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Sample records for injections subcutaneous

  1. Injectable agents affecting subcutaneous fats.

    PubMed

    Chen, David Lk; Cohen, Joel L; Green, Jeremy B

    2015-09-01

    Mesotherapy is an intradermal or subcutaneous injection of therapeutic agents to induce local effects, and was pioneered in Europe during the 1950s. For the past 2 decades, there has been significant interest in the use of mesotherapy for minimally invasive local fat contouring. Based on the theorized lipolytic effects of the agent phosphatidylcholine, initial attempts involved its injection into subcutaneous tissue. With further studies, however, it became apparent that the activity attributed to phosphatidylcholine mesotherapy was due to the adipolytic effects of deoxycholate, a detergent used to solubilize phosphatidylcholine. Since then, clinical trials have surfaced that demonstrate the efficacy of a proprietary formulation of deoxycholate for local fat contouring. Current trials on mesotherapy with salmeterol, a b-adrenergic agonist and lipolysis stimulator, are underway-with promising preliminary results as well. PMID:26566569

  2. Panniculitis with crystals induced by etanercept subcutaneous injection.

    PubMed

    Llamas-Velasco, Mar; Requena, Luis

    2015-06-01

    Panniculitis with lipid crystallization within adipocytes may be seen in several disorders, including crystal-storing histiocytosis, gouty panniculitis, subcutaneous fat necrosis of the newborn, post-steroid panniculitis, sclerema neonatorum, oxalosis and subcutaneous fungal infections by mucormycosis, zygomycosis or aspergillosis. Panniculitis at the sites of subcutaneous injection of drugs are frequent, but to our knowledge no crystals have been described in the drug-induced panniculitis at the sites of subcutaneous injections. We report on a patient who developed a panniculitis with lipid crystallization at the site of etanercept injection. PMID:25727404

  3. Injection site reactions after subcutaneous oligonucleotide therapy.

    PubMed

    van Meer, Leonie; Moerland, Matthijs; Gallagher, Jolie; van Doorn, Martijn B A; Prens, Errol P; Cohen, Adam F; Rissmann, Robert; Burggraaf, Jacobus

    2016-08-01

    Oligonucleotides (ONs) are short fragments of nucleic acids, currently being investigated as therapeutic agents. When administered subcutaneously (sc), ONs cause a specific local reaction originating around the injection site, such as erythema, itching, discomfort and pain, including more severe manifestations such as ulceration or necrosis. These injection site reactions (ISRs) are common, but rather poorly described in the literature. With this review, we aim to provide an overview on the extent of the problem of ISRs, based on reported incidence. A structured literature search was performed to identify reported incidence and clinical features of ISRs which yielded 70 manuscripts that contained information regarding ISRs. The data from literature was combined with data on file available at our institution. All sc administered ONs described in the literature lead to the occurrence of ISRs. The percentage of trial subjects that developed ISRs ranged from 22 to 100% depending on ON. The majority of ONs caused ISRs in more than 70% of the trial subjects. The severity of the observed reactions varied between different ONs. Occurrence rate as well as severity of ISRs increases with higher doses. For chemistry and target of the compounds, no clear association regarding ISR incidence or severity was identified. All ONs developed to date are associated with ISRs. Overcoming the problem of ISRs might add greatly to the potential success of sc-administered ONs. Knowledge of these skin reactions and their specific immunostimulatory properties should be increased in order to obtain ONs that are more suitable for long-term use and clinically applicable in a broader patient population. PMID:27061947

  4. [Drugs administration by subcutaneous injection within palliative care].

    PubMed

    Tanguy-Goarin, Charlotte; Cogulet, Virginie

    2010-01-01

    Drugs delivery by subcutaneous injection is often the last resort/appeal for a doctor anxious to limit the aggressive and invasive treatments, particularly within palliative care. A review was made to list the drugs which can be administered by this route. Concerned antibiotics are teicoplanin, netilmicin and gentamicin with a risk of skin necrosis for aminoglycosids. Midazolam is useful in various indications and can be associated with morphine in case of dyspnoea. Data about subcutaneous injection of dexamethasone, clonazepam, haloperidol and levomepromazine are published; it is the same for fentanyl, nefopam, ondansetron and metoclopramide. The subcutaneous injection of these quoted drugs is possible, but requires further studies. PMID:21176759

  5. Interferon Beta-1a Subcutaneous Injection

    MedlinePlus

    ... course of disease where symptoms flare up from time to time) of multiple sclerosis (MS, a disease in which ... under the skin). It is usually injected three times a week. You should inject this medication on ...

  6. Localized interstitial granuloma annulare induced by subcutaneous injections for desensitization.

    PubMed

    Spring, Philipp; Vernez, Maxime; Maniu, Christa-Maria; Hohl, Daniel

    2013-06-01

    We describe a patient with interstitial granuloma annulare associated with subcutaneous injection therapy (SIT) for desensitization to a type I allergy. Asymptomatic, erythematous, violaceous annular patches were located at the injection sites on both her arms. Medical history revealed perennial rhinoconjonctivitis treated with SIT (Phostal Stallergen® cat 100% and D. pteronyssinus/D.farinae 50%:50%). PMID:24011321

  7. Injection therapy for the management of superficial subcutaneous lipomas.

    PubMed

    Amber, Kyle T; Ovadia, Steven; Camacho, Ivan

    2014-06-01

    Superficial subcutaneous lipomas are common benign tumors of the subcutaneous adipose tissue. Removal of superficial subcutaneous lipomas is achieved with simple surgical excision for the purposes of improved cosmesis, removing painful lipomas, or for the removal of a lipoma affecting function through mass effect. As research in localized fat reduction has improved, therapies successful in this domain have been applied to the management of lipomas as a surgical alternative. In this review article, the authors review the basic science of injection therapies used in the management of lipomas as well as their potential efficacy and limitations. PMID:25013540

  8. Injection Therapy for the Management of Superficial Subcutaneous Lipomas

    PubMed Central

    Ovadia, Steven; Camacho, Ivan

    2014-01-01

    Superficial subcutaneous lipomas are common benign tumors of the subcutaneous adipose tissue. Removal of superficial subcutaneous lipomas is achieved with simple surgical excision for the purposes of improved cosmesis, removing painful lipomas, or for the removal of a lipoma affecting function through mass effect. As research in localized fat reduction has improved, therapies successful in this domain have been applied to the management of lipomas as a surgical alternative. In this review article, the authors review the basic science of injection therapies used in the management of lipomas as well as their potential efficacy and limitations. PMID:25013540

  9. Interferon Beta-1a Subcutaneous Injection

    MedlinePlus

    ... used syringes or automatic injection devices in a puncture resistant container that is out of the reach ... doctor or pharmacist about how to discard the puncture-resistant container.Always look at the medication in ...

  10. Subcutaneous Injection Volume of Biopharmaceuticals-Pushing the Boundaries.

    PubMed

    Mathaes, Roman; Koulov, Atanas; Joerg, Susanne; Mahler, Hanns-Christian

    2016-08-01

    Administration into the subcutaneous (SC) tissue is a typical route of delivery for therapeutic proteins, especially for frequent treatments, long-term regimens, or self-administration. It is currently believed that the maximum volume for SC injections is approximately 1.5 mL. Larger SC injection volumes are considered to be associated with injection pain and adverse events at the injection site. However, no controlled clinical studies and actual evidence exist to support this assumption. In this review, we discuss current and publically available data related to SC administration volumes. We conclude that injection volumes higher than 3.5 mL are worth exploring if required for the development of efficacious drug treatments. Studying tissue back pressure, injection site leakage, local tolerability, and injection-related adverse events, such as injection pain, should be considered for the development of higher SC injection volumes. PMID:27378678

  11. Subcutaneous Injection of Mercury: “Warding Off Evil”

    PubMed Central

    Prasad, Venkat L.

    2004-01-01

    Deliberate injection of mercury, especially subcutaneous injection, is rare but is seen in psychiatric patients, individuals who attempt suicide, those who are accidentally injected, and boxers who wish to build muscle bulk. Metallic mercury plays a major role in ethnic folk medicine. Neurologic and renal complications can result from high systemic levels of mercury, and subcutaneous injection usually results in sterile abscesses. Urgent surgical evacuation and close monitoring for neurologic and renal functions as well as chelation (if toxicity is indicated) are key aspects of treatment. Education of the adverse effects and dangers of mercury is important, especially in pregnant women and children. As increased immigration changes demographic patterns, proper disposal of mercury and preventing its sale and use should become urgent societal priorities. Psychiatric consultation should be obtained whenever appropriate. PMID:15345347

  12. Nitroxynil. Anthelmintic activity in cattle following subcutaneous injection.

    PubMed

    Wellington, A C

    1978-07-01

    Nitroxynil injected subcutaneously at 10 mg/kg live mass achieved Class A efficacy when evaluated by the non parametric method against adult Fasciola gigantica. Haemonchus placei, Bonustomum phlebotomum and Oesophagostomum radiatum in cattle. The compound was not effective against adult Cooperia spp. at the same dosage. PMID:569707

  13. Two Cases of Accidental Injection of Epinephrine into a Digit Treated with Subcutaneous Phentolamine Injections

    PubMed Central

    Bodkin, Ryan P.; Acquisto, Nicole M.; Wiegand, Timothy J.

    2013-01-01

    Accidental injection into the digit from an epinephrine autoinjection device can cause discoloration, pain, and paresthesias. Although loss of digit is rare, treatment in the emergency department is commonly aimed at vasodilation of the affected tissue. We report two cases of accidental injection of epinephrine into the digits that were successfully treated with subcutaneous phentolamine injection with no adverse events. PMID:24024046

  14. Evaluation of the impact of viscosity, injection volume, and injection flow rate on subcutaneous injection tolerance

    PubMed Central

    Berteau, Cecile; Filipe-Santos, Orchidée; Wang, Tao; Rojas, Humberto E; Granger, Corinne; Schwarzenbach, Florence

    2015-01-01

    Aim The primary objective of this study was to evaluate the impact of fluid injection viscosity in combination with different injection volumes and flow rates on subcutaneous (SC) injection pain tolerance. Methods The study was a single-center, comparative, randomized, crossover, Phase I study in 24 healthy adults. Each participant received six injections in the abdomen area of either a 2 or 3 mL placebo solution, with three different fluid viscosities (1, 8–10, and 15–20 cP) combined with two different injection flow rates (0.02 and 0.3 mL/s). All injections were performed with 50 mL syringes and 27G, 6 mm needles. Perceived injection pain was assessed using a 100 mm visual analog scale (VAS) (0 mm/no pain, 100 mm/extreme pain). The location and depth of the injected fluid was assessed through 2D ultrasound echography images. Results Viscosity levels had significant impact on perceived injection pain (P=0.0003). Specifically, less pain was associated with high viscosity (VAS =12.6 mm) than medium (VAS =16.6 mm) or low (VAS =22.1 mm) viscosities, with a significant difference between high and low viscosities (P=0.0002). Target injection volume of 2 or 3 mL was demonstrated to have no significant impact on perceived injection pain (P=0.89). Slow (0.02 mL/s) or fast (0.30 mL/s) injection rates also showed no significant impact on perceived pain during SC injection (P=0.79). In 92% of injections, the injected fluid was located exclusively in SC tissue whereas the remaining injected fluids were found located in SC and/or intradermal layers. Conclusion The results of this study suggest that solutions of up to 3 mL and up to 15–20 cP injected into the abdomen within 10 seconds are well tolerated without pain. High viscosity injections were shown to be the most tolerated, whereas injection volume and flow rates did not impact perceived pain. PMID:26635489

  15. Retention of bacterial lipopolysaccharide at the site of subcutaneous injection.

    PubMed Central

    Yokochi, T.; Inoue, Y.; Yokoo, J.; Kimura, Y.; Kato, N.

    1989-01-01

    The tissue distribution of Klebsiella pneumoniae O3 lipopolysaccharide (KO3 LPS) was studied in mice injected subcutaneously (s.c.) or intraperitoneally (i.p.) with 125I-labeled KO3 LPS. Marked retention of KO3 LPS radioactivity could be found at the site of s.c. injection for several weeks. On the other hand, about 85% of the radioactivity rapidly disappeared from the peritoneal cavity within 6 h after i.p. injection. The long-term presence of KO3 LPS at the injection site was also supported by experiments with 51Cr-labeled KO3 LPS and immunoblotting and immunofluorescence staining methods. The R-form LPS lacking the O-specific polysaccharide chain of KO3 LPS and the lipid A fraction of KO3 LPS seemed to remain at the site in larger amounts and for longer times than KO3 LPS. There were no marked differences in the retention pattern at the injection site among KO3 LPS, Escherichia coli LPS, Salmonella typhosa LPS, and Salmonella enteritidis LPS. However, much less radioactivity accumulated in the livers and spleens of mice injected with either KO3 LPS or S. typhosa LPS compared with the other LPS preparations. It was suggested that retention of LPS at the site of s.c. injection may play an important role in the development of various biological actions of s.c. injected LPS. Images PMID:2722239

  16. Understanding Subcutaneous Tissue Pressure for Engineering Injection Devices for Large-Volume Protein Delivery.

    PubMed

    Doughty, Diane V; Clawson, Corbin Z; Lambert, William; Subramony, J Anand

    2016-07-01

    Subcutaneous injection allows for self-administration of monoclonal antibodies using prefilled syringes, autoinjectors, and on-body injector devices. However, subcutaneous injections are typically limited to 1 mL due to concerns of injection pain from volume, viscosity, and formulation characteristics. Back pressure can serve as an indicator for changes in subcutaneous mechanical properties leading to pain during injection. The purpose of this study was to investigate subcutaneous pressures and injection site reactions as a function of injection volume and flow rate. A pressure sensor in the fluid path recorded subcutaneous pressures in the abdomen of Yorkshire swine. The subcutaneous tissue accommodates large-volume injections and with little back pressure as long as low flow rates are used. A 1 mL injection in 10 seconds (360 mL/h flow rate) generated a pressure of 24.0 ± 3.4 kPa, whereas 10 mL delivered in 10 minutes (60 mL/h flow rate) generated a pressure of 7.4 ± 7.8 kPa. After the injection, the pressure decays to 0 over several seconds. The subcutaneous pressures and mechanical strain increased with increasing flow rate but not increasing dose volume. These data are useful for the design of injection devices to mitigate back pressure and pain during subcutaneous large-volume injection. PMID:27287520

  17. Spatial distribution of soluble insulin in pig subcutaneous tissue: Effect of needle length, injection speed and injected volume.

    PubMed

    Thomsen, Maria; Rasmussen, Christian Hove; Refsgaard, Hanne H F; Pedersen, Karen-Margrethe; Kirk, Rikke K; Poulsen, Mette; Feidenhans'l, Robert

    2015-11-15

    The spatial distribution of a soluble insulin formulation was visualized and quantified in 3-dimensions using X-ray computed tomography. The drug distribution was visualized for ex vivo injections in pig subcutaneous tissue. Pig subcutaneous tissue has very distinct layers, which could be separated in the tomographic reconstructions and the amount of drug in each tissue class was quantified. With a scan time of about 45min per sample, and a robust segmentation it was possible to analyze differences in the spatial drug distribution between several similar injections. It was studied how the drug distribution was effected by needle length, injection speed and injected volume. For an injected volume of 0.1ml and injection depth of 8mm about 50% of the injections were partly intramuscular. Using a 5mm needle resulted in purely subcutaneous injections with minor differences in the spatial drug distribution between injections. Increasing the injected volume from 0.1ml to 1ml did not increase the intramuscular volume fraction, but gave a significantly higher volume fraction placed in the fascia separating the deep and superficial subcutaneous fat layers. Varying the injection speed from 25l/s up to 300l/s gave no changes in the drug concentration distribution. The method presented gives novel insight into subcutaneous injections of soluble insulin drugs and can be used to optimize the injection technique for subcutaneous drug administration in preclinical studies of rodents. PMID:26341408

  18. Enhanced bioavailability of subcutaneously injected insulin coadministered with collagen in rats and humans

    SciTech Connect

    Hori, R.; Komada, F.; Iwakawa, S.; Seino, Y.; Okumura, K. )

    1989-09-01

    The present study was undertaken to develop an agent that stabilizes insulin injected subcutaneously. {sup 125}I-Porcine insulin with 0.2 U/kg unlabeled porcine insulin was subcutaneously injected with or without collagen in the rat under the depilated skin of the back. At various times, the radioactivity in subcutaneous tissue was assayed for insulin and its metabolites by gel filtration. The degradation and absorption rate constants of insulin at the subcutaneous injection site were estimated according to a one-compartment model. The degradation rate constant of insulin in the presence of collagen at the injection site was less than half of the control rate. The inhibition was confirmed by increases in the immunoreactive insulin plasma levels and the hypoglycemic effect in rats and healthy volunteers. We postulate that collagen prevents insulin from being degraded by inhibiting proteolytic enzymes, mainly collagenase-like peptidase, in subcutaneous tissue.

  19. Model Study of the Pressure Build-Up during Subcutaneous Injection

    PubMed Central

    Thomsen, Maria; Hernandez-Garcia, Anier; Mathiesen, Joachim; Poulsen, Mette; Sørensen, Dan N.; Tarnow, Lise; Feidenhans'l, Robert

    2014-01-01

    In this study we estimate the subcutaneous tissue counter pressure during drug infusion from a series of injections of insulin in type 2 diabetic patients using a non-invasive method. We construct a model for the pressure evolution in subcutaneous tissue based on mass continuity and the flow laws of a porous medium. For equivalent injection forces we measure the change in the infusion rate between injections in air at atmospheric pressure and in tissue. From a best fit with our model, we then determine the flow permeability as well as the bulk modulus of the tissue, estimated to be of the order 10−11–10−10 m2 and 105 Pa, respectively. The permeability is in good agreement with reported values for adipose porcine tissue. We suggest our model as a general way to estimate the pressure build-up in tissue during subcutaneous injection. PMID:25122138

  20. Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections.

    PubMed Central

    Hutin, Yvan; Hauri, Anja; Chiarello, Linda; Catlin, Mary; Stilwell, Barbara; Ghebrehiwet, Tesfamicael; Garner, Julia

    2003-01-01

    OBJECTIVE: To draw up evidence-based guidelines to make injections safer. METHODS: A development group summarized evidence-based best practices for preventing injection-associated infections in resource-limited settings. The development process included a breakdown of the WHO reference definition of a safe injection into a list of potentially critical steps, a review of the literature for each of these steps, the formulation of best practices, and the submission of the draft document to peer review. FINDINGS: Eliminating unnecessary injections is the highest priority in preventing injection-associated infections. However, when intradermal, subcutaneous, or intramuscular injections are medically indicated, best infection control practices include the use of sterile injection equipment, the prevention of contamination of injection equipment and medication, the prevention of needle-stick injuries to the provider, and the prevention of access to used needles. CONCLUSION: The availability of best infection control practices for intradermal, subcutaneous, and intramuscular injections will provide a reference for global efforts to achieve the goal of safe and appropriate use of injections. WHO will revise the best practices five years after initial development, i.e. in 2005. PMID:12973641

  1. Atypical manifestations of organophosphorus poisoning following subcutaneous injection of Dichlorvos with suicidal intention.

    PubMed

    Ghosh, Supradip

    2014-04-01

    Current case report describes a 37-year-old female patient who was admitted to the hospital following subcutaneous injection of Dichlorvos with an insulin syringe. The only peripheral cholinergic sign observed on admission was excessive salivation with bilateral pyramidal tract signs. Locally she had necrosis of skin and subcutaneous tissue with surrounding blisters. In the subsequent course of her illness, she developed respiratory arrest requiring ventilator support. She also had delayed extrapyramidal manifestations. Relevant literature is reviewed. Possibility of route-specific, delayed predominant central nervous system effect of Dichlorvos postulated. PMID:24872656

  2. A comparison of continuous subcutaneous paliperidone infusion and repeated subcutaneous injection of risperidone free-base in rats.

    PubMed

    Marchese, G; Pittau, B; Casu, G; Peddio, G; Spada, G P; Pira, M; Deriu, A; Portesani, F; Pisu, C; Lazzari, P; Pani, L

    2010-03-01

    It is proposed that to achieve a therapeutic effect in schizophrenia patients, dopamine D(2)-receptor occupancy by antipsychotics within the striatum must exceed 60-65%. However, at high levels of D(2)-receptor occupancy, the risk of extrapyramidal symptoms (EPS) is increased. Following oral dosing of antipsychotics, peaks and troughs in plasma drug concentrations may be mirrored by fluctuations in D(2)-receptor occupancy. Paliperidone, a novel antipsychotic available as extended-release tablets (paliperidone ER), is the major active metabolite of risperidone and exhibits a plasma pharmacokinetic profile with reduced peak-trough fluctuations and consistent D(2)-receptor occupancy compared with conventional oral antipsychotic formulations. Using formulations that resemble those in clinical practice, this study provides a preclinical evaluation of the pharmacological properties of paliperidone ER and risperidone immediate-release formulation in terms of consistent antipsychotic efficacy over time and extrapyramidal symptom liability. Significant fluctuations in inhibition of d-amphetamine-induced hyperlocomotion were observed for repeated subcutaneous (SC) risperidone injections, whereas stable inhibitory efficacy was demonstrated during continuous SC paliperidone infusion. Similarly, significant fluctuations in latency on-bar were observed with repeated SC risperidone injections, whereas significantly lower latency on-bar was demonstrated following continuous SC paliperidone infusion. These results in an animal model suggest that although risperidone and paliperidone demonstrate similar pharmacologic effects, continuous administration of paliperidone achieves more stable antipsychotic efficacy with reduced motor impairment, akin to the effects observed with paliperidone ER in clinical studies. PMID:19640686

  3. A mouse model of premature ovarian insufficiency induced by tripterygium glycoside via subcutaneous injection

    PubMed Central

    Chen, Xiu-Ying; Gu, Chao; Ma, Min; Cong, Qing; Guo, Ting; Ma, Duan; Li, Bin

    2014-01-01

    Premature ovarian insufficiency (POI) is a main cause of infertility and affects nearly 1% women under 40 years old. This study was aimed to utilize the side effects of tripterygium glycoside (TG) to induce a mouse model of POI. 48 female KM mice were divided into four groups: control, oral, intraperitoneal injection and subcutaneous injection group. The mice in last three groups were treated with TG (50 mg•kg-1) daily for 35 days, while the mice in control group were treated with parallel volume of sterile water. Vaginal smears were taken to monitor the estrous cycles and estrous frequency for the last 21 days. Ovarian and uterine index and histomorphological change were determined when finished the administration. Serum levels of FSH were assessed by ELISA. Ki-67 expression in the uterus was analyzed from using immunohistochemical detection. And the apoptosis of follicle cells were detected by TUNEL assay. The results showed that mice in subcutaneous injection group presented the critical manifestations with significantly prolonged estrous cycles, decreased estrous frequency, reduced ovarian and uterine index, and increased serum FSH levels. At this dose level, TG could reduce developing follicles and corpus luteum, and increase atretic follicles, which might be induced by the increasing levels of follicle apoptosis. The proliferation index of uterus, evaluated by histomorphological changes and the expression of Ki-67, was significantly suppressed in TG treated animals. These data suggested that TG was feasible to induce a mice model via subcutaneous injection which could mimic the manifestations of POI. PMID:24427334

  4. Tissue barriers and novel approaches to achieve hepatoselectivity of subcutaneously-injected insulin therapeutics.

    PubMed

    Shao, Juntang; Zaro, Jennica L; Shen, Wei-Chiang

    2016-01-01

    Current subcutaneously (s.c.)-injected insulin (INS) products result in a hyperinsulin exposure to peripheral tissues (skeletal muscle and adipose) while INS hardly accesses to liver after injection. This unphysiological distribution raises risks of hypoglycemia episode and causes weight gain after long term treatment. An ideal INS replacement therapy requires the distribution or action of exogenous INS to more closely mimic physiological INS in terms of its preferential hepatic action. However, there are 2 factors that limit the ability of s.c. injected INS to restore the liver: peripheral gradient in INS deficient diabetes patients: (1) the transport of INS in capillary endothelium and peripheral tissues from the injection site; and (2) peripheral INS receptor (IR) mediated INS degradation. In this review, the tissue barriers against efficient liver targeting of s.c. injected INS are discussed and current advances in developing hepatoselective insulin therapeutics are introduced. PMID:27358753

  5. A comparison of epidural catheters with or without subcutaneous injection ports for treatment of cancer pain.

    PubMed

    de Jong, P C; Kansen, P J

    1994-01-01

    The aim of this study was to compare the incidence of technical complications of epidural catheters with subcutaneous injection ports to percutaneous epidural catheters without ports, fixed only by adhesive dressing. We reviewed 149 patients who received 250 epidural catheters for treatment of cancer pain during a 3 1/2-yr period from January 1, 1989, to June 30, 1992. Of the 250 catheters, 52 were provided with subcutaneous injection ports and 198 were percutaneous catheters. Of the 198 percutaneous catheters, 41 were tunneled for a short distance; the remainder entered the skin at the dorsal midline. In the percutaneous group 21% of the catheters became dislodged. In the injection port group, there were no catheter dislodgements. The overall incidence of infections was similar in both groups (13.6%). When we indexed the infection rate to catheter-days, the number of infections per 1000 catheter-days in the injection port group was half that of the percutaneous group (2.86 infections versus 5.97 for percutaneous catheters). No injection port became infected during the first 70 days of treatment, whereas in the percutaneous group infections occurred as early as the first week. Within the percutaneous group the complication rate in the tunneled epidural catheters was as high as in the nontunneled. We conclude that injection ports reduce the complication rate of epidural catheters, particularly catheter dislodgement and early infections. PMID:8267188

  6. Dose comparison of ultrasonic transdermal insulin delivery to subcutaneous insulin injection

    NASA Astrophysics Data System (ADS)

    Park, Eun-Joo; Dodds, Jeff; Barrie Smith, Nadine

    2010-03-01

    Prior studies have demonstrated the effectiveness of noninvasive transdermal insulin delivery using a cymbal transducer array. In this study the physiologic response to ultrasound mediated transdermal insulin delivery is compared to that of subcutaneously administered insulin. Anesthetized rats (350-550 g) were divided into four groups of four animals; one group representing ultrasound mediated insulin delivery and three representing subcutaneously administered insulin (0.15, 0.20, and 0.25 U/kg). The cymbal array was operated for 60 minutes at 20 kHz with 100 mW/cm2 spatial-peak temporal-peak intensity and a 20% duty cycle. The blood glucose level was determined at the beginning of the experiment and, following insulin administration, every 15 minutes for 90 minutes for both the ultrasound and injection groups. The change in blood glucose from baseline was compared between groups. When administered by subcutaneous injection at insulin doses of 0.15 and 0.20 U/kg, there was little change in the blood glucose levels over the 90 minute experiment. Following subcutaneous administration of insulin at a dose of 0.25 U/kg, blood glucose decreased by 190±96 mg/dl (mean±SD) at 90 minutes. The change in blood glucose following ultrasound mediated insulin delivery was -262±40 mg/dl at 90 minutes. As expected, the magnitude of change in blood glucose between the three injection groups was dependant on the dose of insulin administered. The change in blood glucose in the ultrasound group was greater than that observed in the injection groups suggesting that a higher effective dose of insulin was delivered.

  7. Cerebral venous and sinus thrombosis associated with subcutaneous immunoglobulin injection and oral contraceptive use.

    PubMed

    Min, Jiangyong; Bhatt, Archit; Aburashed, Rany; Burton, Stephen

    2012-06-01

    Although patients of cerebral sinus thrombosis after intravenous immunoglobulin (IVIG) has been previously reported; reports of cerebral venous thrombosis secondary to subcutaneous injection of immunoglobulin (SIG) in conjunction with oral contraceptives are nonexistent in the current literature. We describe here a patient of cerebral venous and sinus thrombosis occurring after the combination of SIG and oral contraceptive use. Furthermore, we shall explore proper clinical precautions for someone who receives IG therapy, especially in conjunction with the use of oral contraceptives. PMID:21915646

  8. Pharmacokinetic model for the absorption of subcutaneously injected soluble insulin and monomeric insulin analogues.

    PubMed

    Trajanoski, Z; Wach, P; Kotanko, P; Ott, A; Skraba, F

    1993-09-01

    A subcutaneous insulin absorption model is presented for parameter estimation from the time course of plasma insulin. Modifications of a published model were made for the absorption of soluble insulin and monomeric insulin analogues in the range of therapeutic concentrations and volumes. The modified diffusion-dissociation model with distributed parameters was approximated by a multiple-compartment model. Subcutaneous absorption of soluble insulin and monomeric insulin analogues with various volumes, concentrations, and injection depths was simulated. The model for soluble insulin exhibits volume, concentration, and injection depth dependent absorption, as experimentally observed. It was found that binding of soluble insulin in the subcutaneous tissue is negligible for U-40 and U-100 strengths. The absorption of identical doses (10 U) of soluble U-40 insulin was markedly faster (T-50% = 159.4 min) than the absorption of U-100 (T-50% = 196.2 min). According to the simulation results, the absorption rate of monomeric analogues is not dependent on concentration. No significant chances of the absorption rate could also be observed by varying volume and injection depth of the monomeric analogues. PMID:8218870

  9. Encapsulation of interleukin-2 in murine erythrocytes and subsequent deposition in mice receiving a subcutaneous injection

    SciTech Connect

    DeLoach, J.R.; Andrews, K.; Sheffield, C.L.

