetes.


Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Injections/adverse effects , Insulin/administration & dosage , Pain/prevention & control , Qigong , Adolescent , Child , Cross-Over Studies , Female , Humans , Male
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(2): 248-252, 2017 Feb 10.
Article in Chinese | MEDLINE | ID: mdl-28231676

ABSTRACT

Objective: To evaluate the safety of Tanreqing injection among children in the real world. Methods: A multicenter, large sample, ambispective cohort study, with registration-type clinical safety monitoring. A total of 6 188 inpatients and patients from the emergency units, aged ≤ 14 years who all had been using Tanreqing injection in 59 secondary and tertiary hospitals in China, were recruited between January, 2014 and May, 2015. The main outcomes would include incidence and severity of adverse drug reaction (ADR)/adverse drug event (ADE) of Tanreqing injection. Univariate analysis was used to explain the risk factors of ADR. Results: The overall incidence of ADE was 4.20‰ (26 cases), including 4 serious ones. The incidence of ADR was 3.07‰ (19 cases), including 17 cases of general ADR and 2 cases of new ADR. All the ADR cases were mild or moderate, mostly showing damages in skin and appendages. The onset of disease happened in 24 hours after the Tanreqing injection but all the ADR cases got improved or cured. Having histories of allergies to drugs or foods would increase the incidence of ADR. Conclusion:Tanreqing injection caused low incidence of ADR in children. Progams as stratifying high-risk patients and improving administrative management could further increase the safety level of Tanreqing injection.


Subject(s)
Drug-Related Side Effects and Adverse Reactions/epidemiology , Drugs, Chinese Herbal/adverse effects , Injections/adverse effects , Product Surveillance, Postmarketing , Adolescent , Child , Child, Preschool , China , Cohort Studies , Drugs, Chinese Herbal/administration & dosage , Female , Humans , Male , Safety , Skin/drug effects
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