    1988-04-01

    Radiolabeled recombinant human interleukin-2 (IL-2) was successfully encapsulated in both mouse and sheep erythrocytes. Of the added IL-2, 70% was recovered bound to or encapsulated within the carrier cells. Erythrocytes containing IL-2 were stable in vitro and most of the IL-2 remained associated with the cells following a 16-h incubation at 37 degrees C. When carrier erythrocytes containing IL-2 were injected subcutaneously into mice, intact (/sup 35/S)IL-2 was detectable in a number of tissues 3 days after injection.

  10. The Effect of Administration Protocol of Subcutaneous Enoxaparin Injection on Formation of Ecchymosis.

    PubMed

    Uzun, Senay; Aciksoz, Semra; Arslan, Filiz; Yildiz, Cemil; Akyol, Mesut

    2016-01-01

    Subcutaneous heparin administration is routinely used for many patients in orthopaedic clinics. Nurses frequently encounter ecchymosis formation with heparin administration. Previous research indicates that the administration protocol may have effect on ecchymosis formation. The study was performed to determine and compare the effect of three different approaches of subcutaneous enoxaparin injection on ecchymosis formation in patients who underwent joint replacement surgery. Three protocols were compared: (1) injecting enoxaparin in 10 seconds, (2) injecting enoxaparin in 30 seconds, and (3) injecting enoxaparin in 30 seconds and waiting for an additional 10 seconds before withdrawing the needle. Ecchymosis formation was assessed in both size and frequency. Descriptive statistics, Kruskal-Wallis analysis, Mann-Whitney U test, and Spearman rank correlation test were used to assess the data. The ecchymosis frequency was higher in the 10-second administration. Ecchymosis size was smaller when the enoxaparin was administered in 30 seconds and the needle was kept in the tissue for 10 seconds after injection. The enoxaparin should be administered in a longer duration (30 seconds). Keeping the needle in the tissue for 10 seconds may further decrease the size but not the incidence of ecchymosis. PMID:27028689

  11. Treatment of pretibial myxedema with dexamethazone injected subcutaneously by mesotherapy needles.

    PubMed

    Vannucchi, Guia; Campi, Irene; Covelli, Danila; Forzenigo, Laura; Beck-Peccoz, Paolo; Salvi, Mario

    2013-05-01

    Pretibial myxedema (PTM) is a rare extrathyroidal manifestation of Graves' disease that requires treatment when the clinical picture is markedly evident. In addition to topical treatment with steroid ointments, there have been previous reports of subcutaneous injections of steroids. This procedure may cause nodular degeneration of the skin due to fat atrophy when standard needles are used. In the present study, we have tried a novel modality of treatment of PTM by injecting a solution of dexamethasone in the subcutaneous tissue using needles employed for mesotherapy. These needles are ≤4 mm long and deliver the medication within the dermis or the first layer of the subcutaneous fat. We have treated five patients, four with diffuse and one with elephanthiasic PTM. We utilized multiple injections of a solution of dexamethasone, lidocaine, and saline in the PTM plaque and in the pretibial area, both in the PTM plaque and in the area surrounding the lesions, once a week for three consecutive weeks. Two patients with a more severe form of PTM underwent another two cycles four to six weeks after initial treatment. Patients were studied before and after treatment by clinical assessment and ultrasound of the pretibial skin. The treatment was well-tolerated, with only moderate pain upon injection of the solution. One month after treatment, all patients showed improvement of PTM at clinical assessment and a reduction of the thickness of the lesions at ultrasound of ∼15%, involving mostly the dermis. Moreover, all patients reported amelioration of the leg appearance. The present study, although preliminary, shows that intralesion steroid injection with mesotherapy needles in PTM is effective and well tolerated, and does not cause undesired long-term modifications of the skin. More studies are warranted to standardize such treatment in larger groups of patients. PMID:23397966

  12. Visualization of subcutaneous insulin injections by x-ray computed tomography

    NASA Astrophysics Data System (ADS)

    Thomsen, M.; Poulsen, M.; Bech, M.; Velroyen, A.; Herzen, J.; Beckmann, F.; Feidenhans'l, R.; Pfeiffer, F.

    2012-11-01

    We report how the three-dimensional structure of subcutaneous injections of soluble insulin can be visualized by x-ray computed tomography using an iodine based contrast agent. The injections investigated are performed ex vivo in porcine adipose tissue. Full tomography scans carried out at a laboratory x-ray source with a total acquisition time of about 1 min yield CT-images with an effective pixel size of 109 × 109 μm2. The depots are segmented using a modified Chan-Vese algorithm and we are able to observe differences in the shape of the injection depot and the position of the depot in the skin among equally performed injections. To overcome the beam hardening artefacts, which affect the quantitative prediction of the volume injected, we additionally present results concerning the visualization of two injections using synchrotron radiation. The spatial concentration distribution of iodine is calculated to show the dilution of the insulin drug inside the depot. Characterisation of the shape of the depot and the spatial concentration profile of the injected fluid is important knowledge when improving the clinical formulation of an insulin drug, the performance of injection devices and when predicting the effect of the drug through biomedical simulations.

  13. Generating local amyloidosis in mice by the subcutaneous injection of human insulin amyloid fibrils.

    PubMed

    Chinisaz, Maryam; Ebrahim-Habibi, Azadeh; Yaghmaei, Parichehreh; Parivar, Kazem; Dehpour, Ahmad-Reza

    2014-08-01

    Localized deposits of amyloid structures are observed in various pathological conditions. One example of when local amyloidosis occurs is following repeated insulin injections in diabetic patients. The present study aimed to simulate the same condition in mice. To obtain the amyloid structures, regular insulin was incubated at 57°C for 24 h. The subsequently formed amyloid fibrils were analyzed using the Congo red absorbance test, as well as transmission electron microscopy images, and then injected into mice once per day for 21 consecutive days. Firm waxy masses were developed following this period, which were excised, prepared as thin sections and stained with hematoxylin and eosin, Congo red and Sudan black. Histological examination revealed that these masses contained adipose cells and connective tissue, in which amyloid deposition was visible. Thus, localized amyloidosis was obtained by the subcutaneous injection of insulin fibrils. The present results may be of further use in the development of models of amyloid tumors. PMID:25009591

  14. Generating local amyloidosis in mice by the subcutaneous injection of human insulin amyloid fibrils

    PubMed Central

    CHINISAZ, MARYAM; EBRAHIM-HABIBI, AZADEH; YAGHMAEI, PARICHEHREH; PARIVAR, KAZEM; DEHPOUR, AHMAD-REZA

    2014-01-01

    Localized deposits of amyloid structures are observed in various pathological conditions. One example of when local amyloidosis occurs is following repeated insulin injections in diabetic patients. The present study aimed to simulate the same condition in mice. To obtain the amyloid structures, regular insulin was incubated at 57°C for 24 h. The subsequently formed amyloid fibrils were analyzed using the Congo red absorbance test, as well as transmission electron microscopy images, and then injected into mice once per day for 21 consecutive days. Firm waxy masses were developed following this period, which were excised, prepared as thin sections and stained with hematoxylin and eosin, Congo red and Sudan black. Histological examination revealed that these masses contained adipose cells and connective tissue, in which amyloid deposition was visible. Thus, localized amyloidosis was obtained by the subcutaneous injection of insulin fibrils. The present results may be of further use in the development of models of amyloid tumors. PMID:25009591

  15. Comparison of Intramuscular or Subcutaneous Injections vs. Castration in Pigs-Impacts on Behavior and Welfare.

    PubMed

    McGlone, John; Guay, Kimberly; Garcia, Arlene

    2016-01-01

    Physical castration (PC) is painful and stressful for nursing piglets. One alternative to PC is immunological castration (IC), but the pain and stress of handling associated with injections have not been assessed. The objectives of this study were to measure the pain and distress of subcutaneous (SQ) and intramuscular (IM) injections compared to PC in piglets, and to compare SQ or IM injections in finishing pigs. After farrowing, 3 to 5 d old male piglets were randomly assigned to (control) no handling treatment (NO), sham-handling (SHAM), IM, SQ, or PC. Finishing pigs were assigned to NO, SHAM, IM, or SQ. Behavior was monitored for 1 h prior and 1 h post treatment in each age group. Social, feeding behaviors, and signs of pain were recorded. Finishing pigs treated with SQ injections had higher feeding behaviors pre-treatment than they did post-treatment. Overall, physical castrations caused measurable pain-like behaviors and general behavioral dysregulation at a much higher level than the other treatment groups. SQ and IM injections did not cause either significant behavioral or physiological alterations in piglets. SQ injections caused a decrease in finishing pig feed behaviors post treatment ( p = 0.02) and SHAM treated finishing pigs spent significantly more time lying than the other treatment groups. In general IM and SQ injections did not cause any other significant changes in behavior or physiology. PMID:27589810

  16. The pharmacokinetics of subcutaneously injected Bimosiamose disodium in healthy male volunteers.

    PubMed

    Meyer, Michael; Beyer, Diana; Vollhardt, Karin; Woischwill, Christiane; Jilma, Bernd; Wolff, Gerhard

    2007-12-01

    Bimosiamose is a novel synthetic pan-selectin antagonist developed for the treatment of acute and chronic inflammatory disorders. Therefore the pharmacokinetics of Bimosiamose disodium were studied in healthy male volunteers after single and multiple subcutaneous injections. A randomized, double-blind, placebo-controlled dose escalation trial was carried out. The subjects received subcutaneous injections of placebo or 100, 200 or 300 mg Bimosiamose disodium into the abdomen. Plasma and urine concentrations of Bimosiamose were determined. The maximum plasma concentration was 2.17+/-0.70 microg/ml and the AUC(0-infinity) 11.1+/-2.9 h microg/ml after the highest dose on day 1 (mean+/-SD). For the apparent clearance CL/f 28.7+/-7.3 l/h and the terminal half life t(1/2) 3.7+/-0.6 h were calculated. The mean residence time MRT(infinity) of 5.5 to 6.3 h for s.c. injection exceeded that after i.v. infusion due to an extended absorption time. For multiple dosing, constant pre-dose concentrations of about 20 ng/ml may be reached after two subsequent doses of 200 or 300 mg Bimosiamose disodium once daily. Almost 15% of the administered drug was excreted unchanged in urine. Moreover, Bimosiamose was well tolerated. PMID:17876866

  17. Pharmacokinetics of tulathromycin after subcutaneous injection in North American bison (Bison bison).

    PubMed

    Bachtold, K; Alcorn, J; Matus, J; Boison, J; Woodbury, M

    2015-10-01

    Tulathromycin is approved for the treatment of respiratory disease in cattle and swine. It is intended for long-acting, single-dose injection therapy (Draxxin), making it particularly desirable for use in bison due to the difficulty in handling and ease of creating stress in these animals. The pharmacokinetic properties of tulathromycin in bison were investigated. Ten wood bison received a single 2.5 mg/kg subcutaneous injection of Draxxin. Serum concentrations were measured by liquid chromatography-mass spectrometry (LC-MS) detection. Tulathromycin demonstrated early maximal serum concentrations, extensive distribution, and slow elimination characteristics. The mean maximum serum concentration (Cmax) was 195 ng/mL at 1.04 h (tmax) postinjection. The mean area under the serum concentration-time curve, extrapolated to infinity (AUC0-inf ), was 9341 ng · h/mL. The mean apparent volume of distribution (Vd /F) and clearance (Cls/F) was 111 L/kg and 0.4 L/h/kg, respectively, and the mean half-life (t1/2) was 214 h (8.9 days). Compared to values for cattle, Cmax and AUC0-inf were lower in bison, while the Vd /F was larger and the t1/2 longer. Tissue distribution and clinical efficacy studies in bison are needed to confirm the purported extensive distribution of tulathromycin into lung tissue and to determine whether a 2.5 mg/kg subcutaneous dosage is adequate for bison. PMID:25772094

  18. Early Reactions of the Subcutaneous Tissue to Repeated Injections of Carcinogens in Aqueous Solutions

    PubMed Central

    Hooson, Jean; Grasso, P.; Gangolli, S. D.

    1971-01-01

    Four water-soluble carcinogens were injected at the same site subcutaneously into rats, mice or guinea-pigs, twice weekly for 5-8 weeks in order to study the evolution of the early tissue reaction. MNU was injected into rats as 0·1 ml. of 0·5% solution, and into mice as 0·1 ml. of 0·05% solution. NQO was administered to rats (0·1 or 0·2 ml. of 0·25 or 0·1%) mice (0·1 of 0·05%) and guinea-pigs (0·5 of 0·1%). Propane sultone and BEI were administered to rats only, the former as 0·1 ml. of 3% and the latter as 0·5 ml. of 2·0% solution. The principal features of the tissue reaction produced by each of the four compounds in rats were similar and consisted of destruction of subcutaneous tissue, deposition of fibrin and “fibrinoid”, an abnormal pattern of fibroblastic proliferation with cytomegaly of some fibroblasts and deposition of mucopolysaccharide but little collagen formation. Moreover, the appearance of fibroblastic proliferation was delayed from the normal 2-5 days to 14-16 days. These features are consistent with the known early effects of carcinogens on proliferating target tissues, and differ considerably from those found in the early reactive lesions to repeated injection of solutions of substances possessing physical properties such as surface activity or hypertonicity, or which precipitate at the injection site. ImagesFigs. 5-7Figs. 8-9Figs. 1-2Figs. 3-4 PMID:4259386

  19. Monoclonal antibody imaging of human melanoma. Radioimmunodetection by subcutaneous or systemic injection.

    PubMed Central

    Lotze, M T; Carrasquillo, J A; Weinstein, J N; Bryant, G J; Perentesis, P; Reynolds, J C; Matis, L A; Eger, R R; Keenan, A M; Hellström, I

    1986-01-01

    Fab fragments of monoclonal antibodies (MoAb) to melanoma, radiolabeled with 131I, were evaluated as diagnostic reagents to determine their ability to localize systemic--MoAb injected intravenously (IV)--or nodal metastatic disease--injected subcutaneously (SQ) at a site proximal to draining lymph nodes. Sixty-one scans were performed (40 IV, 21 SQ) in 59 patients who had injections of 0.2-50 mg of 131I coupled (0.2-12 mCi) antibody. These included 48.7, which identifies a high molecular weight antigen (HMW), or 96.5, which identifies a transferrin like molecule, p97. 125I coupled nonspecific Fab 1.4, reacting with murine leukemia virus, or the whole antibody BL3, reactive with a human B cell idiotypic determinant, was generally used in tandem with the patients injected SQ as a nonspecific control. All patients had immunohistochemical studies performed on biopsied lesions and demonstrated binding to the antibodies injected. Of the IV patients, 22/38 (58%) had (+) scans, 13 at SQ or nodal sites, four at visceral sites, and five at visceral and SQ sites. Patients with clinical stage II disease had SQ injection of MoAb, including 11 additional patients injected with the whole antibody 9.2.27 (anti-HMW) labeled with 111In (6 patients) or 131I (5 patients). Nodal dissection was performed 2-4 days later. All 111In coupled antibodies demonstrated excellent nodal delineation without specific identification of tumor deposits. Of the 21 patients injected SQ with MoAb, 17 had confirmed tumor in nodes. Of patients injected with Fab fragments, 4/8 (50%) had specific uptake of MoAb, although only two were successfully imaged. Increased uptake of antimelanoma antibodies was observed in some patients in lymph nodes not containing tumor and was possibly related to antigen shedding. Clearance of labeled antibody from the injection site occurred with a half life of 16-50 hours. Toxicity was limited to local discomfort at the site of SQ injection. Melanoma metastases can be identified

  20. Comparative reactogenicity and immunogenicity of 23 valent pneumococcal vaccine administered by intramuscular or subcutaneous injection in elderly adults.

    PubMed

    Cook, Ian F; Pond, Dimity; Hartel, Gunter

    2007-06-15

    23 Valent pneumococcal vaccine is provided to the elderly through public health programs in many countries. However there is no clear recommendation regarding its route of administration (subcutaneous or intramuscular). In a randomised, observer blind study of 254 elderly subjects, the immunogenicity of a 23 valent pneumococcal vaccine was not influenced by its route of administration. A low rate of systemic adverse reactions was observed with the vaccine (subcutaneous and intramuscular both 6.3%). Local adverse reaction rates were; intramuscular 7.1% and subcutaneous 18.9% and these were predicted by: * Pre-vaccination antibody titres>1 microg/ml, odds ratio 22.4 (8.06-74.84) compared with pre-vaccination antibody titre<1 microg/ml. * Female gender, odds ratio 5.0 (1.85-14.83) compared with male gender. * Subcutaneous injection route, odds ratio 3.20 (1.13-9.13) compared with intramuscular injection route. * Female gender subcutaneous injection route, odds ratio 2.99 (1.10-8.70) compared with female gender intramuscular injection route. These data support the intramuscular injection of 23 valent pneumococcal vaccine, especially in elderly females. PMID:17512098

  1. Investigating high-concentration monoclonal antibody powder suspension in nonaqueous suspension vehicles for subcutaneous injection.

    PubMed

    Bowen, Mayumi; Armstrong, Nick; Maa, Yuh-Fun

    2012-12-01

    Developing high-concentration monoclonal antibody (mAb) liquid formulations for subcutaneous (s.c.) administration is challenging because increased viscosity makes injection difficult. To overcome this obstacle, we investigated a nonaqueous powder suspension approach. Three IgG1 mAbs were spray dried and suspended at different concentrations in Miglyol® 840, benzyl benzoate, or ethyl lactate. Suspensions were characterized for viscosity, particle size, and syringeability; physical stability was visually inspected. Suspensions generally outperformed liquid solutions for injectability despite higher viscosity at the same mAb concentrations. Powder formulations and properties had little effect on viscosity or injectability. Ethyl lactate suspensions had lowest viscosity (<20 cP) and lowest syringe injection glide force (<15 N) at mAb concentrations as high as 333 mg/mL (500 mg powder/mL). Inverse gas chromatography analysis indicated that the vehicle was the most important factor impacting suspension performance. Ethyl lactate rendered greater heat of sorption (suggesting strong particle-suspension vehicle interaction may reduce particle-particle self-association, leading to low suspension viscosity and glide force) but lacked the physical suspension stability exhibited by the other vehicles. Specific mixtures of ethyl lactate and Miglyol® 840 improved overall performance in high mAb concentration suspensions. This study demonstrated the viability of high mAb concentration (>300 mg/mL) in suspension formulations for s.c. administration. PMID:23001898

  2. Monoclonal antibody imaging of human melanoma. Radioimmunodetection by subcutaneous or systemic injection

    SciTech Connect

    Lotze, M.T.; Carrasquillo, J.A.; Weinstein, J.N.; Bryant, G.J.; Perentesis, P.; Reynolds, J.C.; Matis, L.A.; Eger, R.R.; Keenan, A.M.; Hellstroem, Ie.

    1986-09-01

    Fab fragments of monoclonal antibodies (MoAb) to melanoma, radiolabeled with /sup 131/I, were evaluated as diagnostic reagents to determine their ability to localize systemic--MoAb injected intravenously (IV)--or nodal metastatic disease--injected subcutaneously (SQ) at a site proximal to draining lymph nodes. Sixty-one scans were performed (40 IV, 21 SQ) in 59 patients who had injections of 0.2-50 mg of /sup 131/I coupled (0.2-12 mCi) antibody. These included 48.7, which identifies a high molecular weight antigen (HMW), or 96.5, which identifies a transferrin like molecule, p97. 125I coupled nonspecific Fab 1.4, reacting with murine leukemia virus, or the whole antibody BL3, reactive with a human B cell idiotypic determinant, was generally used in tandem with the patients injected SQ as a nonspecific control. All patients had immunohistochemical studies performed and demonstrated binding to the antibodies injected. Of the IV patients, 22/38 (58%) had (+) scans, 13 at SQ or nodal sites, four at visceral sites, and five at visceral and SQ sites. Patients with clinical stage II disease had SQ injection of MoAb, including 11 additional patients injected with the whole antibody 9.2.27 (anti-HMW) labeled with 111In (6 patients) or /sup 131/I (5 patients). Nodal dissection was performed 2-4 days later. All 111In coupled antibodies demonstrated excellent nodal delineation without specific identification of tumor deposits. Of the 21 patients injected SQ with MoAb, 17 had confirmed tumor in nodes. Of patients injected with Fab fragments, 50% had specific uptake of MoAb, although only two were successfully imaged. Increased uptake of antimelanoma antibodies was observed in some patients in lymph nodes not containing tumor. Clearance of labeled antibody from the injection site occurred with a half life of 16-50 hours. Toxicity was limited to local discomfort at the site of SQ injection.

  3. Metabolic and Structural Effects of Phosphatidylcholine and Deoxycholate Injections on Subcutaneous Fat

    PubMed Central

    Reeds, Dominic N.; Mohammed, B. Selma; Klein, Samuel; Boswell, Craig Brian

    2013-01-01

    Background: Phosphatidylcholine and deoxycholate (PC-DC) injections are a popular nonsurgical method to eliminate unwanted fat. The safety and efficacy of this approach is uncertain. Objective: The authors evaluate the effects of PC-DC treatments on body composition, adipocyte function, and mechanisms responsible for fat loss. Methods: This randomized, open-label study enrolled 13 women with a body mass index (BMI) ≤30 kg/m2 and lower abdominal subcutaneous fat suitable for small-volume liposuction. Patients were randomized by the final digit of their Social Security numbers and received between 2 and 4 PC-DC treatments, spaced 8 weeks apart. One side below the umbilicus was injected with PC-DC. The contralateral, control side received no treatment. Adipose tissue biopsies were performed on the treated side at baseline, 1 week after the first treatment, and 8 weeks after the final treatment. The primary outcome was change in adipose tissue thickness at baseline and 8 weeks after the final treatment. Results: Seven women completed the study. Treatment with PC-DC significantly reduced the thickness of the anterior subcutaneous abdominal fat (P = .004). Adipose tissue showed rapid increases in crown-like structures, macrophage infiltration, and reduced expression of leptin, hormone-sensitive lipase, adipose tissue triglyceride lipase, and CD36. Plasma C-reactive protein, lipid profile, and plasma glucose concentrations were unchanged. Conclusions: PC-DC injections can effectively reduce abdominal fat volume and thickness by inducing adipocyte necrosis. These treatments do not appear to increase circulating markers of inflammation or affect glucose and lipid metabolism. Level of Evidence: 3 PMID:23439063

  4. Factors influencing adverse skin responses in rats receiving repeated subcutaneous injections and potential impact on neurobehavior

    PubMed Central

    Levoe, S. Nikki; Flannery, Brenna M.; Brignolo, Laurie; Imai, Denise M.; Koehne, Amanda; Austin, Adam T.; Bruun, Donald A.; Tancredi, Daniel J.; Lein, Pamela J.

    2015-01-01

    Repeated subcutaneous (s.c.) injection is a common route of administration in chronic studies of neuroactive compounds. However, in a pilot study we noted a significant incidence of skin abnormalities in adult male Long-Evans rats receiving daily s.c. injections of peanut oil (1.0 ml/kg) in the subscapular region for 21 d. Histopathological analyses of the lesions were consistent with a foreign body reaction. Subsequent studies were conducted to determine factors that influenced the incidence or severity of skin abnormalities, and whether these adverse skin reactions influenced a specific neurobehavioral outcome. Rats injected daily for 21 d with food grade peanut oil had an earlier onset and greater incidence of skin abnormalities relative to rats receiving an equal volume (1.0 ml/kg/d) of reagent grade peanut oil or triglyceride of coconut oil. Skin abnormalities in animals injected daily with peanut oil were increased in animals housed on corncob versus paper bedding. Comparison of animals obtained from different barrier facilities exposed to the same injection paradigm (reagent grade peanut oil, 1.0 ml/kg/d s.c.) revealed significant differences in the severity of skin abnormalities. However, animals from different barrier facilities did not perform differently in a Pavlovian fear conditioning task. Collectively, these data suggest that environmental factors influence the incidence and severity of skin abnormalities following repeated s.c. injections, but that these adverse skin responses do not significantly influence performance in at least one test of learning and memory. PMID:25705100

  5. Tolerability of Vidaza (azacitidine) subcutaneous administration using a maximum volume of 3 ml per injection.

    PubMed

    Ferruccio, Lauren F; Murray, Cindy; Yee, Karen W; Incekol, Diana; Lee, Roy; Paisley, Emma; Ng, Pamela

    2016-08-01

    The azacitidine (Vidaza®) product monograph indicates that doses greater than 4 ml should be divided equally into two syringes and injected into different sites. Although 2 ml is a more commonly used maximum volume for subcutaneous injections, there is a lack of evidence to support the use of any given maximum volume with azacitidine. Applying the status quo of 2 ml to azacitidine results in patients receiving 3-4 injections per visit. This prospective study evaluated the frequency and type of injection site reactions when the maximum subcutaneous injection volume was increased from 2 to 3 ml per injection site. Among 30 patients, 309 doses were administered, and injection site reactions were noted in 92.9% of all doses, with the majority (82.2%) being grade 1; only 10.7% of doses resulted in grade 2 reactions, and there were no grade 3 or 4 reactions. There was no increase in frequency or severity of injection site reactions when the maximum volume was increased to 3 ml. The median number of injections that patients received per visit decreased from 3 to 2 after the volume was increased, and there was a statistically significant reduction in the incidence of pain. Decreasing the number of injections also facilitates ease of rotation of injection sites and decreases pharmacy preparation time. This is the first time that injection site reaction data relating to injection volume have been reported for azacitidine. PMID:26248754

  6. Depletion of intramuscularly and subcutaneously injected procaine penicillin G from tissues and plasma of yearling beef steers.

    PubMed Central

    Korsrud, G O; Boison, J O; Papich, M G; Yates, W D; MacNeil, J D; Janzen, E D; Cohen, R D; Landry, D A; Lambert, G; Yong, M S

    1993-01-01

    Withdrawal periods required when doses of 24,000 IU and 66,000 IU of procaine penicillin G/kg body weight were administered to yearling beef steers by intramuscular injection daily for five consecutive days were investigated. These dosages are in excess of product label recommendations, but are in the range of procaine penicillin G dosages that have been administered for the treatment of some feedlot bacterial diseases. The approved dose in Canada is 7,500 IU/kg body weight intramuscularly, once daily, with a withdrawal period of five days. Based on the tissue residue data from this study, the appropriate withdrawal period is ten days for the 24,000 IU/kg body weight dose and 21 days for the 66,000 IU/kg body weight dose when administered intramuscularly to yearling beef steers. In a related study, 18 yearling beef steers received 66,000 IU of procaine penicillin G/kg body weight administered by subcutaneous injection, an extra-label treatment in terms of both dose and route of administration, typical of current practice in some circumstances. Deposits of the drug were visible at subcutaneous injection sites up to ten days after injection, with more inflammation and hemorrhage observed than for intramuscular injections of the same dose. These results suggest that procaine penicillin G should not be administered subcutaneously at high doses; and therefore a withdrawal period was not established for subcutaneous injection. Images Fig. 3. Fig. 4. PMID:8269359

  7. Practical aspects and considerations when switching between continuous subcutaneous insulin infusion and multiple daily injections.

    PubMed

    Meneghini, Luigi; Sparrow-Bodenmiller, Jane

    2010-06-01

    Insulin pump therapy is considered the gold standard for insulin management in patients requiring full physiologic insulin replacement. Compared to traditional delivery of short- and long-acting insulin preparations by multiple daily insulin injections, delivery of insulin via continuous subcutaneous infusion brings with it several advantages, which in the past have translated into better glycemic control and treatment satisfaction. Delivery of insulin via pump reduces the number needle insertions (from four or five per day to once every 2-3 days), allows for greater flexibility of insulin delivery with regard to both the basal and prandial component, facilitates portability of the insulin preparation, and allows for more accurate dosing. Continuous subcutaneous insulin infusion does have some drawbacks, including a greater risk of inadvertent insulin non-delivery, greater costs of therapy, and the need to be "tethered" with some systems that might be considered "burdensome" or even undesirable to some patients. For the most part patients who initiate insulin pump therapy are satisfied and continue using the technology, but there might be instances that arise that require the re-introduction of insulin delivery by pen or syringe. This article will review some of the reasons and strategies for switching from one mode of delivery to the other. PMID:20515298

  8. Outbreak of sarcoptic mange in alpacas (Vicugna pacos) and control with repeated subcutaneous ivermectin injections.

    PubMed

    Twomey, D F; Birch, E S; Schock, A

    2009-02-01

    An outbreak of sarcoptic mange was investigated in an alpaca herd. Clinical disease occurred 2 months after the introduction of four alpacas with dry seborrhoeic skin lesions, the cause of which was not investigated. Initially a group of females was affected, despite repeated topical treatment with ivermectin at a dose of 0.5mg/kg bodyweight. One female died and post-mortem examination indicated sarcoptic mange as the cause of death. Infection with Sarcoptes scabiei was also demonstrated on microscopic examination of skin scrapes taken from clinically affected cohorts. Later in the outbreak, a separate group of male alpacas was also affected. Treatment using subcutaneous ivermectin injections at a dose of 0.2mg/kg, administered at 14-day intervals, was evaluated. During this course of treatment, another female died. A successful response in the other alpacas was eventually reached following 12 treatments of the female group and 8 treatments of the male group. PMID:19019545

  9. Removal rate of ( sup 3 H)hyaluronan injected subcutaneously in rabbits

    SciTech Connect

    Reed, R.K.; Laurent, U.B.; Fraser, J.R.; Laurent, T.C. )

    1990-08-01

    Hyaluronan is an important constituent of the extracellular matrix in skin, and recent studies suggest that there is a pool of easily removable (free) hyaluronan drained by lymph. The removal rate of free hyaluronan in skin was measured from the elimination of ({sup 3}H)hyaluronan, injected subcutaneously in 13 rabbits. The removal of radioactivity was determined from appearance of {sup 3}H in plasma. During the first 24 h after injection, 10-87% of the tracer entered blood, less in injectates with high concentrations of hyaluronan. The removal was monoexponential with a half-life of 0.5-1 day when concentration of hyaluronan was 5 mg/ml or less. When hyaluronan concentration was 10 mg/ml or higher, the removal was slow for about 24 h and then became similar to that in experiments with low hyaluronan concentration. Free hyaluronan at physiological concentrations is thus turned over with the same rate as serum albumin, supporting the concept that hyaluronan is removed essentially by lymph flow to be degraded in lymph nodes and liver.

  10. Ricobendazole kinetics and availability following subcutaneous administration of a novel injectable formulation to calves.

    PubMed

    Lanusse, C E; Virkel, G L; Sanchez, S F; Alvarez, L I; Lifschitz, A L; Imperiale, F; Monfrinotti, A

    1998-01-01

    The plasma and abomasal fluid disposition kinetics of ricobendazole (RBZ) after subcutaneous (s.c.) administration of a novel injectable formulation to calves, and the comparative plasma availability after s.c. injection of RBZ and that obtained after oral treatment with albendazole (ABZ), were characterised. Six parasite-free Holstein calves received RBZ (solution 150 mg ml(-1)) by s.c. injection at 3.75 mg kg(-1) (Experiment 1). Experiment 2 was conducted in two experimental phases; in phase I, five calves (Group A) received RBZ by s.c. injection and five animals (Group B) were orally treated with ABZ (suspension 100 mg ml(-1)), at 5 mg kg(-1). Drug treatments were reversed for each group in phase II and given at 7.5 mg kg(-1). Samples of abomasal fluid (via cannula) and jugular blood were collected over 72 hours post-treatment and analysed by HPLC. RBZ and its sulphone metabolite were detected in plasma following its s.c. administration. RBZ was rapidly absorbed, reaching the plasma Cmax at 4.5 hours post-dosing. The sulphone metabolite followed a similar kinetic pattern. Both molecules were rapidly and extensively distributed into the abomasum, being detected in abomasal fluid between 30 minutes and 36 hours post-administration. An extensive plasma/abomasum exchange process, with ionic-trapping in the abomasum, accounted for the higher AUC value (>200 per cent) obtained for RBZ in abomasum compared with plasma. The s.c. treatment with RBZ formulated as a solution resulted in a significantly greater plasma availability (measured as ABZ sulphoxide) than the oral treatment with ABZ (suspension) given at the same dose rates. PMID:9769065

  11. Central Retinal and Posterior Ciliary Artery Occlusion After Intralesional Injection of Sclerosant to Glabellar Subcutaneous Hemangioma

    SciTech Connect

    Matsuo, Toshihiko; Fujiwara, Hiroyasu; Gobara, Hideo; Mimura, Hidefumi; Kanazawa, Susumu

    2009-03-15

    The aim of this study is to describe vision loss caused by central retinal artery and posterior ciliary artery occlusion as a consequence of sclerotherapy with a polidocanol injection to a glabellar hemangioma. An 18-year-old man underwent direct injection with a 23-gauge needle of 1 mL of a polidocanol-carbon dioxide emulsion into the glabellar subcutaneous hemangioma under ultrasound visualization of the needle tip by radiologists. He developed lid swelling the next day, and 3 days later at referral, the visual acuity in the left eye was no light perception. Funduscopy revealed central retinal artery occlusion and fluorescein angiography disclosed no perfusion at all in the left fundus, indicating concurrent posterior ciliary artery occlusion. The patient also showed mydriasis, blepharoptosis, and total external ophthalmoplegia on the left side. Magnetic resonance imaging demonstrated the swollen medial rectus muscle. In a month, blepharoptosis and ophthalmoplegia resolved but the visual acuity remained no light perception. Sclerosing therapy for facial hemangioma may develop a severe complication such as permanent visual loss.

  12. The devastating outcome of massive subcutaneous injection of highly viscous fluids in male-to-female transsexuals.

    PubMed

    Hage, J J; Kanhai, R C; Oen, A L; van Diest, P J; Karim, R B

    2001-03-01

    Illicit subcutaneous injections of massive quantities of highly viscous fluids are still performed, often by unqualified persons. Fifteen male-to-female transsexuals consulted the authors regarding their devastating long-term outcomes after the injection of up to 8 liters of alleged silicone or mineral oil to feminize their bodies. After a latency period of up to 17 years, these injections led to complications ranging from scarring and deformity to infections. These patients were treated conservatively for inflammation and infection or surgically by resection of the oil-infested areas. In view of the potential dangers, feminization by the injection of high-viscosity fluids should be soundly condemned. PMID:11304599

  13. The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

    PubMed Central

    Jin, Jing-fen; Zhu, Ling-ling; Chen, Meng; Xu, Hui-min; Wang, Hua-fen; Feng, Xiu-qin; Zhu, Xiu-ping; Zhou, Quan

    2015-01-01

    Background Intravenous (IV), intramuscular (IM), and subcutaneous (SC) are the three most frequently used injection routes in medication administration. Comparative studies of SC versus IV, IM versus IV, or IM versus SC have been sporadically conducted, and some new findings are completely different from the dosage recommendation as described in prescribing information. However, clinicians may still be ignorant of such new evidence-based findings when choosing treatment methods. Methods A literature search was performed using PubMed, MEDLINE, and Web of Sciences™ Core Collection to analyze the advantages and disadvantages of SC, IV, and IM administration in head-to-head comparative studies. Results “SC better than IV” involves trastuzumab, rituximab, antitumor necrosis factor medications, bortezomib, amifostine, recombinant human granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, recombinant interleukin-2, immunoglobulin, epoetin alfa, heparin, and opioids. “IV better than SC” involves ketamine, vitamin K1, and abatacept. With respect to insulin and ketamine, whether IV has advantages over SC is determined by specific clinical circumstances. “IM better than IV” involves epinephrine, hepatitis B immu-noglobulin, pegaspargase, and some antibiotics. “IV better than IM” involves ketamine, morphine, and antivenom. “IM better than SC” involves epinephrine. “SC better than IM” involves interferon-beta-1a, methotrexate, human chorionic gonadotropin, hepatitis B immunoglobulin, hydrocortisone, and morphine. Safety, efficacy, patient preference, and pharmacoeconomics are four principles governing the choice of injection route. Safety and efficacy must be the preferred principles to be considered (eg, epinephrine should be given intramuscularly during an episode of systemic anaphylaxis). If the safety and efficacy of two injection routes are equivalent, clinicians should consider more about patient preference and

  14. Qualitative analysis of subcutaneous Lispro and regular insulin injections for stress hyperglycemia: a pilot numerical study.

    PubMed

    Strilka, Richard J; Armen, Scott B; Indeck, Matthew C

    2014-09-01

    Increased glucose variability (GV) is an independent risk factor for mortality in the critically ill; unfortunately, the optimal insulin therapy that minimizes GV is not known. We simulate the glucose-insulin feedback system to study how stress hyperglycemia (SH) states, taken to be a non-uniform group of physiologic disorders with varying insulin resistance (IR) and similar levels of hyperglycemia, respond to the type and dose of subcutaneous (SQ) insulin. Two groups of 100 virtual patients are studied: those receiving and those not receiving continuous enteral feeds. Stress hyperglycemia was facilitated by doubling the gluconeogenesis rate and IR was stepwise varied from a borderline to a high value. Lispro and regular insulin were simulated with dosages that ranged from 0 to 6 units; the resulting GV was analyzed after each insulin injection. The numerical model used consists of a set of non-linear differential equations with two time delays and five adjustable parameters. The results show that regular insulin decreased GV in both patient groups and rarely caused hypoglycemia. With continuous enteral feeds and borderline to mild IR, Lispro showed minimal effect on GV; however, rebound hyperglycemia that increased GV occurred when the IR was moderate to high. Without a nutritional source, Lispro worsened GV through frequent hypoglycemia episodes as the injection dose increased. The inferior performance of Lispro is a result of its rapid absorption profile; half of its duration of action is similar to the glucose ultradian period. Clinical trials are needed to examine whether these numerical results represent the glucose-insulin dynamics that occur in intensive care units, and if such dynamics are present, their clinical effects should be evaluated. PMID:24769252

  15. Fate of Multimeric Oligomers, Submicron, and Micron Size Aggregates of Monoclonal Antibodies Upon Subcutaneous Injection in Mice.

    PubMed

    Kijanka, Grzegorz; Bee, Jared S; Bishop, Steven M; Que, Ivo; Löwik, Clemens; Jiskoot, Wim

    2016-05-01

    The aim of this study was to examine the fate of differently sized protein aggregates upon subcutaneous injection in mice. A murine and a human monoclonal immunoglobulin G 1 (IgG1) antibody were labeled with a fluorescent dye and subjected to stress conditions to create aggregates. Aggregates fractionated by centrifugation or gel permeation chromatography were administered subcutaneously into SKH1 mice. The biodistribution was measured by in vivo fluorescence imaging for up to 1 week post injection. At several time points, mice were sacrificed and selected organs and tissues were collected for ex vivo analysis. Part of injected aggregated IgGs persisted much longer at the injection site than unstressed controls. Aggregate fractions containing submicron (0.1-1 μm) or micron (1-100 μm) particles were retained to a similar extent. Highly fluorescent "hot-spots" were detected 24 h post injection in spleens of mice injected with submicron aggregates of murine IgG. Submicron aggregates of human IgG showed higher accumulation in draining lymph nodes 1 h post injection than unstressed controls or micron size aggregates. For both tested proteins, aggregated fractions seemed to be eliminated from circulation more rapidly than monomeric fractions. The biodistribution of monomers isolated from solutions subjected to stress conditions was similar to that of unstressed control. PMID:27044942

  16. Study of severe scorpion envenoming following subcutaneous venom injection into dogs: Hemodynamic and concentration/effect analysis.

    PubMed

    Elatrous, Souheil; Ouanes-Besbes, Lamia; Ben Sik-Ali, Habiba; Hamouda, Zineb; BenAbdallah, Saoussen; Tilouche, Nejla; Jalloul, Faten; Fkih-Hassen, Mohamed; Dachraoui, Fahmi; Ouanes, Islem; Abroug, Fekri

    2015-09-15

    To evaluate the dose-effects of Androctonus australis hector (Aah) venom injected subcutaneously on hemodynamics and neurohormonal secretions, 10 anesthetized and ventilated mongrel dogs, were split in two groups (n = 5/group). Subcutaneous injection was done with either 0.2 mg/kg or 0.125 mg/kg of the purified G50 scorpion toxic fraction. Hemodynamic parameters using right heart catheter were recorded and plasma concentrations of catecholamine, troponin, and serum toxic fraction were measured sequentially from baseline to 120 min. We identified the dose of toxic fraction evoking characteristic hemodynamic perturbation of severe envenomation, the time-lapse to envenomation, and the associated plasma level. The injection of 0.125 mg/kg toxic fraction was not associated with significant variations in hemodynamic parameters, whereas the 0.2 mg/kg dose caused envenomation characterized by significant increase in plasma catecholamines, increased pulmonary artery occluded pressure, mean arterial pressure, and systemic vascular resistance (p < 0.05), in association with sustained decline in cardiac output (p < 0.001). Envenomation occurred by the 30th minute, and the corresponding concentration of toxic fraction was 1.14 ng/ml. The current experiment allowed the identification of the sub-lethal dose (0.2 mg/kg) of the toxic fraction of Aah administered by the subcutaneous route. Two parameters with potential clinical relevance were also uncovered: the time-lapse to envenomation and the corresponding concentration of toxic fraction. PMID:26166304

  17. Effect of subcutaneous selenium injection and supplementary selenium source on blood selenium and glutathione peroxidase in feedlot heifers

    PubMed Central

    Chorfi, Younes; Girard, Vincent; Fournier, Alain; Couture, Yvon

    2011-01-01

    This study measured the effect on glutathione peroxidase (GSH-Px) and selenium (Se) in whole blood and plasma associated with subcutaneous Se injections in beef heifers fed organic or inorganic Se. Heifers (n = 120) were randomly divided into 2 groups, 1 of which received subcutaneous Se injections. Both groups were given the same total mixed ration with 3 mg of organic or inorganic Se daily. Until week 2, heifers that had received Se injections showed higher concentrations of plasma Se and GSH-Px and whole blood Se (P < 0.001) than those having had no injections. Concentrations of plasma Se and GSH-Px were higher in the group receiving organic Se than the group receiving inorganic Se. Whole blood GSH-Px concentrations increased significantly (P < 0.001) throughout a 12-week period but were not affected by Se source. Combination of Se injections and supplementation could help maintain normal Se and GSH-Px blood status in beef heifers during the first few weeks in the feedlot. PMID:22467963

  18. Reactogenicity and immunogenicity of an inactivated influenza vaccine administered by intramuscular or subcutaneous injection in elderly adults.

    PubMed

    Cook, Ian F; Barr, Ian; Hartel, Gunter; Pond, Dimity; Hampson, Alan W

    2006-03-20

    In many countries there is no clear recommendation regarding the preferred route of administration of inactivated influenza vaccines. In a randomised, observer blind study of 720 elderly subjects, a split, trivalent influenza vaccine was significantly more immunogenic for both A strains (H3N2 and H1N1, p = 0.0016 and 0.003, respectively) when given intramuscularly compared to subcutaneously. This difference was due entirely to a gender effect, with females in the intramuscular (IM) group having a significantly greater serological response than females in the subcutaneous (SC) group for both of these strains. Similar results were seen with local adverse effects. These data suggest that vaccination practices that ensure intramuscular injection are required for optimal administration of influenza vaccines in the elderly. PMID:16406171

  19. Subcutaneous injections of low doses of humanized anti-CD20 veltuzumab: a phase I study in chronic lymphocytic leukemia.

    PubMed

    Kalaycio, Matt E; George Negrea, O; Allen, Steven L; Rai, Kanti R; Abbasi, Rashid M; Horne, Heather; Wegener, William A; Goldenberg, David M

    2016-01-01

    To evaluate the potential of subcutaneous (SC) injections with anti-CD20 antibody veltuzumab in chronic lymphocytic leukemia (CLL), 21 patients received 80, 160, or 320 mg injections every 2 weeks × 4 doses (n = 11) or 160 or 320 mg twice-weekly × 16 doses (n = 10). Treatment was well tolerated with only occasional, mild-moderate, transient injection reactions. Lymphocytosis decreased in all patients (maximum decrease, 5-91%), with 12 patients obtaining >50% decreases. Of 14 patients with lymphadenopathy on CT imaging, 5 (36%) achieved 14-61% reductions (sum of perpendicular diameters). By NCI-WG criteria, two patients achieved partial responses (10%). SC veltuzumab appeared active in all dose groups, with no obvious exposure-response relationship, despite cumulative doses ranging from 320-5120 mg. Overall median progression-free survival was 7.7 months; three patients remained progression-free >1 year (2 ongoing at 2-year study completion). These data suggest further studies of SC veltuzumab in CLL are warranted. PMID:26389849

  20. Dose Responsive Effects of Subcutaneous Pentosan Polysulfate Injection in Mucopolysaccharidosis Type VI Rats and Comparison to Oral Treatment

    PubMed Central

    Frohbergh, Michael; Ge, Yi; Meng, Fanli; Karabul, Nesrin; Solyom, Alexander; Lai, Alon; Iatridis, James; Schuchman, Edward H.; Simonaro, Calogera M.

    2014-01-01

    Background We previously demonstrated the benefits of daily, oral pentosan polysulfate (PPS) treatment in a rat model of mucopolysaccharidosis (MPS) type VI. Herein we compare these effects to once weekly, subcutaneous (sc) injection. The bioavailability of injected PPS is greater than oral, suggesting better delivery to difficult tissues such as bone and cartilage. Injected PPS also effectively treats osteoarthritis in animals, and has shown success in osteoarthritis patients. Methodology/Principal Findings One-month-old MPS VI rats were given once weekly sc injections of PPS (1, 2 and 4 mg/kg, human equivalent dose (HED)), or daily oral PPS (4 mg/kg HED) for 6 months. Serum inflammatory markers and total glycosaminoglycans (GAGs) were measured, as were several histological, morphological and functional endpoints. Overall, weekly sc PPS injections led to similar or greater therapeutic effects as daily oral administration. Common findings between the two treatment approaches included reduced serum inflammatory markers, improved dentition and skull lengths, reduced tracheal deformities, and improved mobility. Enhanced effects of sc treatment included GAG reduction in urine and tissues, greater endurance on a rotarod, and better improvements in articular cartilage and bone in some dose groups. Optimal therapeutic effects were observed at 2 mg/kg, sc. No drug-related increases in liver enzymes, coagulation factor abnormalities or other adverse effects were identified following 6 months of sc PPS administration. Conclusions Once weekly sc administration of PPS in MPS VI rats led to equal or better therapeutic effects than daily oral administration, including a surprising reduction in urine and tissue GAGs. No adverse effects from sc PPS administration were observed over the 6-month study period. PMID:24964042

  1. Pentosan Polysulfate: Oral Versus Subcutaneous Injection in Mucopolysaccharidosis Type I Dogs

    PubMed Central

    Simonaro, Calogera M.; Tomatsu, Shunji; Sikora, Tracy; Kubaski, Francyne; Frohbergh, Michael; Guevara, Johana M.; Wang, Raymond Y.; Vera, Moin; Kang, Jennifer L.; Smith, Lachlan J.; Schuchman, Edward H.; Haskins, Mark E.

    2016-01-01

    Background We previously demonstrated the therapeutic benefits of pentosan polysulfate (PPS) in a rat model of mucopolysaccharidosis (MPS) type VI. Reduction of inflammation, reduction of glycosaminoglycan (GAG) storage, and improvement in the skeletal phenotype were shown. Herein, we evaluate the long-term safety and therapeutic effects of PPS in a large animal model of a different MPS type, MPS I dogs. We focused on the arterial phenotype since this is one of the most consistent and clinically significant features of the model. Methodology/Principal Findings MPS I dogs were treated with daily oral or biweekly subcutaneous (subQ) PPS at a human equivalent dose of 1.6 mg/kg for 17 and 12 months, respectively. Safety parameters were assessed at 6 months and at the end of the study. Following treatment, cytokine and GAG levels were determined in fluids and tissues. Assessments of the aorta and carotid arteries also were performed. No drug-related increases in liver enzymes, coagulation factors, or other adverse effects were observed. Significantly reduced IL-8 and TNF-alpha were found in urine and cerebrospinal fluid (CSF). GAG reduction was observed in urine and tissues. Increases in the luminal openings and reduction of the intimal media thickening occurred in the carotids and aortas of PPS-treated animals, along with a reduction of storage vacuoles. These results were correlated with a reduction of GAG storage, reduction of clusterin 1 staining, and improved elastin integrity. No significant changes in the spines of the treated animals were observed. Conclusions PPS treatment led to reductions of pro-inflammatory cytokines and GAG storage in urine and tissues of MPS I dogs, which were most evident after subQ administration. SubQ administration also led to significant cytokine reductions in the CSF. Both treatment groups exhibited markedly reduced carotid and aortic inflammation, increased vessel integrity, and improved histopathology. We conclude that PPS may be a

  2. Increased Sensitivity to Inflammatory Pain Induced by Subcutaneous Formalin Injection in Serine Racemase Knock-Out Mice

    PubMed Central

    Tabata-Imai, Ayako; Inoue, Ran; Mori, Hisashi

    2014-01-01

    D-Serine, an endogenous coagonist of the N-methyl-D-aspartate receptor (NMDAR), is widely distributed in the central nervous system and is synthesized from L-serine by serine racemase (SR). NMDAR plays an important role in pain processing including central sensitization that eventually causes hyperalgesia. To elucidate the roles of D-serine and SR in pain transmission, we evaluated the behavioral changes and spinal nociceptive processing induced by formalin using SR knock-out (KO) mice. We found that SR is mainly distributed in lamina II of the dorsal horn of the spinal cord in wild-type (WT) mice. Although the formalin injected subcutaneously induced the biphasic pain response of licking in SR-KO and WT mice, the time spent on licking was significantly longer in the SR-KO mice during the second phase of the formalin test. The number of neurons immunopositive for c-Fos and phosphorylated extracellular signal-regulated kinase (p-ERK), which are molecular pain markers, in laminae I-II of the ipsilateral dorsal horn was significantly larger in the SR-KO mice. Immunohistochemical staining revealed that the distribution of SR changed from being broad to being concentrated in cell bodies after the formalin injection. On the other hand, the expression level of the cytosolic SR in the ipsilateral dorsal horn significantly decreased. Oral administration of 10 mM D-serine in drinking water for one week cancelled the difference in pain behaviors between WT and SR-KO mice in phase 2 of the formalin test. These findings demonstrate that the SR-KO mice showed increased sensitivity to inflammatory pain and the WT mice showed translocation of SR and decreased SR expression levels after the formalin injection, which suggest a novel antinociceptive mechanism via SR indicating an important role of D-serine in pain transmission. PMID:25133605

  3. Acute toxicological studies on paraquat: pathological findings in beagle dogs following single subcutaneous injections.

    PubMed

    Nagata, T; Kono, I; Masaoka, T; Akahori, F

    1992-04-01

    Sixteen beagles were allocated into 4 groups, each group consisting of 2 males and 2 females, which were injected sc with 1,3,5 or 7 mg paraquat/kg. The beagles were observed for 2 w after the administration. At the end of the observation period all the dying and surviving dogs were studied pathologically. The LD50 was calculated as 1.8 (1.0-6.1) in males and 3.5 (2.4-10.1) mg/kg in females. Clinical laboratory tests showed increases in segmented neutrophils and monocytes, decreases in lymphocytes, slight decreases in chloride, moderate increases in BUN, GOT, GPT and phospholipids, slight increases in uric acid, total protein, creatine, total cholesterol and total bilirubin, and prolonged prothrombin times. Marked edema, congestion and hemorrhage of lungs, as well as slight congestion in various organs, were observed grossly. In histopathological examination, marked pulmonary hemorrhage and congestion, fibroblast-like cells in alveolar septa, breakdown of alveolar walls, thickening of alveolar walls and pleura, mild congestion and degeneration of the liver, and mild degeneration of renal tubules were observed. The cause of death was respiratory distress and renal failure. The surviving animals had mild atelectasis of the lungs. Electromicroscopic examination on the surviving animals revealed the appearance of spindle-shaped cells, proliferation of type II alveolar cells and fibroblasts, mitosis of fibroblasts, and abundant collagen fiber in the lung, calcium deposition, stratification and thickening of basement membranes, and localized necrotic epithelial cells in the proximal tubules of kidneys, and stratification of intramitochondrial cristae of the liver. Pulmonary fibrosis in the switchover stage was present with participation from type II alveolar cells, fibroblasts and myofibroblasts. PMID:1509667

  4. Physico-chemical Stability of MabThera Drug-product Solution for Subcutaneous Injection under in-use Conditions with Different Administration Materials.

    PubMed

    Mueller, Claudia; Dietel, Elke; Heynen, Severin R; Nalenz, Heiko; Goldbach, Pierre; Mahler, Hanns-Christian; Schmidt, Johannes; Grauschopf, Ulla; Schoenhamnmer, Karin

    2015-01-01

    MabThera is an essential component of the standard-of-care regimens in the treatment of non-Hodgkin lymphoma and Chronic Lymphatic Leukemia. MabThera for subcutaneous injection is a novel line extension that has been approved by the European Medicines Agency for the treatment of patients with follicular lymphoma and diffuse large B-cell lymphoma. This study aimed to evaluate in-use stability data of MabThera subcutaneous drug-product solution in single-use syringes for subcutaneous administration according to the European Medicines Agency guideline. The drug-product solution was exposed to material contact surfaces of five different administration setups commonly used in subcutaneous drug delivery. MabThera subcutaneous was transferred under aseptic conditions into polypropylene and polycarbonate syringes and stored for 1, 2, and 4 weeks at 2°C to 8°C followed by 24 hours at 30°C. After storage, subcutaneous administration was simulated and MabThera subcutaneous drug-product solution quality attributes were evaluated by using compendial physico-chemical tests, as well as suitable and validated molecule- and formulation-specific analytical methods. MabThera subcutaneous vials were treated and analyzed in parallel. The physico-chemical results of MabThera subcutaneous in the different setups were comparable to the control for all timepoints. No change in drug-product quality after storage and simulated administration was found compared to the control. However, since single-dose products do not contain preservatives, microbial contamination and growth needs to be avoided and product sterility needs to be ensured. The results showed that MabThera subcutaneous remains compatible and stable, from a physico-chemical perspective, for up to 4 weeks at 2°C to 8°C followed by 24 hours at 30°C with the contact materials tested in this study. In order to avoid and minimize microbial growth, MabThera subcutaneous should be used immediately after removal from the original

  5. Effect of methacrylic acid beads on the sonic hedgehog signaling pathway and macrophage polarization in a subcutaneous injection mouse model.

    PubMed

    Lisovsky, Alexandra; Zhang, David K Y; Sefton, Michael V

    2016-08-01

    Poly(methacrylic acid-co-methyl methacrylate) (MAA) beads promote a vascular regenerative response when used in diabetic wound healing. Previous studies reported that MAA beads modulated the expression of sonic hedgehog (Shh) and inflammation related genes in diabetic wounds. The aim of this work was to follow up on these observations in a subcutaneous injection model to study the host response in the absence of the confounding factors of diabetic wound healing. In this model, MAA beads improved vascularization in healthy mice of both sexes compared to control poly(methyl methacrylate) (MM) beads, with a stronger effect seen in males than females. MAA-induced vessels were perfusable, as evidenced from the CLARITY-processed images. In Shh-Cre-eGFP/Ptch1-LacZ non-diabetic transgenic mice, the increased vessel formation was accompanied by a higher density of cells expressing GFP (Shh) and β-Gal (patched 1, Ptch1) suggesting MAA enhanced the activation of the Shh pathway. Ptch1 is the Shh receptor and a target of the pathway. MAA beads also modulated the inflammatory cell infiltrate in CD1 mice: more neutrophils and more macrophages were noted with MAA relative to MM beads at days 1 and 7, respectively. In addition, MAA beads biased macrophages towards a MHCII-CD206+ ("M2") polarization state. This study suggests that the Shh pathway and an altered inflammatory response are two elements of the complex mechanism whereby MAA-based biomaterials effect vascular regeneration. PMID:27264502

  6. Plasma insulin profiles after subcutaneous injection: how close can we get to physiology in people with diabetes?

    PubMed

    Home, P D

    2015-11-01

    Many people with diabetes rely on insulin therapy to achieve optimal blood glucose control. A fundamental aim of such therapy is to mimic the pattern of 'normal' physiological insulin secretion, thereby controlling basal and meal-time plasma glucose and fatty acid turnover. In people without diabetes, insulin release is modulated on a time base of 3-10 min, something that is impossible to replicate without intravascular glucose sensing and insulin delivery. Overnight physiological insulin delivery by islet β cells is unchanging, in contrast to requirements once any degree of hyperglycaemia occurs, when diurnal influences are evident. Subcutaneous pumped insulin or injected insulin analogues can approach the physiological profile, but there remains the challenge of responding to day-to-day changes in insulin sensitivity. Physiologically, meal-time insulin release begins rapidly in response to reflex activity and incretins, continuing with the rise in glucose and amino acid concentrations. This rapid response reflects the need to fill the insulin space with maximum concentration as early as 30 min after starting the meal. Current meal-time insulins, by contrast, are associated with a delay after injection before absorption begins, and a delay to peak because of tissue diffusion. While decay from peak for monomeric analogues is not dissimilar to average physiological needs, changes in meal type and, again, in day-to-day insulin sensitivity, are difficult to match. Recent and current developments in insulin depot technology are moving towards establishing flatter basal and closer-to-average physiological meal-time plasma insulin profiles. The present article discusses the ideal physiological insulin profile, how this can be met by available and future insulin therapies and devices, and the challenges faced by healthcare professionals and people with diabetes in trying to achieve an optimum plasma insulin profile. PMID:26041603

  7. Energy dispersive X-ray analysis of titanium dioxide nanoparticle distribution after intravenous and subcutaneous injection in mice.

    PubMed

    Patri, Anil; Umbreit, Thomas; Zheng, J; Nagashima, K; Goering, Peter; Francke-Carroll, Sabine; Gordon, Edward; Weaver, James; Miller, Terry; Sadrieh, Nakissa; McNeil, Scott; Stratmeyer, Mel

    2009-11-01

    In an effort to understand the disposition and toxicokinetics of nanoscale materials, we used EDS (energy dispersive X-ray spectroscopy) to detect and map the distribution of titanium dioxide (TiO2) in tissue sections from mice following either subcutaneous (s.c.) or intravenous (i.v.) injection. TiO2 nanoparticles were administered at a dose of 560 mg/kg (i.v.) or 5600 mg/kg (s.c.) to Balb/c female mice on two consecutive days. Tissues (liver, kidney, lung, heart, spleen, and brain) were examined by light microscopy, TEM (transmission electron microscopy), SEM (scanning electron microscopy), and EDS following necropsy one day after treatment. Particle agglomerates were detected by light microscopy in all tissues examined, EDS microanalysis was used to confirm that these tissues contained elemental titanium and oxygen. The TEM micrographs and EDS spectra of the aggregates were compared with in vitro measurements of TiO2 nanoparticle injection solution (i.e., in water). The nanoparticles were also characterized using dynamic light scattering in water, 10 mM NaCl, and phosphate buffered saline (PBS). In low ionic strength solvents (water and 10 mM NaCl), the TiO2 particles had average hydrodynamic diameters ranging from 114-122 nm. In PBS, however, the average diameter increases to 1-2 microm, likely due to aggregation analogous to that observed in tissue by TEM and EDS. This investigation demonstrates the suitability of energy dispersive X-ray spectroscopy (EDS) for detection of nanoparticle aggregates in tissues and shows that disposition of TiO2 nanoparticles depends on the route of administration (i.v. or s.c.). PMID:19626582

  8. Continuous infusion or subcutaneous injection of granulocyte-macrophage colony-stimulating factor: increased efficacy and reduced toxicity when given subcutaneously.

    PubMed Central

    Honkoop, A. H.; Hoekman, K.; Wagstaff, J.; van Groeningen, C. J.; Vermorken, J. B.; Boven, E.; Pinedo, H. M.

    1996-01-01

    Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a haematopoietic growth factor with a wide variety of applications in the clinic. In early phase I studies the continuous intravenous (c.i.) route of administration was often used. Later it was shown that subcutaneous (s.c.) administration was also effective. The optimal route of administration remains, however, poorly defined, and no studies have made a direct comparison between these two routes of administration. We treated patients with advanced breast cancer with moderately high-dose doxorubicin and cylophosphamide and GM-CSF. The first 14 patients received GM-CSF by c.i, while subsequently 47 patients received it s.c. Comparison between the two groups showed that c.i. GM-CSF was more toxic in several respects. There was a higher need for erythrocyte and platelet transfusions and a significant deterioration in the performance status. This study indicates that subcutaneous GM-CSF is the preferred route of administration. Randomised trials are, however, needed to confirm these conclusions. PMID:8855987

  9. Human neuroblastoma cell growth in xenogeneic hosts: comparison of T cell-deficient and NK-deficient hosts, and subcutaneous or intravenous injection routes.

    PubMed

    Turner, W J; Chatten, J; Lampson, L A

    1990-04-01

    We have examined two features of neuroblastoma cells that had not been well-characterized in a xenogeneic model: The cells display unusual immunologic properties in other experimental systems, and the original tumors display widespread and characteristic patterns of metastasis. To determine the most appropriate immunodeficient host for primary tumor growth, T cell-deficient nude mice, NK-deficient beige mice, beige-nudes, and controls were injected with the well-characterized line CHP-100. To define the pattern of tumor spread, complete autopsies were performed following subcutaneous, intraperitoneal and intravenous injections. CHP-100 consistently formed subcutaneous tumors in T cell-deficient mice (nude and beige-nude), but not in T cell-competent mice (beige, heterozygous nu/+ and bg/+, or wild-type). The growth rate and final size of the subcutaneous tumors were not greater in beige-nudes than in nudes. All mice showed early CHP-100 cell death after subcutaneous injection; the nature of the immunodeficiency was more relevant for the surviving subpopulation. Widespread dissemination was seen following intravenous injection, particularly in beige-nudes. Aspects of the growth patterns were appropriate to the tumor of origin. The behavior in immunodeficient mice suggests that T cells can play a role in controlling the growth of these cells; the next steps will be to define the effector mechanisms, and to determine if they can be exploited for human patients. The hematogenous spread following intravenous injection suggests that insights into the control of blood-borne tumor may also come from further study of this model. PMID:2358846

  10. Subcutaneous Construction of Engineered Adipose Tissue with Fat Lobule-Like Structure Using Injectable Poly-Benzyl-L-Glutamate Microspheres Loaded with Adipose-Derived Stem Cells

    PubMed Central

    Yong, Qi; Li, Sufang; Xie, Qingping; Yin, Jingbo; Cui, Lei

    2015-01-01

    Porous microcarriers were fabricated from synthesized poly(γ-benzyl-L-glutamate) (PBLG) polymer to engineer adipose tissue with lobule-like structure via the injectable approach. The adipogenic differentiation of human adipose-derived stem cells (hASCs) seeded on porous PBLG microcarriers was determined by adipogenic gene expression and glycerol-3-phosphate dehydrogenase enzyme activity. In vitro adipogenic cultivation was performed for 7 days, and induced hASC/PBLG complex (Adi-ASC/PBLG group) was subcutaneously injected into nude mice. Injections of PBLG microcarriers alone (PBLG group) and non-induced hASC/PBLG complex (ASC/PBLG group) served as controls. Newly formed tissues were harvested after 4 and 8 weeks. Generation of subcutaneous adipose tissue with typical lobule-like structure separated by fibrous septa was observed upon injection of adipogenic-induced hASC/microsphere complex. Adipogenesis significantly increased in the Adi-ASC/PBLG group compared with the control groups. The angiogenesis in the engineered adipose tissue was comparable to that in normal tissue as determined by capillary density and luminal diameter. Cell tracking assay demonstrated that labeled hASCs remained detectable in the neo-generated tissues 8 weeks post-injection using green fluorescence protein-labeled hASCs. These results indicate that adipose tissue with typical lobule-like structure could be engineered using injectable porous PBLG microspheres loaded with adipogenic-induced hASCs. PMID:26274326

  11. Switching from subcutaneous insulin injection to oral vildagliptin administration in hemodialysis patients with type 2 diabetes: a pilot study.

    PubMed

    Yoshida, Naoshi; Babazono, Tetsuya; Hanai, Ko; Uchigata, Yasuko

    2016-08-01

    We conducted this pilot study to examine efficacy and safety of switching from subcutaneous injection of insulin to oral administration of a DPP-4 inhibitor, vildagliptin, in type 2 diabetic patients undergoing hemodialysis. Consecutive type 2 diabetic patients on hemodialysis who were switched from insulin to vildagliptin between August 2010 and April 2011 were extracted from the hospital database. In patients whose post-switch increase in glycated albumin (GA) levels was <1.5 % without resuming insulin at least 24 weeks, the switch was defined as efficacious. In patients who resumed insulin therapy due to worsening of glycemic control or in patients whose GA levels increased by 1.5 % or more, the switch was considered inefficacious. To predict patients in whom switch to vildagliptin proved efficacious, receiver-operating characteristic (ROC) analysis and logistic regression analysis were performed. A total of 20 patients were extracted; insulin dose was 12 ± 4 units/day; levels of GA and HbA1c was 21.0 ± 3.7 % and 6.5 ± 0.6 %, respectively. Among them, 11 patients were efficaciously switched to vildagliptin. ROC analysis and logistic analysis showed that patients with a shorter duration of diabetes, as well as lower levels of GA and HbA1c, appeared to have a higher likelihood of successful treatment switches. None of the patients developed hypoglycemic symptoms, ketoacidosis, or serious adverse events. In conclusion, efficacious change from insulin to vildagliptin was possible in approximately a half of type 2 diabetic dialysis patients. Long-term follow-up studies including large number of patients are needed to confirm these results. PMID:27193434

  12. Effect of vaccination with N-glycolyl GM3/VSSP vaccine by subcutaneous injection in patients with advanced cutaneous melanoma

    PubMed Central

    Osorio, Marta; Gracia, Elias; Reigosa, Edmundo; Hernandez, Julio; de la Torre, Ana; Saurez, Giselle; Perez, Kirenia; Viada, Carmen; Cepeda, Meylán; Carr, Adriana; Ávila, Yisel; Rodríguez, Migdalia; Fernandez, Luis E

    2012-01-01

    NeuGc-containing gangliosides have been described in melanoma cells and are an attractive target for cancer immunotherapy because they are minimally or not expressed in normal human tissues. Melanoma patients treated with a vaccine based on N-glycolyl gangliosides have shown benefit in progression free survival and overall survival. We conducted a multicenter Phase I/II clinical trial in patients with metastatic cutaneous melanoma treated with the N-gycolyl GM3/very-small-size proteoliposomes vaccine by the subcutaneous route. Selecting the optimal biological dose of the vaccine was the principal objective based on immunogenicity, efficacy, and safety results. Six dose levels were studied and the treatment schedule consisted of five doses administered every 2 weeks and then monthly until 15 doses had been given. Dose levels evaluated were 150, 300, 600, 900, 1200, and 1500 μg with five patients included in each dose level except the 900 μg dose (n = 10). Immunogenicity was determined by antibody titers generated in patients after vaccination. Antitumor effect was measured by response criteria of evaluation in solid tumors and safety was evaluated by common toxicity criteria of adverse events. The vaccine was safe and immunogenic at all doses levels. The most frequent adverse events related to vaccination were mild to moderate injection site reactions and flu-like symptoms. Vaccination induced specific anti-NeuGcGM3 immunoglobulin M and immunoglobulin G antibody responses in all patients. Disease control (objective response or stable disease) was obtained in 38.46% of patients. Global median overall survival was 20.20 months. Two patients achieved overall survival duration of about 4 and 5 years, respectively. The 900 μg dose resulted in overall survival duration of 19.40 months and was selected as the biological optimal dose. PMID:23055778

  13. Dose dependence and temporal evolution of the T1 relaxation time and MRI contrast in the rat brain after subcutaneous injection of manganese chloride.

    PubMed

    Shazeeb, Mohammed Salman; Sotak, Christopher H

    2012-12-01

    Divalent manganese ion (Mn(2+)) is a widely used T(1) contrast agent in manganese-enhanced MRI studies to visualize functional neural tracts and anatomy in the brain in vivo. In animal studies, Mn(2+) is administered at a dose that will maximize the contrast, while minimizing its toxic effects. In rodents, systemic administration of Mn(2+) via intravenous injection has been shown to create unique MRI contrast in the brain at a maximum dose of 175 mg kg(-1). However, intravenous administration of Mn(2+) results in faster bioelimination of excess Mn(2+) from the plasma due to a steep concentration gradient between plasma and bile. By contrast, following subcutaneous injection (LD(50) value = 320 mg kg(-1)), Mn(2+) is released slowly into the bloodstream, thus avoiding immediate hepatic elimination resulting in prolonged accumulation of Mn(2+) in the brain via the choroid plexus than that obtained via intravenous administration. The goal of this study was to investigate MRI dose response of Mn(2+) in rat brain following subcutaneous administration of Mn(2+). Dose dependence and temporal dynamics of Mn(2+) after subcutaneous injection can prove useful for longitudinal in vivo studies that require brain enhancement to persist for a long period of time to visualize neuroarchitecture like in neurodegenerative disease studies. PMID:22294279

  14. Time Savings with Rituximab Subcutaneous Injection versus Rituximab Intravenous Infusion: A Time and Motion Study in Eight Countries

    PubMed Central

    De Cock, Erwin; Kritikou, Persefoni; Sandoval, Mariana; Tao, Sunning; Wiesner, Christof; Carella, Angelo Michele; Ngoh, Charles; Waterboer, Tim

    2016-01-01

    Background Rituximab is a standard treatment for non-Hodgkin lymphoma. The SABRINA trial (NCT01200758) showed that a subcutaneous (SC) rituximab formulation did not compromise efficacy or safety compared with intravenous (IV) infusion. We aimed to quantify active healthcare professional (HCP) time and patient chair time for rituximab SC and IV, including potential time savings. Methods This non-interventional time and motion study was run in eight countries and 30 day oncology units. Rituximab SC data were collected alongside the MabCute trial (NCT01461928); IV data were collected per routine real-world practice. Trained observers recorded active HCP time for pre-specified tasks (stopwatch) and chair time (time of day). A random intercept model was used to analyze active HCP time (by task and for all tasks combined) in the treatment room and drug preparation area, drug administration duration, chair time and patient treatment room time by country and/or across countries. Active HCP and chair time were extrapolated to a patient’s first year of treatment (11 rituximab sessions). Results Mean active HCP time was 35.0 and 23.7 minutes for IV and SC process, respectively (-32%, p <0.0001). By country, relative reduction in time was 27–58%. Absolute reduction in extrapolated active HCP time (first year of treatment) was 1.1–5.2 hours. Mean chair time was 262.1 minutes for IV, including 180.9 minutes infusion duration, vs. 67.3 minutes for SC, including 8.3 minutes SC injection administration (-74%, p <0.0001). By country, relative reduction was 53–91%. Absolute reduction in extrapolated chair time for the first year of treatment was 3.1–5.5 eight-hour days. Conclusions Compared with rituximab IV, rituximab SC was associated with reduced chair time and active HCP time. The latter could be invested in other activities, whereas the former may lead to more available appointments, reducing waiting lists and increasing the efficiency of day oncology units. Trial

  15. Human Placental Extract as a Subcutaneous Injection Is Effective in Chronic Fatigue Syndrome: A Multi-Center, Double-Blind, Randomized, Placebo-Controlled Study.

    PubMed

    Park, Sat Byul; Kim, Kyu-Nam; Sung, Eunju; Lee, Suk Young; Shin, Ho Cheol

    2016-05-01

    Chronic fatigue (CF) is a common reason for consulting a physician due to affecting quality of life, but only a few effective treatments are available. The aim of this study was to examine the effectiveness of subcutaneous injection of the human placental extract (HPE) on medically indescribable cases of CF and safety in a randomized, double-blind, placebo-controlled clinical trial. A total of 78 subjects with CF were randomly assigned to either a HPE group or a placebo group. Subjects in the HPE group were treated with HPE three times a week subcutaneously for 6 weeks, whereas those in the placebo group with normal saline. Then, the fatigue severity scale (FSS), visual analog scale (VAS) and multidimensional fatigue inventory (MFI) were measured in both CF group and chronic fatigue syndrome (CFS) and idiopathic chronic fatigue (ICF) subgroup. The FSS, VAS and MFI score at baseline were not different between the HPE and placebo group in total subjects with CF. In CFS group, the FSS (p=0.0242), VAS (p=0.0009) and MFI (p=0.0159) scores measured at the end of the study period decreased more in the HPE group than in the placebo group when compared with those at the baseline. There were no significant differences between the HPE group and placebo group in the mean change from baseline in FSS, VAS, and MFI in subjects with ICF during the study period. The subcutaneous injection of HPE was effective in the improvement of CFS. PMID:26911970

  16. Pharmacokinetics and pharmacodynamics of recombinant human growth hormone by subcutaneous jet- or needle-injection in patients with growth hormone deficiency.

    PubMed

    Houdijk, E C; Herdes, E; Delemarre-Van de Waal, H A

    1997-12-01

    Eighteen growth hormone (GH) deficient children and adolescents (11 6/12-20 9/12 y) participated in a randomized open, two-period (4 weeks) cross-over study to evaluate the pharmacokinetics and pharmacodynamics of recombinant human growth hormone (rhGH) administered daily, either by subcutaneous jet-injection or conventional needle-injection. Plasma growth hormone (GH), insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), glucose, insulin, HbAlc and serum-free fatty acids (FFA) levels were analysed repeatedly. GH absorption characteristics, expressed as AUC(0-infinity), Cmax and Tmax ratio (%) jet-injected over needle-injected were similar in both groups. IGF-I and IGFBP-3 plasma levels were identical in both groups. Serum FFA concentrations were comparable after GH administration with either injection device. Surprisingly nocturnal blood glucose decreased to asymptomatic hypoglycaemic levels in all patients. The results of this study showed equal responses concerning absorption and bioavailability of growth hormone administered daily for 4 weeks by either a jet- or a needle-injection device in GH-deficient children and adolescents. PMID:9475305

  17. Subcutaneous emphysema

    MedlinePlus

    ... after certain infections, including gas gangrene , and after scuba diving. ... will determine the outcome. Subcutaneous emphysema associated with scuba diving is usually less worrisome or serious.

  18. Golimumab Injection

    MedlinePlus

    ... it.Golimumab injection comes in prefilled syringes and auto-injection devices for subcutaneous injection. Use each syringe ... method.Do not remove the cap from the auto-injection device or the cover from the prefilled ...

  19. Subcutaneous entomophthoromycoses

    PubMed Central

    Karuna, Tadepalli; Asati, Dinesh P.; Biswas, Debasis; Purwar, Shashank

    2015-01-01

    Subcutaneous entomophthoromycoses is a zygomycosis caused by Basidiobolus ranarum that is endemic in southern India. We report the case of a 63-year-old male from central India who presented with a nontender subcutaneous hyperpigmented plaque on his leg with mild discharge that yielded Basidiobolus ranarum. PMID:26753142

  20. Effect of subcutaneous injection of a long-acting analogue of somatostatin (SMS 201-995) on plasma thyroid-stimulating hormone in normal human subjects

    SciTech Connect

    Itoh, S.; Tanaka, K.; Kumagae, M.; Takeda, F.; Morio, K.; Kogure, M.; Hasegawa, M.; Horiuchi, T.; Watabe, T.; Miyabe, S.

    1988-01-01

    SMS 201-995 (SMS), a synthetic analogue of somatostatin (SRIF) has been shown to be effective in the treatment of the hypersecretion of hormones such as in acromegaly. However, little is known about the effects of SMS on the secretion of thyroid-stimulating hormone (TSH) in normal subjects. In this study, plasma TSH was determined with a highly sensitive immunoradiometric assay, in addition to the concentration of SMS in plasma and urine with a radioimmunoassay, following subcutaneous injection of 25, 50, 100 ..mu..g of SMS or a placebo to normal male subjects, at 0900 h after an overnight fast. The plasma concentrations of SMS were dose-responsive and the peak levels were 1.61 +/- 0.09, 4.91 +/- 0.30 and 8.52 +/- 1.18 ng/ml, which were observed at 30, 15 and 45 min after the injection of 25, 50, and 100 ..mu..g of SMS, respectively. Mean plasma disappearance half-time of SMS was estimated to be 110 +/- 3 min. Plasma TSH was suppressed in a dose dependent manner and the suppression lasted for at least 8 hours. At 8 hours after the injection of 25, 50, and 100 ..mu..g of SMS, the plasma TSH levels were 43.8 +/- 19.4, 33.9 +/- 9.4 and 24.9 +/- 3.2%, respectively, of the basal values.

  1. Subcutaneous injection of thymopentin in the area of the supramammary lymph node to reduce milk somatic cell count in subclinically mastitic cows.

    PubMed

    Guan, R; Xu, W; Pan, T; Su, X; Hu, S

    2016-02-01

    The objective of this study was to evaluate the therapeutic effects of thymopentin (TP-5) injections on subclinical intramammary infection (IMI) in lactating cows. In Experiment I, 40 cows were randomly divided into four groups. The cows in groups 1, 2, and 3 received subcutaneous injections of TP-5 in the region of the supramammary lymph node at doses of 1, 2, and 4 mg, respectively, for 3 days. In Experiment II, 20 cows were randomly divided into two groups. The cows in group 1 were treated with injections of TP-5 (4 mg) for 3 days in the same area as in Experiment I. Group 4 in Experiment I and group 2 in Experiment II were not treated and served as control groups. Milk samples were collected before and after treatment for bacteriological examination and analysis of the somatic cell count and level of N-acetyl-β-d-glucosaminidase (NAGase). The results showed that treatment with TP-5 significantly reduced the somatic cell count (SCC) and NAGase activity of the milk and numerically reduced IMI. A dose of 4 mg was found to be optimal for the reduction of SCC and NAGase in milk. Therefore, further study of the use of TP-5 in the treatment of bovine mastitis is warranted. PMID:25976252

  2. Subcutaneously administered methotrexate for rheumatoid arthritis, by prefilled syringes versus prefilled pens: patient preference and comparison of the self-injection experience

    PubMed Central

    Demary, Winfried; Schwenke, Holger; Rockwitz, Karin; Kästner, Peter; Liebhaber, Anke; Schoo, Ulrich; Hübner, Georg; Pichlmeier, Uwe; Guimbal-Schmolck, Cécile; Müller-Ladner, Ulf

    2014-01-01

    Purpose This multicenter, randomized, crossover study compared preference, ease of use, acceptability, satisfaction, and safety of repeated subcutaneous (SC) self-administrations with prefilled pens and prefilled syringes delivering methotrexate (MTX), in patients with rheumatoid arthritis (RA). Patients and methods The study (ClinicalTrials.gov number NCT01793259) enrolled 120 patients requiring initiation or intensification of MTX therapy for RA. Patients were randomized to receive the test drug, a prefilled pen (Metex® PEN/Metoject® PEN), or the reference drug, a prefilled syringe (Metex®/Metoject®), at doses of 15, 17.5, or 20 mg MTX SC once a week for 3 weeks. This was followed by receipt of the reference drug (prefilled syringe) or the test drug (prefilled pen) in a crossover design, with each patient serving as his/her own control. Questionnaires regarding patient preference, the Self-Injection Assessment Questionnaire (SIAQ), and diaries regarding local tolerability were used to document outcomes. Results Overall patient preference for the MTX prefilled pen was 75% (P<0.0001). In a six-item questionnaire, 73% to 76% of the patients preferred the prefilled pen in relation to use, acceptability, and satisfaction, and 67% of the patients confirmed that it did not take much effort to overcome SC self-injection with the pen. The SIAQ showed no clinical differences, in any domain scores, between both devices. Overall patient attitude towards self-injection at baseline was positive, as was patient experience with both devices during the study. As well, 92% of physicians and study nurses indicated that they would recommend the MTX prefilled pen to patients for future MTX treatment. The formulations were generally well tolerated. Conclusion SC self-injection of MTX with a prefilled pen was generally preferred, by patients with RA, over a prefilled syringe with regard to use, acceptability, and satisfaction. This is supported by the strong appreciation of their

  3. Subcutaneous Injections of the Mannose-Sensitive Hemagglutination Pilus Strain of Pseudomonas aeruginosa Stimulate Host Immunity, Reduce Bladder Cancer Size and Improve Tumor Survival in Mice.

    PubMed

    Li, Tao; Yang, Li; Fu, Sheng-Jun; Xiao, Er-Long; Yuan, Xuan; Lu, Jian-Zhong; Ma, Bao-Liang; Shi, Ting-Kai; Wang, Zhi-Ping

    2015-09-01

    We wished to evaluate the effects of Pseudomonas aeruginosa (mannose-sensitive hemagglutination pilus strain, PA-MSHA) as an immunostimulating and anti-tumor agent for treatment of bladder cancer. Immunostimulating effects were assessed by the in vitro proliferation assay of murine splenic lymphocytes. Anti-tumor effects were studied in a subcutaneous tumor model established in female C57BL/6 mice using the MB49 bladder cell line. These mice received subcutaneous injections of normal saline (control group) or PA-MSHA (high, medium, or low dose, respectively, 1.6-2.0 × 10(9), 3.2- .0 × 10(8), 6.4-8.0 × 10(7) CFU/ml) twice a week for 3 weeks. Mice survival, tumor volume, vascular endothelial growth factor (VEGF) expression, microvessel density (MVD), serum levels of TNF-α and IFN-γ, and blood CD4(+) /CD8(+) counts were the study outcomes. We observed that PA-MSHA promoted the growth of splenic lymphocytes in vitro. In the murine tumor model, PA-MSHA prolonged mice survival and reduced tumor growth. Furthermore, VEGF and MVD were also diminished by PA-MSHA. Mice that received high and medium dose of PA-MSHA had significantly higher serum levels of IFN-γ and TNF-α (days 21 and 28), and higher levels of CD4(+) /CD8(+) cells (days 21 and 28). In conclusion, PA-MSHA exerts beneficial effects on increasing proliferation of murine splenic lymphocytes in vitro and inhibits the growth of bladder tumor in a murine model. Therefore, PA-MSHA may be useful an immunostimulating and anti-tumor agent for bladder cancer therapy. PMID:25724441

  4. Very High Plasma Concentrations of a Monoclonal Antibody against the Human Insulin Receptor Are Produced by Subcutaneous Injection in the Rhesus Monkey.

    PubMed

    Boado, Ruben J; Hui, Eric Ka-Wai; Lu, Jeff Zhiqiang; Pardridge, William M

    2016-09-01

    Brain penetration of recombinant protein drugs is possible following the re-engineering of the drug as an IgG fusion protein. The IgG domain is a monoclonal antibody (mAb) against an endogenous blood-brain barrier (BBB) receptor transporter, such as the insulin receptor. One such mAb targets the human insulin receptor (HIR) and is active in Rhesus monkeys. Prior work has measured the plasma pharmacokinetics of HIRMAb-derived fusion proteins following intravenous (IV) infusion. However, an alternative method of administration for chronic treatment of brain disease is the subcutaneous (SQ) route. The extent to which an antibody against the insulin receptor undergoes systemic distribution and clearance is unknown. Therefore, in the present study, the rate of plasma clearance of the HIRMAb is measured in Rhesus monkeys following IV or SQ administration of 3, 10, and 30 mg/kg doses of the antibody. The HIRMAb is readily absorbed into the systemic circulation following SQ injection with a 42% plasma bioavailability. The rate of plasma clearance of the antibody, 0.04-0.06 mL/min/kg, is the same following either IV or SQ administration. Owing to the slow rate of plasma clearance of the antibody, high concentrations of the HIRMAb are sustained in plasma for days after the SQ injection. The plasma concentration of the HIRMAb exceeds 0.8 mg/mL, which is 9% of the entire plasma IgG pool in the primate, after the SQ injection of the high dose, 30 mg/kg, of the antibody. In summary, the pharmacokinetics of plasma clearance of the HIRMAb are such that HIRMAb-derived fusion proteins can be developed as protein therapeutics for the brain with chronic SQ administration on a weekly or twice-weekly regimen. PMID:27513815

  5. Golimumab, a human antibody to tumour necrosis factor α given by monthly subcutaneous injections, in active rheumatoid arthritis despite methotrexate therapy: the GO-FORWARD Study

    PubMed Central

    Keystone, E C; Genovese, M C; Klareskog, L; Hsia, E C; Hall, S T; Miranda, P C; Pazdur, J; Bae, S-C; Palmer, W; Zrubek, J; Wiekowski, M; Visvanathan, S; Wu, Z; Rahman, M U

    2009-01-01

    Objective: The phase III GO-FORWARD study examined the efficacy and safety of golimumab in patients with active rheumatoid arthritis (RA) despite methotrexate therapy. Methods: Patients were randomly assigned in a 3 : 3 : 2 : 2 ratio to receive placebo injections plus methotrexate capsules (group 1, n  =  133), golimumab 100 mg injections plus placebo capsules (group 2, n  =  133), golimumab 50 mg injections plus methotrexate capsules (group 3, n  =  89), or golimumab 100 mg injections plus methotrexate capsules (group 4, n  =  89). Injections were administered subcutaneously every 4 weeks. The co-primary endpoints were the proportion of patients with 20% or greater improvement in the American College of Rheumatology criteria (ACR20) at week 14 and the change from baseline in the health assessment questionnaire-disability index (HAQ-DI) score at week 24. Results: The proportion of patients who achieved an ACR20 response at week 14 was 33.1% in the placebo plus methotrexate group, 44.4% (p = 0.059) in the golimumab 100 mg plus placebo group, 55.1% (p = 0.001) in the golimumab 50 mg plus methotrexate group and 56.2% (p<0.001) in the golimumab 100 mg plus methotrexate group. At week 24, median improvements from baseline in HAQ-DI scores were 0.13, 0.13 (p = 0.240), 0.38 (p<0.001) and 0.50 (p<0.001), respectively. During the placebo-controlled portion of the study (to week 16), serious adverse events occurred in 2.3%, 3.8%, 5.6% and 9.0% of patients and serious infections occurred in 0.8%, 0.8%, 2.2% and 5.6%, respectively. Conclusion: The addition of golimumab to methotrexate in patients with active RA despite methotrexate therapy significantly reduced the signs and symptoms of RA and improved physical function. PMID:19066176

  6. Comparative Effectiveness of Continuous Subcutaneous Insulin Infusion Using Insulin Analogs and Multiple Daily Injections in Pregnant Women with Diabetes Mellitus: A Systematic Review and Meta-Analysis

    PubMed Central

    Maruthur, Nisa M.; Nicholson, Wanda K.; Yeh, Hsin-Chieh; Brown, Todd; Suh, Yong; Wilson, Lisa M.; Nannes, Elisabeth B.; Berger, Zack; Bass, Eric B.; Golden, Sherita Hill

    2015-01-01

    Abstract We systematically reviewed the effectiveness and safety of continuous subcutaneous insulin infusion (CSII) with insulin analogs compared with multiple daily injections (MDI) in pregnant women with diabetes mellitus. We searched Medline®, Embase®, and the Cochrane Central Register of Controlled Trials through May 2013. Studies comparing CSII with MDI in pregnant women with diabetes mellitus were included. Studies using regular insulin CSII were excluded. We conducted meta-analyses where there were two or more comparable studies based on the type of insulin used in the MDI arm. Seven cohort studies of pregnant women with type 1 diabetes reported improvement in hemoglobin A1c (HbA1c) in both groups. Meta-analysis showed no difference in maternal and fetal outcomes for CSII versus MDI. Results were similar when CSII was compared with MDI with insulin analogs or regular insulin. Studies had moderate to high risk bias with incomplete descriptions of study methodology, populations, treatments, follow up, and outcomes. We conclude that observational studies reported similar improvements in HbA1c with CSII and MDI during pregnancy, but evidence was insufficient to rule out possible important differences between CSII and MDI for maternal and fetal outcomes. This highlights the need for future studies to examine the effectiveness and safety of CSII with insulin analogs and MDI in pregnant women with diabetes mellitus. PMID:25713996

  7. Mortality rate and gross pathology due to tuberculosis in wild brushtail possums (Trichosurus vulpecula) following low dose subcutaneous injection of Mycobacterium bovis.

    PubMed

    Nugent, Graham; Yockney, Ivor; Whitford, Jackie; Cross, Martin L

    2013-04-01

    Gross pathology due to tuberculosis can be established experimentally in brushtail possums (Trichosurus vulpecula) within 7 weeks of injection of virulent Mycobacterium bovis into subcutaneous connective tissues of the peripheral limbs. This pathology involves lymphadenomegaly and development of gross lesions in peripheral lymph nodes, with subsequent gross lesions in the lungs and reticuloendothelial organs. Using this artificial infection model, we here assessed the mortality rate for possums in the wild, to provide new information on the likely survival period for New Zealand's major wildlife host. Possums were trapped and inoculated with <50 CFU of M. bovis, then fitted with mortality signal emitting radio tracking collars, released and re-tracked for 6 months. Possum survival probability was 89% up to 12 weeks post-injection (p.i.), but cumulative mortality was rapid from then on. The median survival period, based on study of 38 possums, was 18 weeks p.i.; this corresponds with a predicted time interval of 11 weeks between first presentation of TB as palpable lymphadenomegaly and death for an average possum, shorter than period values currently used in possum TB epidemiological modelling. We also examined gross pathology in 11 possums by post mortem necropsy, and confirmed lymphadenomegaly and tuberculous lesions at 7 and 12 weeks p.i. Extra-peripheral gross lesions were more frequent among possums at 12 weeks p.i. than at 7 weeks, while the occurrence of lung lesions (the most likely cause of disease-induced mortality) was apparent in animals at 12 weeks but not at 7 weeks p.i. Our results suggest that the time course of TB from development of gross lesions to mortality may be shorter than previously estimated from field studies of naturally tuberculous possums. PMID:23063260

  8. A Comparison of Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Insulin Injection in Children with Type I Diabetes in Kuwait: Glycemic Control, Insulin Requirement, and BMI

    PubMed Central

    Mousa, Mohammad; Al-Mahdi, Maria; Al-Sanaa, Hala; Al-Kandari, Hessa

    2015-01-01

    Objective Continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) are two methods currently used to manage type I diabetes mellitus (T1DM). Here we compare our experiences with CSII and MDI in a large cohort of pediatric patients in Kuwait. Methods Data on 326 patients with T1DM who were started on CSII between 2007 and 2012 were retrospectively compared with those of 326 patients on MDI. They were matched for sex, age at diagnosis, T1DM duration, glycemic control, insulin requirement, and body mass index (BMI). Data were collected at baseline and every three months and included glycated hemoglobin (HbA1c), insulin dose, and adverse events (severe hypoglycemia, diabetic ketoacidosis, and skin problems). Results The main reason for switching to CSII was to achieve better glycemic control (37%), followed by reducing hypoglycemia, and improving the quality of life (13.3% each). Although HbA1c decrease was most significant in the first year, it continued to be significantly lower in the CSII group compared to the MDI throughout the study period. Total daily insulin requirements were significantly lower in the CSII group. BMI increased in both groups, but the difference was significant only at the end of the fifth year. There was no significant change in the rate of diabetic ketoacidosis in either group. The CSII patients had more severe hypoglycemic episodes at baseline; however, it significantly decreased throughout the study period. Only five patients discontinued CSII therapy and two of these restarted within three months. Conclusion CSII is a safe intensive insulin therapy in youngsters with T1DM and achieved markedly fewer severe hypoglycemic episodes and lower daily insulin requirements PMID:26421114

  9. No Effect of Route of Exposure (Oral; Subcutaneous Injection) on Plasma Bisphenol A throughout 24 hr after Administration in Neonatal Female Mice

    PubMed Central

    Taylor, Julia A.; Welshons, Wade V.; vom Saal, Frederick S.

    2008-01-01

    Route of administration of chemicals in adults is an important factor in pharmacokinetics of chemicals such as bisphenol A (BPA), the monomer with estrogenic activity used to make polycarbonate plastic products and to line food and beverage cans. Based on findings in adults it has been proposed (CERHR, 2007) that non-oral routes of administration in newborn rodents would also lead to high exposure relative to oral administration. However, in fetuses and neonates, the enzyme that conjugates BPA (UDP-glucuronosyltransferase) is expressed at low levels, suggesting that there may be no differences in pharmacokinetics between oral and non-oral dosing. We thus conducted an analysis of plasma concentrations of unconjugated 3H-BPA after HPLC separation in postnatal day 3 female mice throughout the 24 hr after administering 3H-BPA orally or via subcutaneous injection at doses above and below the current EPA reference dose. We found no significant difference in plasma BPA based on route of administration in neonatal mice at either dose. However, compared to data from other studies conducted with adults, there was a markedly higher plasma BPA level after oral administration of BPA in newborn mice. This finding sets aside the belief that non-oral administration of BPA renders data as not suitable for consideration of the hazard posed by low-dose exposure to BPA during neonatal life. Therefore the large numbers of BPA studies that used non-oral administration at very low doses during the neonatal period should not be dismissed by scientists or the regulatory community based on route of administration. PMID:18295446

  10. No effect of route of exposure (oral; subcutaneous injection) on plasma bisphenol A throughout 24h after administration in neonatal female mice.

    PubMed

    Taylor, Julia A; Welshons, Wade V; Vom Saal, Frederick S

    2008-02-01

    Route of administration of chemicals in adults is an important factor in pharmacokinetics of chemicals such as bisphenol A (BPA), the monomer with estrogenic activity used to make polycarbonate plastic products and to line food and beverage cans. Based on findings in adults it has been proposed (CERHR, 2007) that non-oral routes of administration in newborn rodents would also lead to high exposure relative to oral administration. However, in fetuses and neonates, the enzyme that conjugates BPA (UDP-glucuronosyltransferase) is expressed at low levels, suggesting that there may be no differences in pharmacokinetics between oral and non-oral dosing. We thus conducted an analysis of plasma concentrations of unconjugated 3H-BPA after HPLC separation in postnatal day 3 female mice throughout the 24h after administering 3H-BPA orally or via subcutaneous injection at doses above and below the current EPA reference dose. We found no significant difference in plasma BPA based on route of administration in neonatal mice at either dose. However, compared to data from other studies conducted with adults, there was a markedly higher plasma BPA level after oral administration of BPA in newborn mice. This finding sets aside the belief that non-oral administration of BPA renders data as not suitable for consideration of the hazard posed by low-dose exposure to BPA during neonatal life. Therefore the large numbers of BPA studies that used non-oral administration at very low doses during the neonatal period should not be dismissed by scientists or the regulatory community based on route of administration. PMID:18295446

  11. Immunogenicity and safety of concomitant administration of a measles, mumps and rubella vaccine (M-M-RvaxPro®) and a varicella vaccine (VARIVAX®) by intramuscular or subcutaneous routes at separate injection sites: a randomised clinical trial

    PubMed Central

    Gillet, Yves; Habermehl, Pirmin; Thomas, Stéphane; Eymin, Cécile; Fiquet, Anne

    2009-01-01

    Background When this trial was initiated, the combined measles, mumps and rubella (MMR) vaccine was licensed for subcutaneous administration in all European countries and for intramuscular administration in some countries, whereas varicella vaccine was licensed only for subcutaneous administration. This study evaluated the intramuscular administration of an MMR vaccine (M-M-RvaxPro®) and a varicella vaccine (VARIVAX®) compared with the subcutaneous route. Methods An open-label randomised trial was performed in France and Germany. Healthy children, aged 12 to18 months, received single injections of M-M-RvaxPro and VARIVAX concomitantly at separate injection sites. Both vaccines were administered either intramuscularly (IM group, n = 374) or subcutaneously (SC group, n = 378). Immunogenicity was assessed before vaccination and 42 days after vaccination. Injection-site erythema, swelling and pain were recorded from days 0 to 4 after vaccination. Body temperature was monitored daily between 0 and 42 days after vaccination. Other adverse events were recorded up to 42 days after vaccination and serious adverse events until the second study visit. Results Antibody response rates at day 42 in the per-protocol set of children initially seronegative to measles, mumps, rubella or varicella were similar between the IM and SC groups for all four antigens. Response rates were 94 to 96% for measles, 98% for both mumps and rubella and 86 to 88% for varicella. For children initially seronegative to varicella, 99% achieved the seroconversion threshold (antibody concentrations of ≥ 1.25 gpELISA units/ml). Erythema and swelling were the most frequently reported injection-site reactions for both vaccines. Most injection-site reactions were of mild intensity or small size (≤ 2.5 cm). There was a trend for lower rates of injection-site erythema and swelling in the IM group. The incidence and nature of systemic adverse events were comparable for the two routes of administration

  12. Medroxyprogesterone Injection

    MedlinePlus

    ... Medroxyprogesterone subcutaneous injection is also used to treat endometriosis (a condition in which the type of tissue ... parts of the body in women who have endometriosis. Medroxyprogesterone injection is a very effective method of ...

  13. A Randomized Study of the Relative Pharmacokinetics, Pharmacodynamics, and Safety of Alirocumab, a Fully Human Monoclonal Antibody to PCSK9, After Single Subcutaneous Administration at Three Different Injection Sites in Healthy Subjects

    PubMed Central

    Lunven, Catherine; Paehler, Tobias; Poitiers, Franck; Brunet, Aurélie; Rey, Jacques; Hanotin, Corinne; Sasiela, William J

    2014-01-01

    Aims We investigated the relative pharmacokinetics, pharmacodynamics, and safety of the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab following injection at three different sites. Methods Sixty healthy subjects (39 male, 21 female; age 20–45 years) were randomized to receive a single subcutaneous injection of alirocumab 75 mg via 1-mL prefilled pen into the abdomen, upper arm, or thigh (NCT01785329). Subjects were followed for 85 days ± 2 days following study drug administration. Pharmacokinetic (PK) parameters for the systemic exposure of alirocumab were calculated, and levels of free PCSK9 were assessed. Percentage changes from baseline in LDL-C were compared between injection site groups using linear mixed-effects models. Results Alirocumab concentration–time profiles were similar, and free PCSK9 levels were reduced to approximately zero between Day 3 and Day 4 postinjection in all groups. LDL-C levels reached nadir on Day 15 postinjection in all groups with mean percentage reductions of 48.4% (abdomen), 39.5% (upper arm), and 45.6% (thigh) at this time point. A similar effect on LDL-C levels was seen across the entire time course of the study at all three injection sites. Treatment-emergent adverse events were experienced by 8/20 (abdomen), 11/20 (upper arm), and 13/20 (thigh) subjects. There were 2 mild/transient injection site reactions. There were no serious adverse events. Discussion A single subcutaneous administration of alirocumab 75 mg via prefilled pen was well tolerated with similar pharmacokinetics and pharmacodynamics when injected into the abdomen, upper arm, or thigh. Conclusion These results suggest that alirocumab can be interchangeably injected in the abdomen, upper arm, or thigh. PMID:25256660

  14. Interferon Alfa-2b Injection

    MedlinePlus

    ... medication either subcutaneously or intramuscularly three times a week. HBV, inject the medication either subcutaneously or intramuscularly three times a week usually for 16 weeks. hairy cell leukemia, inject ...

  15. Population Pharmacokinetic Modeling After Repeated Administrations of RBP-6000, a New, Subcutaneously Injectable, Long-Acting, Sustained-Release Formulation of Buprenorphine, for the Treatment of Opioid Use Disorder.

    PubMed

    Laffont, Celine M; Gomeni, Roberto; Heidbreder, Christian; Jones, J P; Nasser, Azmi F

    2016-07-01

    RBP-6000 is a novel sustained-release formulation of buprenorphine for the treatment of opioid use disorder, which has been designed for once-monthly (28 days) subcutaneous (SC) injections. A population pharmacokinetic (PK) model was developed to describe the time course of buprenorphine plasma concentrations after repeated SC injections of RBP-6000 at 50 mg, 100 mg, 200 mg, or 300 mg in treatment-seeking opioid-dependent subjects previously on sublingual buprenorphine (Subutex(®) ) treatment. The μ-opioid receptor occupancy was predicted using a previously developed PK/PD Emax model. The results of the population PK analysis jointly with the predicted level of μ-opioid receptor occupancy provided quantitative criteria for clinical dose selection for RBP-6000: the dose of 300 mg every 28 days seems appropriate for immediately achieving an effective exposure after the first SC injection and to maintain effective levels of exposure during chronic treatment. Furthermore, simulations conducted to evaluate the potential impact of a holiday in drug intake indicated that in the unexpected event of a 2-week holiday, levels of μ-opioid receptor occupancy remained consistently above 70% with no significant loss of drug efficacy. This analysis indicated that RBP-6000 has the potential for becoming an effective treatment for opioid-dependent subjects by addressing compliance issues associated with the current once-a-day treatments. PMID:26479717

  16. Effects of subcutaneous injections of a long acting moxidectin formulation in grazing beef cattle on parasite fecal egg reduction and animal weight gain.

    PubMed

    Cleale, R M; Hart, K B; Hutchens, D E; Johnson, E G; Paul, A J; Smith, L L; Tucker, C; Yazwinski, T A; Doscher, M E; Grubbs, S T; Wulster-Radcliffe, M; Amodie, D M

    2004-12-15

    Trials were conducted in Arkansas, Idaho, Illinois and Wisconsin using a common protocol to evaluate effectiveness and safety of a long acting (LA), oil-based injectable formulation of moxidectin in beef cattle grazing spring and/or summer pastures. At each site, 150 cattle (steers and/or heifers) were blocked based on pretreatment fecal strongyle egg counts (EPG) and then randomly assigned to treatments within blocks. Presence of naturally acquired parasitic infections, confirmed by presence of parasite eggs in feces, was a prerequisite for study enrollment. Within each block of three animals, two received moxidectin LA injectable on day 0 at a dosing rate of 1.0 mg moxidectin/kg b.w. into the dorsal aspect of the proximal third of the ear, and one received a placebo control treatment. Cattle were weighed before treatment and on day 55 or 56 (55/56) after treatment. Fecal samples were also collected from 10 randomly selected blocks of animals at each site on days 14, 28 and 55/56 for EPG quantification. Average daily gain (ADG) was computed over the posttreatment period. Data pertaining to ADG and EPG were combined across sites and analyzed by mixed model analysis of variance to assess the fixed effect of treatment and random effects of site, block within site and the treatment by site interaction. Compared to placebo-treated controls, the geometric means of fecal EPG counts from cattle treated with moxidectin LA injectable were reduced 99.8% 14 days after treatment, 99.1% 28 days after treatment and 96.7% 55/56 days after treatment. Rate of weight gain by cattle treated with moxidectin LA injectable was 0.59 kg/day, or 23% (0.11 kg/day) more than placebo-treated controls (P<0.05). None of the cattle treated with moxidectin LA injectable exhibited signs of macrocyclic lactone toxicosis. Summarized across all study sites, proportions of cattle that received concurrent therapeutic treatments were similar among treatment groups. Study results demonstrate that

  17. Subcutaneous granuloma annulare.

    PubMed

    Requena, Luis; Fernández-Figueras, María Teresa

    2007-06-01

    Subcutaneous granuloma annulare is a rare clinicopathologic variant of granuloma annulare, characterized by subcutaneous nodules that may appear alone or in association with intradermal lesions. The pathogenesis of this deep variant of granuloma annulare remains uncertain. Subcutaneous granuloma annulare appears more frequently in children and young adults, and the lesions consist of subcutaneous nodules with no inflammatory appearance at the skin surface, most commonly located on the anterior aspects of the lower legs, hands, head, and buttocks. Usually, subcutaneous granuloma annulare is an authentic and exclusive panniculitic process with no dermal participation, although in 25% of the patients lesions of subcutaneous granuloma annulare coexist with the classic findings of granuloma annulare in the dermis. Histopathologically, subcutaneous granuloma annulare consist of areas of basophilic degeneration of collagen bundles with peripheral palisading granulomas involving the connective tissue septa of the subcutis. Usually, the area of necrobiosis in subcutaneous granuloma annulare is larger than in the dermal counterpart. The central necrobiotic areas contain increased amounts of connective tissue mucin and nuclear dust from neutrophils between the degenerated collagen bundles. Eosinophils are more common in subcutaneous granuloma annulare than in the dermal counterpart. There are not descriptions of subcutaneous granuloma annulare showing a histopathologic pattern of the so-called incomplete or interstitial variant. Histopathologic differential diagnosis of subcutaneous granuloma annulare includes rheumatoid nodule, necrobiosis lipoidica and epithelioid sarcoma. PMID:17544961

  18. Evaluation of Subcutaneous Phenobarbital Administration in Hospice Patients.

    PubMed

    Hosgood, Jessica Richards; Kimbrel, Jason M; McCrate Protus, Bridget; Grauer, Phyllis A

    2016-04-01

    Phenobarbital is used in hospice and palliative care to treat refractory symptoms. In end-of-life care, Food and Drug Administration approved routes of administration may be unreasonable based on patients' status. In these cases, phenobarbital may be administered subcutaneously for symptom management. However, according to the American Hospital Formulary Service, subcutaneous administration of commercially available injectable phenobarbital is cautioned due to possible skin reactions. This study evaluates the tolerability of phenobarbital administered subcutaneously. Of 69 patients and 774 distinct subcutaneous phenobarbital injections, 2 site reactions were recorded (2.9% of patients; 0.3% of injections). Both were mild, grade 1 reactions. Each patient continued to receive subcutaneous phenobarbital via newly placed ports with no additional reactions. Based on these findings, phenobarbital appears to be well tolerated when administered subcutaneously. PMID:25473092

  19. An Investigative Study of Pancreatic Exocrine Biomarkers, Histology, and Histomorphometry in Male Zucker Diabetic Fatty (ZDF) Rats Given Dulaglutide by Subcutaneous Injection Twice Weekly for 13 Weeks.

    PubMed

    Usborne, Amy; Byrd, Richard A; Meehan, James; Blackbourne, Jamie L; Sullivan, John; Poitout-Belissent, Florence; Prefontaine, Annick; Martin, Jennifer A; Vahle, John L

    2015-12-01

    Glucagon-like peptide-1 (GLP-1) receptor agonist therapy has been implicated as a possible risk factor for acute pancreatitis in patients with type 2 diabetes. Dulaglutide is a long-acting GLP-1 receptor agonist in development for treatment of type 2 diabetes. The effects of dulaglutide were evaluated in male Zucker diabetic fatty (ZDF) rats to examine whether dulaglutide may induce or modulate pancreatitis. Rats were randomized to dose groups receiving twice-weekly subcutaneously administered dulaglutide 0.5, 1.5, and 5.0 mg/kg/dose (corresponding human plasma exposures following twice-weekly dosing are 3-, 8-, and 30-fold, respectively) for 13 weeks or to vehicle control. Following termination, serially trimmed sections of pancreases were stained with hematoxylin and eosin or co-stained with an epithelial marker and a marker of either proliferation or apoptosis. Efficacious reductions in glucose and hemoglobin A1c occurred at all dulaglutide doses. Lipase activity was unaffected, and there were modest increases in total and pancreatic amylase activities at all doses without individual microscopic inflammatory correlates. Microscopic dulaglutide-related pancreatic changes included increased interlobular ductal epithelium without ductal cell proliferation (≥0.5 mg/kg), increased acinar atrophy with/without inflammation (≥1.5 mg/kg), and increased incidence/severity of neutrophilic acinar pancreatic inflammation (5.0 mg/kg). In summary, dulaglutide treatment was associated with mild alterations in ductal epithelium and modest exacerbation of spontaneous lesions of the exocrine pancreas typically found in the ZDF rat model. PMID:26269615

  20. Pharmacokinetics of enrofloxacin and ceftiofur in plasma, interstitial fluid, and gastrointestinal tract of calves after subcutaneous injection, and bactericidal impacts on representative enteric bacteria.

    PubMed

    Foster, D M; Jacob, M E; Warren, C D; Papich, M G

    2016-02-01

    This study's objectives were to determine intestinal antimicrobial concentrations in calves administered enrofloxacin or ceftiofur sodium subcutaneously, and their impact on representative enteric bacteria. Ultrafiltration devices were implanted in the ileum and colon of 12 steers, which received either enrofloxacin or ceftiofur sodium. Samples were collected over 48 h after drug administration for pharmacokinetic/pharmacodynamic analysis. Enterococcus faecalis or Salmonella enterica (5 × 10(5)  CFU/mL of each) were exposed in vitro to peak and tail (48 h postadministration) concentrations of both drugs at each location for 24 h to determine inhibition of growth and change in MIC. Enrofloxacin had tissue penetration factors of 1.6 and 2.5 in the ileum and colon, while ciprofloxacin, an active metabolite of enrofloxacin, was less able to cross into the intestine (tissue penetration factors of 0.7 and 1.7). Ceftiofur was rapidly eliminated leading to tissue penetration factors of 0.39 and 0.25. All concentrations of enrofloxacin were bactericidal for S. enterica and significantly reduced E. faecalis. Peak ceftiofur concentration was bactericidal for S. enterica, and tail concentrations significantly reduced growth. E. faecalis experienced growth at all ceftiofur concentrations. The MICs for both organisms exposed to peak and tail concentrations of antimicrobials were unchanged at the end of the study. Enrofloxacin and ceftiofur achieved intestinal concentrations capable of reducing intestinal bacteria, yet the short exposure of ceftiofur in the intestine may select for resistant organisms. PMID:25989138

  1. ExtaviJect® 30G device for subcutaneous self-injection of interferon beta-1b for multiple sclerosis: a prospective European study

    PubMed Central

    Boeru, Gabriel; Milanov, Ivan; De Robertis, Francesca; Kozubski, Wojciech; Lang, Michael; Rojas-Farreras, Sònia; Tomlinson, Mark

    2013-01-01

    Background The ExtaviJect® 30G autoinjector was developed to facilitate parenteral self-administration of interferon beta-1b (Extavia®), a first-line disease-modifying therapy in patients with multiple sclerosis. Our aim was to assess patient compliance with treatment when using the autoinjector, patients’ and nurses’ experiences of using the device, its tolerability, and patient satisfaction. Methods This was a 12-week, real-world, prospective, observational, noninterventional study conducted in nine European countries. Questionnaires were used to measure patient compliance and to assess patients’ and nurses’ experiences. All adverse events were recorded by severity, including injection site reactions or pain. Patient satisfaction and health-related quality of life were assessed using the Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9) and EuroQol-5 Dimension (EQ-5D) instruments, respectively. Results Of 582 patients enrolled, 568 (98%) received at least one injection and attended the first follow-up visit at 6 weeks, and 542 (93%) attended the second follow-up visit at 12 weeks. For the whole study, 548 of 568 (97%) patients were compliant with treatment. Among the various questions assessing whether the device was easy and quick to use accurately, without fear of the needle, 56%–98% of patients and 59%–98% of nurses were in agreement. There were nine serious adverse events (four disease-related) reported among the 227 (39%) patients reporting adverse events. Scores increased in the TSQM-9 convenience domain between weeks 6 and 12 (P=0.0009), and in the EQ-5D visual analog scale between baseline and week 12 (P<0.0001), indicating improvement in health-related quality of life. Conclusion ExtaviJect 30G was convenient to use and was associated with high levels of compliance. PMID:24255602

  2. A gynecologic oncology group phase II trial of two p53 peptide vaccine approaches: subcutaneous injection and intravenous pulsed dendritic cells in high recurrence risk ovarian cancer patients

    PubMed Central

    Rahma, Osama E.; Ashtar, Ed; Czystowska, Malgorzata; Szajnik, Marta E.; Wieckowski, Eva; Bernstein, Sarah; Herrin, Vincent E.; Shams, Mortada A.; Steinberg, Seth M.; Merino, Maria; Gooding, William; Visus, Carmen; DeLeo, Albert B.; Wolf, Judith K.; Bell, Jeffrey G.; Berzofsky, Jay A.; Whiteside, Theresa L.; Khleif, Samir N.

    2013-01-01

    Purpose Peptide antigens have been administered by different approaches as cancer vaccine therapy, including direct injection or pulsed onto dendritic cells; however, the optimal delivery method is still debatable. In this study, we describe the immune response elicited by two vaccine approaches using the wild-type (wt) p53 vaccine. Experimental design Twenty-one HLA-A2.1 patients with stage III, IV, or recurrent ovarian cancer over-expressing the p53 protein with no evidence of disease were treated in two cohorts. Arm A received SC wt p53:264-272 peptide admixed with Montanide and GM-CSF. Arm B received wt p53:264-272 peptide-pulsed dendritic cells IV. Interleukin-2 (IL-2) was administered to both cohorts in alternative cycles. Results Nine of 13 patients (69%) in arm A and 5 of 6 patients (83%) in arm B developed an immunologic response as determined by ELISPOT and tetramer assays. The vaccine caused no serious systemic side effects. IL-2 administration resulted in grade 3 and 4 toxicities in both arms and directly induced the expansion of T regulatory cells. The median overall survival was 40.8 and 29.6 months for arm A and B, respectively; the median progression-free survival was 4.2 and. 8.7 months, respectively. Conclusion We found that using either vaccination approach generates comparable specific immune responses against the p53 peptide with minimal toxicity. Accordingly, our findings suggest that the use of less demanding SC approach may be as effective. Furthermore, the use of low-dose SC IL-2 as an adjuvant might have interfered with the immune response. Therefore, it may not be needed in future trials. PMID:21927947

  3. Deoxycholic Acid Injection

    MedlinePlus

    ... severe submental fat ('double chin'; fatty tissue located under the chin). Deoxycholic acid injection is in a ... as a liquid to be injected subcutaneously (just under the skin) by a doctor. Your doctor will ...

  4. Comparison of a Multiple Daily Insulin Injection Regimen (Glargine or Detemir Once Daily Plus Prandial Insulin Aspart) and Continuous Subcutaneous Insulin Infusion (Aspart) in Short-Term Intensive Insulin Therapy for Poorly Controlled Type 2 Diabetes Patients

    PubMed Central

    Lv, Wen-shan; Li, Li; Wen, Jun-ping; Pan, Rong-fang; Sun, Rui-xia; Wang, Jing; Xian, Yu-xin; Cao, Cai-xia; Gao, Yan-yan

    2013-01-01

    Aims. To examine the potential differences between multiple daily injection (MDI) regimens based on new long-acting insulin analogues (glargine or detemir) plus prandial insulin aspart and continuous subcutaneous insulin aspart infusion (CSII) in patients with poorly controlled type 2 diabetes. Methods. Patients (n = 119) with poorly controlled type 2 diabetes of a duration exceeding five years were randomly assigned into three groups: Group A treated with CSII using insulin aspart; Group B treated with glargine-based MDI and Group C treated with detemir-based MDI. Results. Good glycemic control was achieved by patients in Group A in a significantly shorter duration than patients in Groups B and C. Total daily insulin, basal insulin dose and dose per kg body weight in Group A were significantly less than those in Groups B and C. Daily blood glucose fluctuation in Group A was significantly less than that in Groups B and C. There were no differences between Groups B and C. Conclusions. Aspart-based CSII may achieve good blood glucose control with less insulin doses over a shorter period compared with glargine or detemir-based MDI. No differences between glargine- and detemir-based MDI were detected in poorly controlled subjects with type 2 diabetes. PMID:23737776

  5. [Subcutaneous myxopapillary ependymoma].

    PubMed

    Bjørn, Niels; Søe, Morten; Detlefsen, Sönke

    2015-11-30

    Subcutaneous myxopapillary ependymoma is a very rare entity, and to our knowledge this is the first published case from Denmark. A previously healthy 32-year-old male presented with subcutaneous swelling and tenderness located at the top of the intergluteal cleft. The circular soft tumour, measuring 1.7 × 1.7 × 1.2 cm, was removed surgically. After histopathological examination with several immunohistochemical and special stainings, the diagnosis surprisingly was subcutaneous myxopapillary ependymoma. The tumour was removed with free margins and no metastases were found on follow-up CT- and MRI scans. PMID:26651556

  6. Simultaneous Treatment with Subcutaneous Injection of Golimumab and Intra-articular Injection of Triamcinolone Acetonide (K-Method) in Patients with Rheumatoid Arthritis Undergoing Switching of Biologics: Retrospective Case–Control Study

    PubMed Central

    Kanbe, Katsuaki; Chiba, Junji; Inoue, Yasuo; Taguchi, Masashi; Yabuki, Akiko; Deguchi, Tomohiko

    2016-01-01

    BACKGROUND Tight control of severe rheumatoid arthritis (RA) in patients with high disease activity, even when using biologics, is sometimes difficult using a treat-to-target strategy. Switching from one biologic to another is associated with lower efficacy than that in treatment-naive cases. We developed the K-method that involves simultaneous treatment with golimumab and intra-articular joint injection of triamcinolone acetonide (TA) in patients undergoing switching of biologics. We performed this retrospective case–control study to investigate the efficacy of achieving an immediate treatment response using the K-method. METHODS This study involved 20 patients with RA (control group, 10 patients; K-method group, 10 patients). Patients in the control group were switched to golimumab from other biologics without intra-articular injection of TA. The K-method involved injection of 1 mL of TA (40 mg/mL) and 2 mL of 1% lidocaine hydrochloride into swollen or painful joints on the same day as golimumab treatment. A quick response one day after treatment was compared between the two groups according to the disease activity score 28 based on C-reactive protein (DAS28 CRP), clinical disease activity index (CDAI), simplified disease activity index (SDAI), European League Against Rheumatism (EULAR) response, and remission rate. These parameters were investigated for 24 weeks. RESULTS The K-method group showed significant improvements in DAS28 CRP, CDAI, and SDAI at one day, 12 weeks, and 24 weeks compared with the control group. The number of swollen and tender joints and the patient and doctor global visual analog scale scores were also significantly different between the two groups. The remission rates based on DAS28 CRP were 30% at one day, 50% at 12 weeks, and 60% at 24 weeks in the K-method group. The EULAR good/moderate response rates were 80% at one day, 90% at 12 weeks, and 90% at 24 weeks in the K-method group; however, these rates were only 10%, 40%, and 40

  7. Pneumoparotitis with subcutaneous emphysema.

    PubMed

    Balasubramanian, S; Srinivas, S; Aparna, K R

    2008-01-01

    We report an adolescent with recurrent bilateral parotitis with pneumoparotitis and subcutaneous emphysema due to self pneumoinsufflation by a Valsalva like maneuver. Investigations for recurrent parotitis did not yield any clue. His la belle indifference, prolonged school absence and the presence of sibling rivalry helped us identify the psychological cause. PMID:18250510

  8. Subcutaneous encapsulated fat necrosis.

    PubMed

    Aydin, Dogu; Berg, Jais O

    2016-04-01

    We have described subcutaneous encapsulated fat necrosis, which is benign, usually asymptomatic and underreported. Images have only been published on two earlier occasions, in which the necrotic nodules appear "pearly" than the cloudy yellow surface in present case. The presented image may help future surgeons to establish the diagnosis peroperatively. PMID:27099753

  9. Insulin Lispro Injection

    MedlinePlus

    ... a solution (liquid) and a suspension (liquid with particles that will settle on standing) to inject subcutaneously ( ... if it is colored, cloudy, or contains solid particles. If you are using insulin lispro suspension, the ...

  10. Subcutaneous administration of carrier erythrocytes: slow release of entrapped agent

    SciTech Connect

    DeLoach, J.R.; Corrier, D.E.

    1988-08-01

    Carrier erythrocytes administered subcutaneously in mice release encapsulated molecules at the injection site and through cells that escape the injection site. One day postinjection, the efflux of encapsulated (/sup 14/C)sucrose, (/sup 3/H)inulin, and /sup 51/Cr-hemoglobin from the injection site was 45, 55, and 65%, respectively. Intact carrier erythrocytes escaped the injection site and entered the blood circulation carrying with them the encapsulated molecules. Most of the encapsulated (/sup 3/H)inulin that reached whole blood circulated within erythrocytes. Small but measurable numbers of encapsulated molecules were trapped within lymph nodes. Subcutaneous injection of carrier erythrocytes may allow for limited extravascular tissue targeting of drugs.

  11. Subcutaneous electrode structure

    NASA Technical Reports Server (NTRS)

    Lund, G. F. (Inventor)

    1980-01-01

    A subcutaneous electrode structure suitable for a chronic implant and for taking a low noise electrocardiogram of an active animal, comprises a thin inflexible, smooth disc of stainless steel having a diameter as of 5 to 30 mm, which is sutured in place to the animal being monitored. The disc electrode includes a radially directed slot extending in from the periphery of the disc for approximately 1/3 of the diameter. Electrical connection is made to the disc by means of a flexible lead wire that extends longitudinally of the slot and is woven through apertures in the disc and held at the terminal end by means of a spot welded tab. Within the slot, an electrically insulative sleeve, such as silicone rubber, is placed over the wire. The wire with the sleeve mounted thereon is captured in the plane of the disc and within the slot by means of crimping tabs extending laterally of the slot and over the insulative wire. The marginal lip of the slot area is apertured and an electrically insulative potting material such as silicone rubber, is potted in place overlaying the wire slot region and through the apertures.

  12. Pharmacokinetics of subcutaneous fentanyl in Greyhounds.

    PubMed

    KuKanich, Butch

    2011-11-01

    The purpose of the study was to describe the pharmacokinetics of subcutaneous fentanyl (15μg/kg) in six healthy Greyhound dogs. Fentanyl plasma concentrations were determined by a liquid chromatography with mass spectrometry method. Non-compartmental pharmacokinetic analysis was used. Fentanyl was rapidly absorbed with a mean peak concentration (C(MAX)) of 3.56ng/mL at 0.24h. The mean terminal half-life, volume of distribution per bioavailability, and clearance per bioavailability were 2.97h, 7.09L/kg, 27.60mL/min/kg, respectively. Pain occurred on injection in all six dogs, but addition of 8.4% sodium bicarbonate (1mL per 20mL fentanyl) resulted in no pain on injection in 3/3 dogs but similar C(MAX) values. The subcutaneous route may be an alternative route of fentanyl administration if intravenous administration is not practical. PMID:21388844

  13. Absorption Kinetics of Subcutaneously Administered Ceftazidime in Hypoperfused Guinea Pigs

    PubMed Central

    Ebihara, Tsuyoshi; Oshima, Shinji; Okita, Mitsuyoshi; Shiina, Sayumi; Negishi, Akio; Ohara, Kousuke; Ohshima, Shigeru; Iwasaki, Hiroyuki; Yoneyama, Akira; Kitazumi, Eiji; Kobayashi, Daisuke

    2014-01-01

    Background Pneumonia is the most common cause of death in patients with severe motor and intellectual disabilities (SMID), and intravenous ceftazidime (CAZ) is a widely used treatment for such infections. However, intravenous administration in patients with SMID may be difficult because of insufficient vascular development. Objectives The aim of our study was to determine the feasibility of subcutaneous drug administration by mentholated warm compresses (WMCs) as an alternative delivery method for ceftazidime in patients with SMID. Methods CAZ was subcutaneously administered to the abdominal region of naphazoline-treated hypoperfused guinea pigs, which were used as a hemodynamic model of patients with SMID. MWCs or warm compresses (WCs) were applied to the injection site to increase blood flow. We calculated the cumulative CAZ absorption over time by using the deconvolution method. Results Application of MWCs or WCs increased blood flow at the administration site and increased CAZ plasma levels. Application of MWCs or WCs after subcutaneous CAZ injection led to higher CAZ plasma levels than the mutant prevention concentration for a longer period than was observed for CAZ administration without the application of MWCs or WCs. Conclusions The application of MWCs or WCs enhanced subcutaneous CAZ absorption by increasing blood flow. MWCs and WCs are considered to be safe and routine methods to induce defecation after surgery on the digestive system; thus, the combination of these methods and subcutaneous CAZ administration is a potential method for treating pneumonia in patients with SMID. PMID:26649076

  14. Two decades of subcutaneous glatiramer acetate injection: current role of the standard dose, and new high-dose low-frequency glatiramer acetate in relapsing–remitting multiple sclerosis treatment

    PubMed Central

    Caporro, Matteo; Disanto, Giulio; Gobbi, Claudio; Zecca, Chiara

    2014-01-01

    Glatiramer acetate, a synthetic amino acid polymer analog of myelin basic protein, is one of the first approved drugs for the treatment of relapsing–remitting multiple sclerosis. Several clinical trials have shown consistent and sustained efficacy of glatiramer acetate 20 mg subcutaneously daily in reducing relapses and new demyelinating lesions on magnetic resonance imaging in patients with relapsing–remitting multiple sclerosis, as well as comparable efficacy to high-dose interferon beta. Some preclinical and clinical data suggest a neuroprotective role for glatiramer acetate in multiple sclerosis. Glatiramer acetate is associated with a relatively favorable side-effect profile, and importantly this was confirmed also during long-term use. Glatiramer acetate is the only multiple sclerosis treatment compound that has gained the US Food and Drug Administration pregnancy category B. All these data support its current use as a first-line treatment option for patients with clinical isolated syndrome or relapsing–remitting multiple sclerosis. More recent data have shown that high-dose glatiramer acetate (ie, 40 mg) given three times weekly is effective, safe, and well tolerated in the treatment of relapsing–remitting multiple sclerosis, prompting the approval of this dosage in the US in early 2014. This high-dose, lower-frequency glatiramer acetate might represent a new, more convenient regimen of administration, and this might enhance patients’ adherence to the treatment, crucial for optimal disease control. PMID:25170258

  15. Aberrant intrathecal pump refill: ultrasound-guided aspiration of a substantial quantity of subcutaneous hydromorphone.

    PubMed

    Peccora, Christian D; Ross, Edgar L; Hanna, George M

    2013-01-01

    Intrathecal drug delivery systems are an effective and increasingly common pain treatment modality for certain patient populations. Pumps are surgically inserted in a subcutaneous abdominal pocket and refilled with highly concentrated medication at regular intervals. Inadvertent injection of medication outside the pump is a known complication of the refill procedure. We describe the injection of hydromorphone into the pump's surrounding subcutaneous pocket, subsequent opioid overdose, and the novel application of ultrasound to visualize and aspirate the subcutaneous drug. Ultrasonography can be used as an effective modality for rapid diagnosis and treatment of an accidental pocket fill. PMID:24121607

  16. 21 CFR 522.480 - Repository corticotropin injection.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... subcutaneous injection in cattle and small animals for stimulation of the adrenal cortex where there is a... injection in dogs as a diagnostic aid to test for adrenal dysfunction. For intramuscular or subcutaneous injection in dogs and cats for stimulation of the adrenal cortex where there is a general deficiency of...

  17. 21 CFR 522.480 - Repository corticotropin injection.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... subcutaneous injection in cattle and small animals for stimulation of the adrenal cortex where there is a... injection in dogs as a diagnostic aid to test for adrenal dysfunction. For intramuscular or subcutaneous injection in dogs and cats for stimulation of the adrenal cortex where there is a general deficiency of...

  18. Penile subcutaneous fibrolipoma postaugmentative phalloplasty.

    PubMed

    Vicini, Patrizio; De Marco, Ferdinando; Letizia, Piero; Alei, Lavinia; Antonini, Gabriele; Alei, Giovanni; Gentile, Vincenzo

    2013-01-01

    Fibrolipomas are a rare subtype of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who three months earlier has been submitted to an augmentative phalloplasty due to aesthetic dysmorphophobia. After six months from the excision of the mass, the penile elongation and penile enlargement were stable, and the patient was satisfied with his sexual intercourse and sexual life. To our knowledge, this is the first reported penile subcutaneous fibrolipoma case in the literature. The diagnostics and surgical features of this case are discussed. PMID:24195003

  19. Fabrication of subcutaneous veins phantom for vessel visualization system

    NASA Astrophysics Data System (ADS)

    Cheng, Kai; Narita, Kazuyuki; Morita, Yusuke; Nakamachi, Eiji; Honda, Norihiro; Awazu, Kunio

    2013-09-01

    The technique of subcutaneous veins imaging by using NIR (Near Infrared Radiation) is widely used in medical applications, such as the intravenous injection and the blood sampling. In the previous study, an automatic 3D blood vessel search and automatic blood sampling system was newly developed. In order to validate this NIR imaging system, we adopted the subcutaneous vein in the human arm and its artificial phantom, which imitate the human fat and blood vessel. The human skin and subcutaneous vein is characterized as the uncertainty object, which has the individual specificity, non-accurate depth information, non-steady state and hardly to be fixed in the examination apparatus. On the other hand, the conventional phantom was quite distinct from the human's characteristics, such as the non-multilayer structure, disagreement of optical property. In this study, we develop a multilayer phantom, which is quite similar with human skin, for improvement of NIR detection system evaluation. The phantom consists of three layers, such as the epidermis layer, the dermis layer and the subcutaneous fat layer. In subcutaneous fat layer, we built a blood vessel. We use the intralipid to imitate the optical scattering characteristics of human skin, and the hemoglobin and melanin for the optical absorption characteristics. In this study, we did two subjects. First, we decide the fabrication process of the phantom. Second, we compared newly developed phantoms with human skin by using our NIR detecting system, and confirm the availability of these phantoms.

  20. [Drainage for Subcutaneous Emphysema after Pulmonary Resection].

    PubMed

    Funakoshi, Yasunobu; Ohmori, Kenichi; Takeda, Shinichi

    2016-05-01

    Severe subcutaneous emphysema sometimes develops after pulmonary resection. We report our management of ten patients who were treated with subcutaneous Penrose drainage. Water seal test at chest closure showed no air leakage in 5, and a small amount in 5. Chest X-ray at the progression of massive subcutaneous emphysema showed no obvious pneumothorax in 2, and slight apical pneumothorax in 8. Subcutaneous emphysema developed after removal of chest tubes in 6, and before removal in 4. Subcutaneous drains were inserted at the midclavicular line or the side chest in 8, and both in 2. Subcutaneous emphysema improved immediately after subcutaneous Penrose drainage with active compressive massage. Subcutaneous penrose drainage is easy and useful for relieving massive subcutaneous emphysema. PMID:27220920

  1. [Subcutaneous abscess following epidural catheterization].

    PubMed

    Radif, Ahmed; Dalsgaard, Lars Bech

    2009-06-01

    A case of subcutaneous abscess and meningitis symptoms after insertion of epidural catheter is presented. The symptoms were pain at the site of insertion two days after insertion, later fever and neck rigidity. Treatment is surgical intervention after appropriate diagnostics by magnetic resonance imaging, and administration of appropriate antibiotics. PMID:19500519

  2. Pharmacokinetics and pharmacodynamics comparison between subcutaneous and intravenous butorphanol administration in horses.

    PubMed

    Chiavaccini, L; Claude, A K; Lee, J H; Ross, M K; Meyer, R E; Langston, V C

    2015-08-01

    The study objective was to compare butorphanol pharmacokinetics and physiologic effects following intravenous and subcutaneous administration in horses. Ten adult horses received 0.1 mg/kg butorphanol by either intravenous or subcutaneous injections, in a randomized crossover design. Plasma concentrations of butorphanol were measured at predetermined time points using highly sensitive liquid chromatography-tandem mass spectrometry assay (LC-MS/MS). Demeanor and physiologic variables were recorded. Data were analyzed with multivariate mixed-effect model on ranks (P ≤ 0.05). For subcutaneous injection, absorption half-life and peak plasma concentration of butorphanol were 0.10 ± 0.07 h and 88 ± 37.4 ng/mL (mean ± SD), respectively. Bioavailability was 87%. After intravenous injection, mean ± SD butorphanol steady-state volume of distribution and clearance was 1.2 ± 0.96 L/kg and 0.65 ± 0.20 L/kg/h, respectively. Terminal half-lives for butorphanol were 2.31 ± 1.74 h and 5.29 ± 1.72 h after intravenous and subcutaneous administrations. Subcutaneous butorphanol reached and maintained target plasma concentrations >10 ng/mL for 2 ± 0.87 h (Mean ± SD), with less marked physiologic and behavioral effects compared to intravenous injection. Subcutaneous butorphanol administration is an acceptable alternative to the intravenous route in adult horses. PMID:25484250

  3. What are subcutaneous adipocytes really good for?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The development and potential function and physiological role of subcutaneous fat cells is reviewed in the context of several species including swine. The function or role subcutaneous fat cells is very dependent on species and location within subcutaneous tissues. Fat cells located around hair foll...

  4. Broncho pleuro subcutaneous fistula with subcutaneous emphysema: A rare presentation of pulmonary tuberculosis

    PubMed Central

    Saxena, Mukul; Shameem, Mohammad; Bhargava, Rakesh; Baneen, Ummul; Alam, Mohd Mazhar; Fatima, Nazish

    2012-01-01

    Subcutaneous tissue emphysema is observed in a several clinical settings but spontaneous subcutaneous emphysema in the absence of pneumothorax with broncho pleuro subcutaneous fistula is rare. We report a case of spontaneous subcutaneous emphysema secondary to cavitary pulmonary tuberculosis in the absence of pneumothorax. PMID:26029604

  5. Residue depletion of tilmicosin in cattle after subcutaneous administration.

    PubMed

    Jiang, Haiyang; Ding, Shuangyang; Li, Jiancheng; An, Dianjin; Li, Cun; Shen, Jianzhong

    2006-07-12

    A study of tissue residue depletion of tilmicosin in cattle was conducted after a single subcutaneous injection at the therapeutic level of 10 mg per kg body weight. Eighteen cross cattle were treated with the tilmicosin oil formulation (30%). Three treated animals (two males and one female) were selected randomly to be scarified at 1, 7, 14, 28, and 35 days withdrawal after injection. Samples of the injection site and of muscle, liver, kidney, and fat were collected. Tilmicosin residue concentrations were determined using a high-performance liquid chromatography (HPLC) method with a UV detector at 290 nm. Using a statistical method recommended by the Committee for Veterinary Medical Products of European Medical Evaluation Agency, the withdrawal time of 34 days was established when all tissue residues except samples in the injection site were below the accepted maximum residue limits. PMID:16819937

  6. Subcutaneous blood flow in psoriasis

    SciTech Connect

    Klemp, P.

    1985-03-01

    The simultaneously recorded disappearance rates of /sup 133/xe from subcutaneous adipose tissue in the crus were studied in 10 patients with psoriasis vulgaris using atraumatic labeling of the tissue in lesional skin (LS) areas and symmetrical, nonlesional skin (NLS) areas. Control experiments were performed bilaterally in 10 younger, healthy subjects. The subcutaneous washout rate constant was significantly higher in LS, 0.79 +/- 0.05 min-1 x 10(2) compared to the washout rate constant of NLS, 0.56 +/- 0.07 min-1. 10(2), or the washout rate constant in the normal subjects, 0.46 +/- 0.17 min-1 x 10(2). The mean washout rate constant in NLS was 25% higher than the mean washout rate constant in the normal subjects. The difference was, however, not statistically significant. Differences in the washout rate constants might be due to abnormal subcutaneous tissue-to-blood partition (lambda) in the LS--and therefore not reflecting the real differences in the subcutaneous blood flow (SBF). The lambda for /sup 133/Xe was therefore measured--using a double isotope washout method (/sup 133/Xe and (/sup 131/I)antipyrine)--in symmetrical sites of the lateral crus in LS and NLS of 10 patients with psoriasis vulgaris and in 10 legs of normal subjects. In LS the lambda was 4.52 +/- 1.67 ml/g, which was not statistically different from that of NLS, 5.25 +/- 2.19 ml/g, nor from that of normal subcutaneous tissue, 4.98 +/- 1.04 ml/g. Calculations of the SBF using the obtained lambda values gave a significantly higher SBF in LS, 3.57 +/- 0.23 ml/100 g/min, compared to SBF in the NLS, 2.94 +/- 0.37 ml/100 g/min. There was no statistically significant difference between SBF in NLS and SBF in the normal subjects. The increased SBF in LS of psoriatics might be a secondary phenomenon to an increased heat loss in the lesional skin.

  7. Comparison of metal versus Vialon subcutaneous catheters in a palliative care setting.

    PubMed

    Currow, D; Cooney, N

    1994-10-01

    In 63 evaluable palliative care patients requiring intermittent bolus subcutaneous administration of medication, who were randomly assigned either a standard metal subcutaneous needle or a PTFE (Vialon) catheter, there was a significantly greater incidence of local reactions at the insertion site with the metal needles (9/30) compared with the PTFE catheters (2/33). Despite this, there was no significant difference between the two in functional survival. Volume of medication injected per day was the best predictor of total time that the subcutaneous lines remained in situ. PMID:7812483

  8. [Subcutaneous emphysema after septoplasty: a case report].

    PubMed

    Balıkçı, Hasan Hüseyin; Bayram, Ali Alper; Özbay, İsa; Özkul, Murat Haluk

    2016-01-01

    Subcutaneous emphysema is characterized by the presence of air in the connective tissue within the fascial planes. The etiology of subcutaneous emphysema includes trauma, iatrogenic causes, or spontaneous development. Head and neck subcutaneous emphysema is a well-defined and life-threatening condition. In case of a large amount of air leaks into the fascial planes, the air can also extend into the retropharyngeal, mediastinal, pleural, and retroperitoneal spaces beyond the subcutaneous layers. Although numerous maxillofacial surgical procedures can cause subcutaneous emphysema, septoplasty has not been reported previously. In this unique case, subcutaneous emphysema developed after elective septoplasty and involved the maxillofacial, retropharyngeal, deep cervical, and orbital regions. The patient was treated conservatively with antibiotic prophylaxis and the condition completely resolved by day 10 spontaneously. Herein, we discuss the available literature data and optimal management strategies for unusual cases of head and neck subcutaneous emphysema. PMID:26794335

  9. Tolerability of hypertonic injectables.

    PubMed

    Wang, Wei

    2015-07-25

    Injectable drug products are ideally developed as isotonic solutions. Often, hypertonic injectables may have to be marketed for a variety of reasons such as product solubilization and stabilization. A key concern during product formulation development is the local and systemic tolerability of hypertonic products upon injection. This report reviews and discusses the tolerability in terms of local discomfort, irritation, sensation of heat and pain, along with other observed side effects of hypertonicity in both in-vitro systems and in-vivo animal and human models. These side effects clearly depend on the degree of hypertonicity. The sensation of pain among different injection routes seems to follow this order: intramuscular>subcutaneous>intravenous or intravascular. It is recommended that the upper osmolality limit should be generally controlled under 600 mOsm/kg for drug products intended for intramuscular or subcutaneous injection. For drug products intended for intravenous or intravascular injection, the recommended upper limit should be generally controlled under 1,000 mOsm/kg for small-volume injections (≤ 100 mL) and 500 mOsm/kg for large-volume injections (>100mL). Several options are available for minimization of hypertonicity-induced pain upon product administration. PMID:26027488

  10. Intravitreal injection

    MedlinePlus

    Retinal vein occlusion-intravitreal injection; Triamcinolone-intravitreal injection; Dexamethasone-intravitreal injection; Lucentis-intravitreal injection; Avastin-intravitreal injection; Bevacizumab-intravitreal injection; Ranibizumab- ...

  11. Regression of diabetic macular edema after subcutaneous exenatide.

    PubMed

    Sarao, Valentina; Veritti, Daniele; Lanzetta, Paolo

    2014-01-01

    The aim of this study is to report a case of complete regression of diabetic macular edema after subcutaneous injection of exenatide in a patient with type 2 diabetes mellitus. This study is an interventional case report. Blood investigations, complete ophthalmic examinations and optical coherence tomography were performed. A 55-year-old female affected by poorly controlled type 2 diabetes mellitus presented with visual impairment due to macular edema in the right eye. The left eye showed mild edema without visual loss. Best-corrected visual acuity (BCVA) was 20/80 and 20/20, respectively. The patient was encouraged to improve metabolic control, and the antidiabetic therapy was modified combining exenatide 10 μg subcutaneously twice daily to her regimen of oral metformin. The patient did not receive any ocular treatment. A complete tomographic resolution of macular edema was observed after 1 month and BCVA improved to 20/63. These findings were confirmed for the entire 6-month follow-up duration. No ocular or non-ocular adverse events were recorded. This is the first reported case of complete regression of macular edema in a diabetic patient after subcutaneous injection of exenatide. PMID:23925692

  12. A case of subcutaneous zygomycosis

    PubMed Central

    Anaparthy, Usha Rani; Deepika, G.

    2014-01-01

    Zygomycosis is an acute or chronic infection caused by several fungal agents belonging to the phylum Zygomycota. These are saprophytic fungi and are found ubiquitously in the environment. These are emerging highly opportunistic pathogenic organisms. Basidiobolus ranarum (B. haptosporus, B. meristoporus) is a fungus belonging to the order Entomophthorales under the family Zygomycota. Basidiobolomycosis is a predominantly subcutaneous infection involving the trunk and limbs in immunocompetent hosts. We hereby report a case of Basidiobolomycosis from the Department of Microbiology, Siddhartha Medical College, Vijayawada in a 6 month old child who presented to us with a painless swelling over her left knee following an insect bite. PMID:24616857

  13. [Intravenous and subcutaneous immunoglobulin therapy].

    PubMed

    Thon, Vojtěch

    2013-07-01

    Patients with agammaglobulinaemia and hypogammaglobulinaemia require immunoglobulin G (IgG) replacement therapy to prevent serious infections. Since the 1950s, therapy with human immune globulin products has been the standard of treatment. Currently, the most common routes of administration of IgG replacement therapy are intravenous (IVIG) or subcutaneous (SCIG). The home therapy may improve the quality of life in patients who require lifelong IgG replacement. The -anti-IgA antibody test identifies the patients with the risk of anaphylactoid reactions in IVIG replacement. The SCIG delivery may be used in patients with anti-IgA antibodies and previous systemic reactions to IVIG. PMID:23964967

  14. Insulin Aspart (rDNA Origin) Injection

    MedlinePlus

    ... a solution (liquid) and a suspension (liquid with particles that will settle on standing) to inject subcutaneously ( ... it is colored, cloudy, thickened, or contains solid particles. If you are using insulin aspart suspension, the ...

  15. A single subcutaneous dose of tramadol for mild to moderate musculoskeletal trauma in the emergency department

    PubMed Central

    Cardozo, Alejandro; Silva, Carlos; Dominguez, Luis; Botero, Beatriz; Zambrano, Paulo; Bareno, Jose

    2014-01-01

    BACKGROUND: Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the perception of a single subcutaneous dose of 50 mg tramadol for pain management in patients with mild to moderate musculoskeletal trauma, likewise to appraise the perception of pain by subcutaneous injection. METHODS: A total of 77 patients, who met inclusion criteria, received a single subcutaneous dose of tramadol. Pain control was evaluated based on the verbal numerical pain scale (0–10) at baseline, 20 and 60 minutes; similarly, pain perception was evaluated secondary to subcutaneous injection of the analgesic. RESULTS: On admission, the average pain perceived by patients was 8; twenty minutes later, 89% of the patients reported five or less, and after sixty minutes, 94% had three or less on the verbal numerical pain scale. Of the patients, 88% reported pain perception by verbal numeric scale of 3 or less by injection of the drug, and 6.5% required a second analgesic for pain control. Two events with drug administration (soft tissue infection and mild abdominal rectus injection) were reported. CONCLUSION: We conclude that a single subcutaneous dose of tramadol is a safe and effective option for the management of patients with mild to moderate pain and musculoskeletal disease in the emergency department. PMID:25548601

  16. Pharmaceutical amyloidosis associated with subcutaneous insulin and enfuvirtide administration

    PubMed Central

    D’Souza, Anita; Theis, Jason D.; Vrana, Julie A.; Dogan, Ahmet

    2014-01-01

    Protein and peptide drugs administered subcutaneously, such as insulin can be amyloidogenic and result in localized amyloid deposits at the sites of medication injections. These iatrogenic amyloidoses typically present as a localized subcutaneous nodule or skin reaction at the site of administration, and often pose diagnostic challenges. We have analyzed the amyloid proteome in 52 cases of insulin and enfuvirtide associated amyloidosis using laser microdissection/tandem mass spectrometry. We show that the deposits are composed of the drug, as well as other amyloid precursor proteins such as apolipoproteins A-I, A-IV, E and serum amyloid protein. Mass spectrometry-based amyloid sub-typing allows for accurate amyloid diagnosis with resultant therapeutic and prognostic implications. This insight into the amyloid proteome in drug-induced amyloidosis may help further understand pathogenesis of amyloid fibril formation. PMID:24446896

  17. The Subcutaneous Implantable Cardioverter Defibrillator.

    PubMed

    Mangels, Daniel; Frishman, William H

    2016-01-01

    The subcutaneous implantable cardioverter defibrillator (S-ICD) is a subcutaneous alternative to conventional transvenous ICD (TV-ICD) systems, which have previously been shown to treat life-threatening ventricular tachyarrhythmias in cardiac disease patients. A review of the literature reveals that S-ICDs have similar shock efficacy rates for both induced and spontaneous ventricular tachyarrhythmias when compared with TV-ICDs. Furthermore, S-ICDs seem to have a higher specificity for withholding therapy when supraventricular tachycardia is present compared with TV-ICDs. The advantages of the S-ICD system are numerous: fewer vascular complications including thrombosis and hemothorax, avoidance of fluoroscopy, and an easier means of lead replacement. These advantages make the S-ICD system most suitable for younger patients who may require replacements in later life, those with abnormal venous anatomy, and individuals prone to infection and/or central vein thrombosis. However, S-ICDs are not without their complications and are associated with a higher incidence of inappropriate shocks secondary to T wave oversensing. S-ICDs also lack antitachycardia pacing, making them a suboptimal device in patients with recurrent monomorphic ventricular tachycardia who would otherwise benefit from the antitachycardia pacing offered in TV-ICDs. Lastly, the limited number of long-term randomized, head-to-head studies involving direct comparison with TV-ICDs poses a challenge in the implementation of the S-ICD. PMID:26807549

  18. Subcutaneous immunoglobulin: opportunities and outlook

    PubMed Central

    Misbah, S; Sturzenegger, M H; Borte, M; Shapiro, R S; Wasserman, R L; Berger, M; Ochs, H D

    2009-01-01

    Immunoglobulin (Ig) administration via the subcutaneous (s.c.) route has become increasingly popular in recent years. The method does not require venous access, is associated with few systemic side effects and has been reported to improve patients' quality of life. One current limitation to its use is the large volumes which need to be administered. Due to the inability of tissue to accept such large volumes, frequent administration at multiple sites is necessary. Most studies conducted to date have investigated the use of subcutaneous immunoglobulin (SCIg) in patients treated previously with the intravenous (i.v.) formulation. New data now support the use of s.c. administration in previously untreated patients with primary immunodeficiencies. SCIg treatment may further be beneficial in the treatment of autoimmune neurological conditions, such as multi-focal motor neuropathy; however, controlled trials directly comparing the s.c. and i.v. routes are still to be performed for this indication. New developments may further improve and facilitate the s.c. administration route. For example, hyaluronidase-facilitated administration increases the bioavailability of SCIg, and may allow for the administration of larger volumes at a single site. Alternatively, more concentrated formulations may reduce the volume required for administration, and a rapid-push technique may allow for shorter administration times. As these developments translate into clinical practice, more physicians and patients may choose the s.c. administration route in the future. PMID:19883424

  19. Subcutaneous electronic identification in cattle: a field study.

    PubMed

    Løken, T; Vatn, G; Kummen, E

    2011-09-01

    The use of injectable transponders in cattle for identification purposes, for up to 30 months, was investigated. Passive electronic transponders, encapsulated in either polymer or glass, were injected subcutaneously into either the ear base or the earlobe of 652 calves in three populations. The animals were clinically examined weekly, and transponder signalling was checked immediately before and after injection, after two weeks and after about eight months. About 10 per cent of animals in one population were also checked after 20 and 30 months. No severe clinical or visible pathological changes were observed, and the calves' welfare was not apparently affected by the procedure. None of the transponders migrated from their injection sites. Eight months after injection, a signal was detected from 98.2 per cent of transponders injected in the ear base and from 90.5 per cent of those in the earlobe. At 20 and 30 months after injection, 10.4 per cent and 2.6 per cent of transponders, respectively, had ceased to signal. Thus, most transponders in the calves' ear base demonstrated functionality for up to 30 months. PMID:21813580

  20. Comparative efficacy of subcutaneous versus oral methotrexate in active rheumatoid arthritis.

    PubMed

    Islam, M S; Haq, S A; Islam, M N; Azad, A K; Islam, M A; Barua, R; Hasan, M M; Mahmood, M; Safiuddin, M; Rahman, M M; Osmany, M F; Bari, N; Rumki, R S; Rashid, F B

    2013-07-01

    This prospective study was conducted in rheumatology clinic under the department of medicine of Bangabandhu Sheikh Mujib Medical University from December 2004 to December 2005 to asses the efficacy, safety and compliance of subcutaneous methotrexate (MTX) in active rheumatoid arthritis (RA) patients. A total of 92 active rheumatoid arthritis patients according to American College of Rheumatology (ACR) criteria were recruited for the trial for six months. Among them 46 cases belonged to injectable MTX group and 46 cases belonged to oral MTX group. Mean±SD age of patients was 45.54±12.42 vs. 44.63±13.99 years in subcutaneous group and oral group respectively. In the subcutaneous group 41 were female and 5 male; in the oral group 34 were female and 12 male. Mean duration of the disease was 49.74 months in subcutaneous group and 49 months in oral group. RA test was positive in 35 cases in both groups whereas Rose Waaler test was positive in 19 patients in subcutaneous group and 14 patients in oral group. At 24 week, response rate of ACR 20 was significantly higher in subcutaneous MTX than oral MTX group (93% vs. 80%, p=0.02). Similarly ACR 50 response was significantly higher in subcutaneous MTX than in oral group (89% vs. 72%, p=0.03). ACR 70 response was not significantly higher in SCMTX group then oral group (11% vs. 9 %, p=0.72). Adverse effects were relatively less in subcutaneous MTX and most common side effects were nausea (37% vs. 63%), vomiting (11% vs. 30%), dyspepsia (29% vs. 48%), dizziness (4l% vs. 52%) and alopecia (72% vs. 85%). The results of the study demonstrated that subcutaneous MTX was significantly more effective than oral MTX at the same dosage in active Rheumatoid arthritis patients with no increase in side effects. PMID:23982537

  1. Pharmacokinetics of moxidectin in alpacas following administration of an oral or subcutaneous formulation.

    PubMed

    Cocquyt, Christine M; Van Amstel, Sarel; Cox, Sherry; Rohrbach, Barton; Martín-Jiménez, Tomás

    2016-04-01

    The purpose of this study was to evaluate the pharmacokinetics of moxidectin in alpacas after single subcutaneous injection of a non-aqueous formulation or oral administration of an aqueous drench at 0.2 mg∗kg(-1). Plasma moxidectin concentrations were measured with reverse phase HPLC, and data analyzed using non-compartmental methods. Half-life was longer (p=0.02) after subcutaneous administration than oral (292+/-170 vs 33+/-39 h). The area under the concentration-time curve was greater (p=0.04) following subcutaneous administration (1484.8+/-1049.5 h∗ng∗ml(-1)) than oral (157.6+/-85.9 h∗ng∗ml(-1)). The peak concentration (Cmax) was higher and the after subcutaneous administration, but the difference was not statistically significant (p=0.18). The relative bioavailability of the oral moxidectin to the subcutaneous moxidectin was 11%. The data suggest a higher relative bioavailability following subcutaneous compared to oral administration. Further studies are needed to determine the therapeutic concentrations of moxidectin in alpacas. PMID:27033926

  2. Indwelling intrathecal catheter with subcutaneous abdominal reservoir: a viable baclofen delivery system in severely cachectic patients.

    PubMed

    Waqar, Mueez; Ellenbogen, Jonathan R; Kumar, Ram; Sneade, Christine; Zebian, Bassel; Williams, Dawn; Pettorini, Benedetta L

    2014-10-01

    Intrathecal baclofen (ITB) is a reversible treatment that reduces muscle tone to ameliorate spasticity and dystonia in patients with cerebral palsy (CP). The resulting decrease in energy expenditure allows patients to gain much-needed weight, albeit temporarily. Modern techniques require sufficient abdominal musculature and subcutaneous fat to permit the implantation of an indwelling pump. In patients with extremely low muscle bulk, visceral pumps may be impractical or impossible, with increased risks of dehiscence and infection. The authors describe a variation of the classical procedure in a young patient with severe cachexia. A 10-year-old boy with spastic-dystonic quadriplegic CP was admitted to the neuromedical unit. Numerous drug trials had failed, and surgical intervention was deemed necessary but was complicated by his cachectic body habitus. The authors inserted a lumbar intrathecal catheter and subcutaneously tunneled it to the anterolateral abdomen, where it was connected to a subcutaneous injection port. Baclofen was continuously infused into the subcutaneous port using a noncoring needle connected to an external pump. The needle and line were changed every 5 days to minimize the risk of sepsis. Although other techniques, such as intraventricular baclofen delivery, have been described, these are largely dependent upon sufficient musculature to support a visceral pump. A subcutaneous injection port system represents an alternative approach that reduces the risk of sepsis and may be better tolerated in cachectic patients. PMID:25084089

  3. Subcutaneous Immunoglobulin in Refractory Juvenile Dermatomyositis.

    PubMed

    de Inocencio, Jaime; Enríquez-Merayo, Eugenia; Casado, Rocío; González-Granado, Luis Ignacio

    2016-04-01

    Juvenile dermatomyositis (JDM) is the most common form of juvenile idiopathic inflammatory myopathy. We report a child with steroid-dependent JDM refractory to hydroxychloroquine and subcutaneous methotrexate who experienced systemic reactions to intravenous immunoglobulin and was successfully treated with subcutaneous immunoglobulin. This form of therapy has been shown to be safe, has a very low rate of adverse effects, does not require hospital admission, reduces the number of missed school days, and decreases the costs associated with treatment. PMID:26966131

  4. Lymphatic transport and catabolism of therapeutic proteins after subcutaneous administration to rats and dogs.

    PubMed

    Wang, Weirong; Chen, Nancy; Shen, Xiaolan; Cunningham, Paul; Fauty, Scott; Michel, Kimberly; Wang, Bo; Hong, Xuening; Adreani, Christine; Nunes, Christian N; Johnson, Chris V; Yin, Kuo-Chang; Groff, Michelle; Zou, Yan; Liu, Liming; Hamuro, Lora; Prueksaritanont, Thomayant

    2012-05-01

    The mechanism underlying subcutaneous absorption of macromolecules and factors that can influence this process were studied in rats using PEGylated erythropoietins (EPOs) as model compounds. Using a thoracic lymph duct cannulation (LDC) model, we showed that PEGylated EPO was absorbed from the subcutaneous injection site mainly via the lymphatic system in rats, which is similar to previous reports in sheep. After subcutaneous administration, the serum exposure was reduced by ∼70% in LDC animals compared with that in the control animals, and most of the systemically available dose was recovered in the lymph. In both LDC and intact rats, the total radioactivity recoveries in excreta after subcutaneous administration were high (70-80%), indicating that catabolism, not poor absorption, was the main cause for the observed low bioavailability (30-40%). Moreover, catabolism of PEGylated EPO was found with both rat subcutaneous tissue homogenate and lymph node cell suspensions, and a significant amount of dose-related breakdown fragments was found in the lymph of LDC rats. In addition, the bioavailability of PEGylated EPOs was shown to be 2- to 4-fold lower in "fat rats," indicating that physiologic features pertinent to lymphatic transport can have a profound impact on subcutaneous absorption. Limited studies in dogs also suggested similar subcutaneous absorption mechanisms. Collectively, our results suggest that the lymphatic absorption mechanism for macromolecules is probably conserved among commonly used preclinical species, e.g., rats and dogs, and that mechanistic understanding of the subcutaneous absorption mechanism and associated determinants should be helpful in biologic drug discovery and development. PMID:22328584

  5. A history of growth hormone injection devices.

    PubMed

    Fidotti, E

    2001-05-01

    In the early 1960s, growth hormone (GH) deficiency was treated by intramuscular injection of GH extracted from human pituitary glands. Since then, there have been many advances in treatment encompassing the route of administration, the injection product and the injection device. This review considers the advances in injection device that have already taken place and how they have benefited the patient, particularly in terms of reduced pain and improved convenience. In the future, needle-free injection techniques and depot formulations of GH are likely to offer alternatives to daily subcutaneous injections. PMID:11393569

  6. Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis

    PubMed Central

    Lourenço, Edmir Américo; Caldeira, Eduardo José; Carvalho, César Alexandre Fabrega; Cunha, Marcelo Rodriques; Carvalho, Marcus Vinícius Henriques; Passos, Saulo Duarte

    2015-01-01

    Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0), meaning absence of these symptoms to three (3), for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions. PMID:26722338

  7. Pharmacokinetics of intravenous and subcutaneous cefovecin in alpacas.

    PubMed

    Cox, S; Sommardahl, C; Seddighi, R; Videla, R; Hayes, J; Pistole, N; Hamill, M; Doherty, T

    2015-08-01

    The purpose of this study was to determine the pharmacokinetics of cefovecin after intravenous and subcutaneous dose of 8 mg/kg to alpacas. Bacterial infections requiring long-term antibiotic therapy such as neonatal bacteremia, pneumonia, peritonitis, dental, and uterine infections are a significant cause of morbidity and mortality in this species. However, few antimicrobials have been evaluated and proven to have favorable pharmacokinetics for therapeutic use. Most antimicrobials that are currently used require daily injections for many days. Cefovecin is a long-acting cephalosporin that is formulated for subcutaneous administration, and its long-elimination half-life allows for 14-day dosing intervals in dogs and cats. The properties of cefovecin may be advantageous for medical treatment of camelids due to its broad spectrum, route of administration, and long duration of activity. Pharmacokinetic evaluation of antimicrobial drugs in camelids is essential for the proper treatment and prevention of bacterial disease, and to minimize development of antibiotic resistant bacterial strains due to inadequate antibiotic concentrations. Cefovecin mean half-life, volume of distribution at steady-state, and clearance after intravenous administration were 10.3 h, 86 mL/kg, and 7.07 mL·h/kg. The bioavailability was 143%, while half-life, C(max), and T(max) were 16.9 h, 108 μg/mL, and 2.8 h following subcutaneous administration. In the absence of additional microbial susceptibility data for alpaca pathogens, the current cefovecin dosage regimen prescribed for dogs (8 mg/kg SC every 14 days) may need to be optimized for the treatment of infections in this species. PMID:25407784

  8. Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis.

    PubMed

    Lourenço, Edmir Américo; Caldeira, Eduardo José; Carvalho, César Alexandre Fabrega; Cunha, Marcelo Rodriques; Carvalho, Marcus Vinícius Henriques; Passos, Saulo Duarte

    2016-01-01

    Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0), meaning absence of these symptoms to three (3), for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions. PMID:26722338

  9. Subcutaneous immunoglobulin in treating inflammatory neuromuscular disorders

    PubMed Central

    Yoon, Min-Suk; Gold, Ralf

    2015-01-01

    Objective: Intravenous immunoglobulin administration has long been used in the treatment of autoimmune neuromuscular disorders. Immunoglobulins may be administered by intramuscular, intravenous or subcutaneous routes. Methods: This is a report on the long-term clinical follow up of six patients with inflammatory neuromuscular disorders, that is, three chronic inflammatory demyelinating polyneuropathy (CIDP), one multifocal motor neuropathy (MMN), one inclusion body myositis (IBM) and one myasthenia gravis (MG), treated with subcutaneous immunoglobulins for a mean of 3.25 years. Results: One MMN and two CIDP patients received a weekly dose of subcutaneous immunoglobulins equivalent to intravenous immunoglobulin. One CIDP patient received a 50% dose reduction, the IBM patient received a 30% reduction and the MG patient a 20% reduction. The lower dose chosen in the majority of patients was based not only on clinical effects, but also on studies of primary immunodeficiency syndromes. One patient with CIDP showed clinical fluctuation, which was successfully treated with an adaptation of the dose of subcutaneous immunoglobulins, while the remaining patients with neuromuscular disorders had a stable clinical course for 2 years. No serious side effects were observed. Conclusions: Our results suggest that subcutaneous immunoglobulins can be an attractive alternative therapy in autoimmune neuromuscular disorders. PMID:26136842

  10. Histological study of subcutaneous fat at NIR laser treatment of the rat skin in vivo

    NASA Astrophysics Data System (ADS)

    Yanina, I. Y.; Svenskaya, Yu. I.; Navolokin, N. A.; Matveeva, O. V.; Bucharskaya, A. B.; Maslyakova, G. N.; Gorin, D. A.; Sukhorukov, G. B.; Tuchin, V. V.

    2015-07-01

    The goal of this work is to quantify impact of in vivo photochemical treatment using indocyanine green (ICG) or encapsulated ICG and NIR laser irradiation through skin of rat with obesity by the follow up tissue sampling and histochemistry. After 1 hour elapsed since 1-min light exposure samples of rat skin with subcutaneous tissue of thickness of 1.5-2.5 mm were taken by surgery from rats within marked 4-zones of the skin site. For hematoxylin-eosin histological examination of excised tissue samples, fixation was carried out by 10%-formaldehyde solution. For ICG and encapsulated ICG subcutaneous injection and subsequent 1-min diode laser irradiation with power density of 8 W/cm2, different necrotic regions with lipolysis of subcutaneous fat were observed. The obtained data can be used for safe layer-by-layer laser treatment of obesity and cellulite.

  11. Subcutaneous anti-D treatment of idiopathic thrombocytopenic purpura in children.

    PubMed

    Kjaersgaard, Mimi; Edslev, Pernille Wendtland; Hasle, Henrik

    2009-12-15

    We investigated the effect of subcutaneous anti-D IgG as platelet enhancing therapy in children with idiopathic thrombocytopenic purpura (ITP). Twenty-three children were treated with subcutaneous anti-D 50 microg/kg. The median platelet count increased from 7 x 10(9) to 31 x 10(9)/L on day 3 (P < 0.01). The median decline in hemoglobin was 1.3 g/dl. Two children experienced minor fever and chills within 24 hr of treatment. Pain at the injection site was common but self-limiting with no effect on activity level. These results suggest subcutaneous anti-D IgG 50 microg/kg as an effective and well-tolerated treatment option in childhood ITP. PMID:19722275

  12. Continuous subcutaneous insulin infusion in diabetes: patient populations, safety, efficacy, and pharmacoeconomics.

    PubMed

    Pozzilli, Paolo; Battelino, Tadej; Danne, Thomas; Hovorka, Roman; Jarosz-Chobot, Przemyslawa; Renard, Eric

    2016-01-01

    The level of glycaemic control necessary to achieve optimal short-term and long-term outcomes in subjects with type 1 diabetes mellitus (T1DM) typically requires intensified insulin therapy using multiple daily injections or continuous subcutaneous insulin infusion. For continuous subcutaneous insulin infusion, the insulins of choice are the rapid-acting insulin analogues, insulin aspart, insulin lispro and insulin glulisine. The advantages of continuous subcutaneous insulin infusion over multiple daily injections in adult and paediatric populations with T1DM include superior glycaemic control, lower insulin requirements and better health-related quality of life/patient satisfaction. An association between continuous subcutaneous insulin infusion and reduced hypoglycaemic risk is more consistent in children/adolescents than in adults. The use of continuous subcutaneous insulin infusion is widely recommended in both adult and paediatric T1DM populations but is limited in pregnant patients and those with type 2 diabetes mellitus. All available rapid-acting insulin analogues are approved for use in adult, paediatric and pregnant populations. However, minimum patient age varies (insulin lispro: no minimum; insulin aspart: ≥2 years; insulin glulisine: ≥6 years) and experience in pregnancy ranges from extensive (insulin aspart, insulin lispro) to limited (insulin glulisine). Although more expensive than multiple daily injections, continuous subcutaneous insulin infusion is cost-effective in selected patient groups. This comprehensive review focuses on the European situation and summarises evidence for the efficacy and safety of continuous subcutaneous insulin infusion, particularly when used with rapid-acting insulin analogues, in adult, paediatric and pregnant populations. The review also discusses relevant European guidelines; reviews issues that surround use of this technology; summarises the effects of continuous subcutaneous insulin infusion on patients

  13. Pneumomediastinum presenting as left periorbital subcutaneous emphysema.

    PubMed

    Orton, Jonathan; Collette, Emily

    2015-12-01

    Idiopathic spontaneous pneumomediastinum is rare but even rarer is associated unilateral periorbital subcutaneous emphysema. There is only 1 known case report noting both of these findings and was associated with endoscopic retrograde cholangiopancreatography complication. Isolated periorbital emphysema has been associated with dental procedures, facial trauma, and sneezing. It is has also been seen with pneumomediastinum caused by barotrauma, pneumothorax, endoscopic retrograde cholangiopancreatography, and esophageal perforation. A 52-year-old White male presents to the emergency department with complaint of left eye swelling that occurred overnight without known cause. He was found to have spontaneous idiopathic pneumomediastinum and unilateral periorbital subcutaneous emphysema. Although rare, it is important to rule out subcutaneous air tracking from pneumomediastinum when evaluating unilateral periorbital swelling in an otherwise asymptomatic patient. PMID:25986202

  14. Subcutaneous Phaeohyphomycosis Caused by Exophiala salmonis

    PubMed Central

    Yoon, Young Ahn; Park, Kyung Sun; Lee, Jang Ho; Sung, Ki-Sun; Ki, Chang-Seok

    2012-01-01

    We report a case of subcutaneous infection in a 55-yr-old Korean diabetic patient who presented with a cystic mass of the ankle. Black fungal colonies were observed after culturing on blood and Sabouraud dextrose agar. On microscopic observation, septated ellipsoidal or cylindrical conidia accumulating on an annellide were visualized after staining with lactophenol cotton blue. The organism was identified as Exophiala salmonis by sequencing of the ribosomal DNA internal transcribed spacer region. Phaeohyphomycosis is a heterogeneous group of mycotic infections caused by dematiaceous fungi and is commonly associated with immunocompromised patients. The most common clinical manifestations of subcutaneous lesions are abscesses or cystic masses. To the best of our knowledge, this is the first reported case in Korea of subcutaneous phaeohyphomycosis caused by E. salmonis that was confirmed by molecular analysis and identification of morphological characteristics. This case suggests that E. salmonis infections are no longer restricted to fish. PMID:23130345

  15. Augmented reality based real-time subcutaneous vein imaging system.

    PubMed

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-07-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed. PMID:27446690

  16. Augmented reality based real-time subcutaneous vein imaging system

    PubMed Central

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-01-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed. PMID:27446690

  17. Combined subcutaneous, intrathoracic and abdominal splenosis.

    PubMed

    Javadrashid, Reza; Paak, Neda; Salehi, Ahad

    2010-09-01

    We report a case of combined subcutaneous, intrathoracic, and abdominal splenosis who presented with attacks of flushing, tachycardia and vague abdominal pain. The patient's past medical history included a splenectomy due to abdominal trauma and years later, a lung lobectomy due to recurrent pneumonia. An enhancing solid mass adjacent to the upper pole of the left kidney and nodular pleural based lesions in the left hemi-thorax along with nodular lesions in subcutaneous tissue of the left chest wall suggested possible adrenal malignancy with multiple metastases. Histopathologic examination demonstrated benign lesions of ectopic splenic tissue. PMID:20804314

  18. Subcutaneous and periorbital emphysema following dental procedure.

    PubMed

    Fleischman, David; Davis, Richard M; Lee, Lyndon B

    2014-01-01

    Subcutaneous emphysema following a dental procedure is a relatively uncommon phenomenon that may produce a dramatic clinical presentation. The advent of high-powered dental equipment that uses directed and highly pressurized air has increased the risk of this complication, but few cases have been described in the ophthalmic literature. The authors present a case of subcutaneous periorbital emphysema in a young woman following a dental procedure. Aside from a temporary ptosis, there were no other ophthalmic complications. An attempt to decompress the air produced minimal relief. The condition resolved spontaneously within 1 week. PMID:24614564

  19. Subcutaneous sacral ependymoma--a histopathological challenge.

    PubMed

    Helbig, Doris

    2016-01-01

    Subcutaneous myxopapillary or sacral ependymoma are rare tumors mostly developing in children or adolescents. The majority occurs in the sacrococcygeal region. There are numerous clinical and histopathological differential diagnoses. Owing to the fact that there have been rare reported cases that followed an aggressive course and in which the patient succumbed to metastatic disease, long term follow-up is necessary despite complete excision. We describe here a 25-year-old male patient with a histological unusual subcutaneous sacral ependymoma and discuss the differential diagnosis as well as treatment options. PMID:26289839

  20. Subcutaneous immunoglobulin replacement therapy: ensuring success.

    PubMed

    Younger, M Elizabeth M; Blouin, William; Duff, Carla; Epland, Kristin Buehler; Murphy, Elyse; Sedlak, Debra

    2015-01-01

    Subcutaneous immunoglobulin (SCIg) infusions are an option for patients requiring immunoglobulin therapy. Nurses are uniquely positioned to advocate for patients and to teach them how to successfully manage their infusions. The purpose of this review is to describe SCIg therapy and to provide teaching instructions as well as creative tips to ensure treatment success. PMID:25545976

  1. Impressive Subcutaneous Calcifications in Systemic Lupus Erythematosus

    PubMed Central

    DIMA, Alina; BERZEA, Ioana; BAICUS, Cristian

    2015-01-01

    Dystrophic calcinosis cutis was commonly described in long-term dermatomyositis or systemic sclerosis, being rarely reported in other connective tissue diseases. We report the case of a 65-years old woman with an only 5-years history of systemic lupus erythematosus, who presents with multiple, impressive subcutaneous calcified masses and biological normal serum calcium and phosphate levels. PMID:26225152

  2. Subcutaneous emphysema of the hand caused by the suction drain -- a case report.

    PubMed

    Saray, A; Tellioglu, A T; Cimen, K; Karaeminogullari, G

    2004-08-01

    Subcutaneous emphysema of the hand can be related to non-infectious causes and most commonly high-pressure injection injuries. Surgical emphysema of the hand is rare. We report a case of surgical emphysema of the dorsum of the hand following the excision of a dorsal wrist ganglion when the inserted suction drain did not work properly, accompanied by the inadvertent compression of the patient's body. Conservative management was adequate; oedema and emphysema subsided in several days. PMID:15368154

  3. Injection of Vaseline under Penis Skin for the Purpose of Penis Augmentation.

    PubMed

    Karakan, Tolga; Ersoy, Erim; Hasçiçek, Metin; Ozgür, Berat Cem; Ozcan, Serkan; Aydın, Arif

    2012-01-01

    Penile foreign body injection is an uncommon entity produced by penile paraffin, mineral oil, and vaseline injections for the purpose of penile enlargement. Generally, penile subcutaneous and glandular injections for penile augmentation are performed by a nonmedical person, under unacceptable conditions. It will be an aim to share our experiences about penile vaseline injection. PMID:23213616

  4. Enhancing the contrast of subcutaneous veins

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar

    1999-07-01

    A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This technique uses a near infrared light source and one or more infrared sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patient's skin using an LCD vein projector. The use of an infrared transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults, both Caucasian and African-American, and it enhances veins quite well in most cases. Preliminary studies on a 9 month old girl indicate promise for pediatric use.

  5. Recent developments in the subcutaneous ICD.

    PubMed

    Willcox, Mark E; Prutkin, Jordan M; Bardy, Gust H

    2016-08-01

    The subcutaneous implantable cardioverter-defibrillator (ICD) was developed as a simple device to reduce the morbidity of ICD therapy while providing a comparable reduction in sudden death from ventricular fibrillation. This review highlights the differences compared to the traditional ICD. It includes recent data on safety and efficacy, as well as best practices on screening and programming, and discusses expected future developments. PMID:27079889

  6. Optimization of subcutaneous vein contrast enhancement

    NASA Astrophysics Data System (ADS)

    Zeman, Herbert D.; Lovhoiden, Gunnar; Deshmukh, Harshal

    2000-05-01

    A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This techniques uses a near IR light source and one or more IR sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patient's skin using a n LCD video projector. The use of an IR transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults and children, both Caucasian and African-American, and it enhances veins quite well in all cases. The most difficult cases are those where significant deposits of subcutaneous fat are present which make the veins invisible under normal room illumination. Recent attempts to see through fat using different IR wavelength bands and both linearly and circularly polarized light were unsuccessful. The key to seeing through fat turns out to be a very diffuse source of RI light. Results on adult and pediatric subjects are shown with this new IR light source.

  7. Golimumab Injection

    MedlinePlus

    ... at golimumab injection before injecting it. Check the expiration date printed on the auto-injection device or carton and do not use the medication if the expiration date has passed. Do not use a prefilled syringe ...

  8. Epinephrine Injection Associated Scrotal Skin Necrosis

    PubMed Central

    Gul, Murat; Kaynar, Mehmet; Sekmenli, Tamer; Ciftci, Ilhan; Goktas, Serdar

    2015-01-01

    Male circumcision is among the most frequent surgical interventions throughout history. Although considered as a minor intervention, it may have complications ranging from insignificant to catastrophic. These complications can be attributed to the surgical procedure and anesthesia. In this report we present two cases of scrotal skin necrosis after lidocaine with epinephrine injection using subcutaneous ring block technique prior to circumcision. PMID:26185706

  9. Injectable Multiple Sclerosis Medications

    PubMed Central

    Tran, Zung Vu

    2012-01-01

    Although injection-site reactions (ISRs) occur with US Food and Drug Administration–approved injectable disease-modifying therapies (DMTs) for multiple sclerosis, there are currently few reports of real-world data on ISR management strategies or possible correlations between ISRs and patient demographics, disease characteristics, and missed injections. Patient-reported data on the use of DMTs, patient demographic and disease characteristics, missed injections, and ISR reduction strategies were collected via e-mail, a patient registry (www.ms-cam.org), and a Web-based survey. Of the 1380 respondents, 1201 (87%) indicated that they had used injectable DMTs, of whom 377 (31%) had used intramuscular (IM) interferon beta-1a (IFNβ-1a), 172 (14%) had used subcutaneous (SC) IFNβ-1a, 183 (15%) had used SC IFNβ-1b, and 469 (39%) had used glatiramer acetate (GA). The majority of respondents were older (73% were ≥40 years), female (79%), married or living with a partner (72%), white (94%), and nonsmoking (82%). Injection-site reaction incidence, grouped according to severity, varied among DMTs, with IM IFNβ-1a causing significantly (P < .001) fewer mild, moderate, or severe ISRs than the other therapies. Female sex and younger age were significantly (P < .05) associated with more moderate ISRs among users of IM IFNβ-1a, SC IFNβ-1b, and GA. Nonwhites reported severe ISRs more often than whites. For all DMTs injection-site massage and avoidance of sensitive sites were the most frequently used strategies to minimize ISRs. These data may help identify patients with characteristics associated with a higher risk for ISRs, allowing health-care professionals to provide anticipatory guidance to patients at risk for decreased adherence or discontinuation. PMID:24453732

  10. [Subcutaneous stimulation as additional therapy to spinal cord stimulation in a post-laminectomy syndrome patient].

    PubMed

    Akbaş, Mert; Yeğin, Mehmet Arif; Özdemir, İrem; Göksu, Ethem; Akyüz, Mahmut

    2016-01-01

    Spinal cord stimulation as treatment of chronic low back pain via neuromodulation has been frequently performed in recent years. The dorsal column is stimulated by an electrode placed at the epidural region. In the case presently described, subcutaneous lead was implanted in a patient with failed back syndrome after spinal cord stimulation was inadequate to treat back and gluteal pain. A 65-year-old male had undergone surgery to treat lumbar disc herniation, after which he received physical therapy and multiple steroid injections due to unrelieved pain. He was admitted to the pain clinic with pain radiating to right gluteal muscle and leg. Spinal cord stimulation was performed and, as pain was not relieved, subcutaneous lead was applied to the right cluneal nerve distribution. Following treatment, the patient scored 1-2 on visual analog scale. Pain had been reduced by over 80%. Octad electrode was placed between T8 and T10 vertebrae after Tuohy needle was introduced to intervertebral area between L1 and L2. Paresthesia occurred in the right extremity. Boundaries were determined by area of right gluteal region in which paresthesia did not occur. Octad electrode was placed subcutaneously after vertical line was drawn from center point. Paresthesia occurred throughout the region. Pulse wave was 390-450 msec; frequency was 10-30 Hz. Subcutaneous electrode replacement is effective additional therapy when pain is not relieved by spinal cord stimulation. PMID:27225614

  11. An abnormal lymphatic phenotype is associated with subcutaneous adipose tissue deposits in Dercum’s disease

    PubMed Central

    Rasmussen, John C.; Herbst, Karen L.; Aldrich, Melissa B.; Darne, Chinmay D.; Tan, I-Chih; Zhu, Banghe; Guilliod, Renie; Fife, Caroline A.; Maus, Erik A.; Sevick-Muraca, Eva M.

    2014-01-01

    Objective Investigational, near-infrared fluorescence (NIRF) lymphatic imaging was used to assess lymphatic architecture and contractile function in participants diagnosed with Dercum’s disease, a rare, poorly understood disorder characterized by painful lipomas in subcutaneous adipose tissues. Design and Methods After informed consent and as part of an FDA-approved feasibility study to evaluate lymphatics in diseases in which their contribution has been implicated, three women diagnosed with Dercum’s disease and four control subjects were imaged. Each participant received multiple intradermal and subcutaneous injections of indocyanine green (ICG, total dose ≤400µg) in arms, legs, and/or trunk. Immediately after injection, ICG was taken up by the lymphatics and NIRF imaging was conducted. Results The lymphatics in the participants with Dercum’s disease were intact and dilated, yet sluggishly propelled lymph when compared to control lymphatics. Palpation of regions containing fluorescent lymphatic pathways revealed tender, fibrotic, tubular structures within the subcutaneous adipose tissue that were associated with painful nodules, and, in some cases, masses of fluorescent tissue indicating that some lipomas may represent tertiary lymphoid tissues. Conclusions These data support the hypothesis that Dercum’s disease may be a lymphovascular disorder and suggest a possible association between abnormal adipose tissue deposition and abnormal lymphatic structure and function. PMID:25044620

  12. In vitro-in vivo evaluation of nanosuspension release from subcutaneously implantable osmotic pumps.

    PubMed

    Hill, A; Geissler, S; Meyring, M; Hecht, S; Weigandt, M; Mäder, K

    2013-07-15

    Utilizing poorly soluble drug candidates in pharmacokinetic studies remains challenging in preclinical drug development. We investigated a nanosuspension-based delivery system to achieve constant drug plasma levels by applying the nanoparticles via subcutaneously implanted micro-osmotic pumps. Various nanosuspension formulations were characterized in vitro prior to Alzet® pump release by means of dynamic light scattering (DLS), scanning electron microscopy (SEM), differential scanning calorimetry (DSC) and rheological measurements. In vitro formulation release was checked by HPLC/UV. The in vivo experiments compared plasma-concentration time profiles of subcutaneously injected nanosuspensions with those of formulations delivered by pumps. Two Poloxamer 338 containing nanosuspensions with different viscosities were found to be stable over observation time, physically resistant against biorelevant media and showed only a low amorphous part after preparation. The more viscous nanosuspension with 31.65 mPas revealed in vitro the expected zero-order release, while the low viscous formulation with 2.18 mPas showed first order release. In in vivo experiments, the higher viscous nanosuspension released from osmotic pumps exhibited elevated plasma levels compared to the lower viscous formulation. Compared to bolus injected nanosuspensions constant plasma levels could be maintained by adapting the viscosity of the nanosuspension. Subcutaneously implanted osmotic pumps prove to be a valuable delivery system for nanosuspensions in pharmacokinetic studies by consideration of the key parameter viscosity in release kinetics. PMID:23628403

  13. Subcutaneously Administered Self-Cleaving Hydrogel-Octreotide Conjugates Provide Very Long-Acting Octreotide.

    PubMed

    Schneider, Eric L; Henise, Jeff; Reid, Ralph; Ashley, Gary W; Santi, Daniel V

    2016-07-20

    We developed a long-acting drug-delivery system that supports subcutaneous administration of the peptidic somatostatin agonist octreotide-a blockbuster drug used to treat acromegaly and neuroendocrine tumors. The current once-a-month polymer-encapsulated octreotide, Sandostatin LAR, requires a painful intragluteal injection through a large needle by a health-care professional. To overcome such shortcomings, Tetra-PEG hydrogel microspheres were covalently attached to the α-amine of d-Phe(1) or the ε-amine of Lys(5) of octreotide by a self-cleaving β-eliminative linker; upon subcutaneous injection in the rat using a small-bore needle, octreotide was slowly released. The released drug from the ε-octreotide conjugate showed a remarkably long serum half-life that exceeded two months. The α-octreotide conjugate had a half-life of ∼2 weeks, and showed an excellent correlation of in vitro and in vivo drug release. Pharmacokinetic models indicate these microspheres should support once-weekly to once-monthly self-administered subcutaneous dosing in humans. The hydrogel-octreotide conjugate shows the favorable pharmacokinetics of Sandostatin LAR without its drawbacks. PMID:27253622

  14. Depletion of the residues of colistin and amoxicillin in turkeys following simultaneous subcutaneous administration.

    PubMed

    Tomasi, L; Giovannetti, L; Rondolotti, A; Della Rocca, G; Stracciari, G L

    1996-01-01

    The tissue distribution and depletion of colistin and amoxicillin were studied in 84 turkeys dosed subcutaneously on 4 consecutive days with a formulation containing the two drugs at 0.2 ml/kg per day, corresponding to 50 000 IU of colistin sulphate/kg and 20 mg of amoxicillin trihydrate/kg. All the turkeys were killed 1-30 days after the final dose and samples of muscle, liver, kidney and cutaneous-subcutaneous tissues and of the injection site were taken for analysis for colistin and amoxicillin residues. The colistin concentrations in the liver (117.5 +/- 26.0 ng/g) and cutaneous-subcutaneous tissue (100.0 +/- 35.6 ng/g) were higher than those in kidney (92.0 +/- 34.4 ng/g) or muscle (67.5 +/- 16.9 ng/g) 1 day after the final dose. The concentration of this drug then increased for 9-14 days, followed by a slow decrease. The antibiotic was still present at low concentrations in the kidneys of all the treated birds and in the livers of two turkeys 30 days after the end of treatment. Amoxicillin concentrations were greatest in muscle (389.2 +/- 195.0 ng/g) and at the injection sites (440.3 +/- 213.9 ng/g) 1 day after treatment ceased, with a subsequent rapid decline. This drug was undetectable in the livers and kidneys by 10 days after dosing ceased. PMID:8711898

  15. Subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei.

    PubMed

    Chen, Yu-Chuan; Su, Yu-Chieh; Tsai, Chen-Chi; Lai, Ning-Sheng; Fan, Kou-Sheng; Liu, Keng-Chang

    2014-12-01

    Exophiala jeanselmei, a saprobe in the environment, is an opportunistic pathogen. We present a rare case of subcutaneous phaeohyphomycosis caused by E jeanselmei in a man aged 66 years with a 3-month history of a tender swelling on the dorsal area of the left middle finger. Purulent fluid was aspirated from the area, and the culture yielded black colonies composed of conidiophores, phialides, and yeast cells. After sequencing of the rDNA ITS1-5.8S-ITS2 gene, the pathogen was confirmed as E jeanselmei. The patient was cured by surgical excision without any antifungal agents. PMID:22841620

  16. Surgical management of subcutaneous Colletotrichum gloeosporioides.

    PubMed

    Allton, David R; Parvez, Najma; Ranganath, Sangeetha; Jinadatha, Chetan

    2015-01-01

    A 52-year-old male patient with a history of sarcoidosis and over 10 years of chronic low-dose glucocorticoid use, cirrhosis and type 2 diabetes mellitus presented with two painful, enlarging subcutaneous nodules ultimately identified as Colletotrichum gloeosporioides. Two attempts at needle aspiration of the larger nodule resulted in rapid reaccumulation. Complete surgical excision of both nodules resulted in complete resolution without the use of any concomitant antifungals. Patient had no recurrence at 2 years of follow-up. PMID:25737220

  17. Pulmonary carcinoid presenting as multiple subcutaneous nodules.

    PubMed

    Oleksowicz, L; Morris, J C; Phelps, R G; Bruckner, H W

    1990-02-28

    A 60-year-old female presented with a one-year history of multiple enlarging tender subcutaneous nodules. Initial biopsy demonstrated a poorly differentiated adenocarcinoma. Mammography showed multiple nodular breast lesions. After the patient failed to respond to tamoxifen, a second biopsy demonstrated a metastatic carcinoid tumor. Further search revealed a single small pulmonary nodule, which on aspiration biopsy proved to be a carcinoid tumor. The patient failed to respond to treatment with streptozotocin and 5'-fluorouracil. Therapy with leucovorin calcium and 5'-fluorouracil then produced a partial response. PMID:2321273

  18. Anaphylaxis to subcutaneous neutral protamine Hagedorn insulin with simultaneous sensitization to protamine and insulin.

    PubMed

    Blanco, C; Castillo, R; Quiralte, J; Delgado, J; García, I; de Pablos, P; Carrillo, T

    1996-06-01

    We report an insulin-treated diabetic patient who suffered, in a 2-month period, three severe anaphylactic reactions immediately after self-administered subcutaneous injections of neutral protamine Hagedorn (NPH) human recombinant-DNA insulin. These reactions consisted of local and systemic symptoms, including dyspnea and hypotension. A simultaneous sensitization to human insulin and to protamine was demonstrated, both by skin tests and by the determination of serum specific IgE. Suspecting protamine allergy, we performed a test dose to human lente insulin with perfect tolerance. After a 1-year follow-up with lente-insulin treatment, no reactions have occurred, despite treatment interruptions. Therefore, protamine IgE-mediated allergy probably caused our patient's reactions. In conclusion, protamine sensitization should be ruled out in any patient with a history of reactions to subcutaneous protamine-containing insulins, even if insulin sensitization is present. PMID:8837667

  19. Inhibition of subcutaneously implanted human pituitary tumor cells in nude mice by LRIG1.

    PubMed

    Wang, X; He, X J; Xu, H Q; Chen, Z W; Fan, H H

    2016-01-01

    The aim of this study was to explore the inhibition of subcutaneously implanted human pituitary tumor cells in nude mice by LRIG1 and its mechanism. For this study, athymic nude mice were injected with either normal pituitary tumor RC-4B/C cells or LRIG1-transfected RC-4B/C cells. We then calculated the volume inhibition rate of the tumors, as well as the apoptosis index of tumor cells and the expression of Ras, Raf, AKt, and ERK mRNA in tumor cells. Tumor cell morphological and structural changes were also observed under electron microscope. Our data showed that subcutaneous tumor growth was slowed or even halted in LRIG1-transfected tumors. The tumor volumes were significantly different between the two groups of mice (χ2 = 2.14, P < 0.05). The tumor apoptosis index was found to be 8.72% in the control group and 39.7% in LRIG1-transfected mice (χ2 = 7.59, P < 0.05). The levels of Ras, Raf, and AKt mRNA in LRIG1-transfected RC-4B/C cells were significantly reduced after transfection (P < 0.01). Transfected subcutaneous tumor cells appeared to be in early or late apoptosis under an electron microscope, while only a few subcutaneous tumor cells appeared to be undergoing apoptosis in the control group. In conclusion, the LRIG1 gene is able to inhibit proliferation and promote apoptosis in subcutaneously implanted human pituitary tumors in nude mice. The mechanism of LRIG1 may involve the inhibition of the PI3K/ Akt and Ras/Raf/ERK signal transduction pathways. PMID:27173312

  20. Subcutaneous rehydration: updating a traditional technique.

    PubMed

    Spandorfer, Philip R

    2011-03-01

    Subcutaneous (SC) rehydration therapy (SCRT), originally referred to as "hypodermoclysis," shows promise as an alternative to intravenous (IV) fluid administration for treatment of dehydration. A simple, safe, and effective technique, SCRT is indicated for treatment of mild-to-moderate dehydration. Augmentation of SCRT with administration of a recombinant human formulation of the hyaluronidase enzyme at the infusion site gives rise to SC fluid administration rates up to 5-fold faster than those achieved without the enzyme, making the technique more clinically practical. Unlike older, animal-derived forms of hyaluronidase, recombinant human hyaluronidase has a lower chance of allergic reactions with repeated dosing. Clinical trials have demonstrated that recombinant human hyaluronidase effectively and safely facilitates fluid delivery in adults and children and is well accepted by parents and clinicians. In the emergency department setting, SCRT may be an appropriate alternative to IV fluid administration in certain situations because it is less invasive and generally less painful, while still permitting administration of appropriate volumes of rehydration fluids. Subcutaneous rehydration therapy appears to be particularly useful in patients who present with mild-to-moderate dehydration and have had failed attempts at oral rehydration. The SC route also provides benefits in patients with small, collapsed, or difficult-to-visualize veins or in those who may be agitated or distressed by IV catheterization. Continued research will further clarify the role of recombinant human hyaluronidase-facilitated SCRT in the rehydration treatment algorithm. PMID:21378529

  1. Growth of subcutaneous chicken testicular transplants.

    PubMed

    Silversides, F G; Robertson, M C; Liu, J

    2013-07-01

    Avian genetic resources have declined dramatically over the past half century, partly because the poultry community has been slow to adopt cryoconservation of avian germplasm. Techniques for gonadal cryopreservation and functional recovery have recently been developed but only some have been optimized. Chicks were castrated at 2 or 6 d and testicles were autotransplanted subcutaneously in one piece after disruption of the tunica membranes to optimize transplantation procedures without the complication of tissue rejection or immunosuppression. At 22 wk of age, the roosters were euthanized and growth of the testicular tissue was evaluated. Mortality with castration at 2 d was high but was much reduced with castration at 6 d. Transplantation of whole testicles subcutaneously on the back of chicks, without complete removal of the tunica membranes, yielded good growth of tissue with transplantation at 2 or 6 d of age. These results will contribute to the use of testicular cryopreservation and transplantation as an effective conservation strategy for avian germplasm. Further definition of the age of treatment will improve the overall efficiency. PMID:23776280

  2. Subcutaneous compliance and gravitational adaptation in snakes.

    PubMed

    Lillywhite, H B

    1993-12-15

    Previous studies have implicated morphological adaptations as important counter-measures to gravitational stresses on the circulatory systems of arboreal or climbing snakes. Such features include tight skin and relatively non-compliant tissue compartments that oppose edema formation, but these traits have not been previously studied quantitatively. To provide information on this subject, interstitial fluid pressures were measured in eleven species of snakes using slit-end catheters positioned in subcutaneous tissue located at the base of the tail. Interstitial pressures in all species were typically 0 to +2 mm Hg in normally hydrated tissue, but varied widely when snakes were active or when the tail was curved at the site of measurement. Local compliance of the free fluid space was determined from measurements of pressure while saline was infused via the catheter tip. Such measurements varied from 0.18 microliters/mm Hg in Philodryas baroni, an arboreal species, to 2.3 microliters/mm Hg in Crotalus adamanteus, a ground-dwelling, terrestrial species. In general, compliance of the subcutaneous tissue space was greatest (P < 0.05) in non-climbing and aquatic species of snakes that do not face problems of gravitational edema in dependent tissues. Presumably, the compliance measurements reflect adaptive structural differences related to requirements for counteracting gravitational stresses in the various species. PMID:8277230

  3. Liposome-mediated DNA immunisation via the subcutaneous route.

    PubMed

    Perrie, Y; McNeil, S; Vangala, A

    2003-01-01

    liposome-mediated DNA immunisation employing two DRV(DNA) formulations as well as naked DNA revealed that humoural responses (immunoglobulin total IgG, and subclasses IgG1 and 1gG2a) engendered by the plasmid encoded NP were substantially higher after dosing twice, 28 days apart with 10 microg liposome-entrapped DNA compared to naked DNA. At all time points measured, mice immunised with naked DNA showed no greater immune response compared to the control, non-immunised group. In contrast, as early as day 49, responses were significantly higher in mice injected with DNA entrapped in DRV liposomes containing DOTAP compared to the control group and mice immunised with naked DNA. By day 56, all total IgG responses from mice immunised with both DRV formulations were significantly higher. Comparison between the DRV formulations revealed no significant difference in immune responses elicited except at day 114, where the humoural responses of the group injected with liposomal formulation containing DC-Chol dropped to significantly lower levels that those measured in mice which received the DOTAP formulation. Similar results were found when the IgG1 and IgG2a subclass responses were determined. These results suggest that, not only can DNA be effectively entrapped within liposomes using the DRV method but that such DRV liposomes containing DNA may be a useful system for subcutaneous delivery of DNA vaccines. PMID:15203925

  4. Chloramphenicol Injection

    MedlinePlus

    Chloramphenicol injection is used to treat certain types of serious infections caused by bacteria when other antibiotics cannot be used. Chloramphenicol injection is in a class of medications called ...

  5. Levoleucovorin Injection

    MedlinePlus

    ... injection is used to prevent harmful effects of methotrexate (Rheumatrex, Trexall) when methotrexate is used to to treat certain types of ... people who have accidentally received an overdose of methotrexate or similar medications. Levoleucovorin injection is in a ...

  6. Estrogen Injection

    MedlinePlus

    ... forms of estrogen injection are used to treat hot flushes (hot flashes; sudden strong feelings of heat and sweating) ... If you are using estrogen injection to treat hot flushes, your symptoms should improve within 1 to ...

  7. Palonosetron Injection

    MedlinePlus

    Palonosetron injection is used to prevent nausea and vomiting that may occur within 24 hours after receiving ... occur several days after receiving certain chemotherapy medications. Palonosetron injection is in a class of medications called ...

  8. Leuprolide Injection

    MedlinePlus

    ... normal number of red blood cells) caused by uterine fibroids (noncancerous growths in the uterus). Leuprolide injection is ... Your doctor will tell you how long your treatment with leuprolide injection will last. When used in ...

  9. Naltrexone Injection

    MedlinePlus

    Naltrexone injection is used along with counseling and social support to help people who have stopped drinking large ... injection is also used along with counseling and social support to help people who have stopped abusing opiate ...

  10. Posaconazole Injection

    MedlinePlus

    Posaconazole injection is used to prevent fungal infections in people with a weakened ability to fight infection. Posaconazole injection is in a class of medications called azole antifungals. It works ...

  11. Paclitaxel Injection

    MedlinePlus

    ... with other medications. Paclitaxel injection manufactured with polyoxyethylated castor oil is used to treat ovarian cancer (cancer that ... cancer, and lung cancer. Paclitaxel injection with polyoxyethylated castor oil is also used to treat Kaposi's sarcoma (a ...

  12. Mipomersen Injection

    MedlinePlus

    ... become pregnant during your treatment, stop using mipomersen injection and call your doctor immediately. ... Mipomersen injection may cause side effects. Tell your doctor if any of these ... and tiredness that are most likely to occur during the first 2 days ...

  13. Levofloxacin Injection

    MedlinePlus

    ... infections. Levofloxacin injection is also used to prevent anthrax (a serious infection that may be spread on ... in people who may have been exposed to anthrax germs in the air. Levofloxacin injection is in ...

  14. Ciprofloxacin Injection

    MedlinePlus

    ... injection is also used to prevent or treat anthrax (a serious infection that may be spread on ... in people who may have been exposed to anthrax germs in the air. Ciprofloxacin injection is in ...

  15. Romidepsin Injection

    MedlinePlus

    ... with at least one other medication given by mouth or by injection. Romidepsin injection is in a ... antifungals such as itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend); cisapride (Propulsid) (not available in the U.S.); ...

  16. Degarelix Injection

    MedlinePlus

    Degarelix injection is used to treat advanced prostate cancer (cancer that begins in the prostate [a male reproductive gland]). Degarelix injection is in a class of medications called gonadotropin-releasing hormone (GnRH) ...

  17. Paclitaxel Injection

    MedlinePlus

    ... other medications. Paclitaxel injection manufactured with polyoxyethylated castor oil is used to treat ovarian cancer (cancer that ... and lung cancer. Paclitaxel injection with polyoxyethylated castor oil is also used to treat Kaposi's sarcoma (a ...

  18. Glatiramer Injection

    MedlinePlus

    ... course of disease where symptoms flare up from time to time) of multiple sclerosis (MS; a disease in which ... to inject glatiramer, inject it around the same time every day. Follow the directions on your prescription ...

  19. Daratumumab Injection

    MedlinePlus

    ... any laboratory test, tell your doctor and the laboratory personnel that you are receiving or received daratumumab injection. ... a blood transfusion, tell your doctor and the laboratory personnel that you are receiving or received daratumumab injection. ...

  20. Pralatrexate Injection

    MedlinePlus

    ... will need to take folic acid and vitamin B12 during your treatment with pralatrexate injection to help ... that you will need to receive a vitamin B12 injection no more than 10 weeks before your ...

  1. Cefoxitin Injection

    MedlinePlus

    ... injection is used to treat infections caused by bacteria including pneumonia and other lower respiratory tract (lung) ... medications called cephamycin antibiotics. It works by killing bacteria.Antibiotics such as cefoxitin injection will not work ...

  2. Chloramphenicol Injection

    MedlinePlus

    ... treat certain types of serious infections caused by bacteria when other antibiotics cannot be used. Chloramphenicol injection ... antibiotics. It works by stopping the growth of bacteria..Antibiotics such as chloramphenicol injection will not work ...

  3. Oxacillin Injection

    MedlinePlus

    ... is used to treat infections caused by certain bacteria. Oxacillin injection is in a class of medications called penicillins. It works by killing bacteria.Antibiotics such as oxacillin injection will not work ...

  4. Nafcillin Injection

    MedlinePlus

    ... to treat infections caused by certain types of bacteria. Nafcillin injection is in a class of medications called penicillins. It works by killing bacteria.Antibiotics such as nafcillin injection will not work ...

  5. Doripenem Injection

    MedlinePlus

    ... tract, kidney, and abdomen that are caused by bacteria. Doripenem injection is not approved by the Food ... medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such as doripenem injection will not work ...

  6. Medroxyprogesterone Injection

    MedlinePlus

    ... Medroxyprogesterone injection is a very effective method of birth control but does not prevent the spread of human ... you have been using a different method of birth control and are switching to medroxyprogesterone injection, your doctor ...

  7. Doxycycline Injection

    MedlinePlus

    Doxycycline injection is used to treat or prevent bacterial infections, including pneumonia and other respiratory tract infections. ... certain skin, genital, intestine, and urinary system infections. Doxycycline injection may be used to treat or prevent ...

  8. Ferumoxytol Injection

    MedlinePlus

    Ferumoxytol injection is used to treat iron-deficiency anemia (a lower than normal number of red blood ... and may cause the kidneys to stop working). Ferumoxytol injection is in a class of medications called ...

  9. Fondaparinux Injection

    MedlinePlus

    ... using fondaparinux injection while you are in the hospital at least 6 to 8 hours after your ... you will continue to use fondaparinux after your hospital stay, you can inject fondaparinux yourself or have ...

  10. Epinephrine Injection

    MedlinePlus

    Adrenalin® Chloride Solution ... a pre-filled automatic injection device containing a solution (liquid) to inject under the skin or into ... device when this date passes. Look at the solution in the device from time to time. If ...

  11. Trastuzumab Injection

    MedlinePlus

    Trastuzumab injection is used along with other medications or after other medications have been used to treat ... has spread to other parts of the body. Trastuzumab injection is also used during and after treatment ...

  12. Aripiprazole Injection

    MedlinePlus

    ... aripiprazole injection and aripiprazole extended-release injection developed gambling problems or other intense urges or behaviors that ... even if you do not realize that your gambling or any other intense urges or unusual behaviors ...

  13. Human dicrocoeliasis presenting as a subcutaneous mass

    PubMed Central

    Samaila, Modupeola Omotara; Shehu, Sani Mohammed; Abubakar, Nasiru; Mohammed, Umar; Jabo, Bashir

    2009-01-01

    Human infection by Dicrocoelium dendriticum, a zoonotic liver fluke, is uncommon and soft tissue manifestation is extremely rare. The infection has no specific clinical signs or symptoms and diagnosis may be missed completely, thus treatment may be delayed. Diagnosis in humans is by identification of the eggs in the stool, while a living or dead fluke is rarely seen. The present report concerns the case of a 7-year-old child who presented with recurrent right flank subcutaneous nodules containing a live fluke on excision, and tissue histology showed characteristic brown operculated ova of D dendriticum. This is the first extraintestinal soft tissue presentation in such a setting. It is important to know the life cycle and natural habitat of this rare human parasite in order to make a correct diagnosis and institute early treatment in patients who have become infected. PMID:21829430

  14. Foreign Body Reaction to Subcutaneous Implants.

    PubMed

    Kastellorizios, Michail; Tipnis, Namita; Burgess, Diane J

    2015-01-01

    Subcutaneously implanted materials trigger the host's innate immune system, resulting in the foreign body reaction. This reaction consists of protein adsorption on the implant surface, inflammatory cell infiltration, macrophage fusion into foreign body giant cells, fibroblast activation and ultimately fibrous encapsulation. This series of events may affect the function of subcutaneous implants, such as inhibition of drug diffusion from long-acting drug delivery depots and medical device failure. The foreign body reaction is a complex phenomenon and is not yet fully understood; ongoing research studies aim to elucidate the cellular and molecular dynamics involved. Recent studies have revealed information about the specific role of macrophages and their differential activation towards pro- and anti-inflammatory states, as well as species differences in the timing of collagen deposition and fibrosis. Understanding of the diverse processes involved in the foreign body reaction has led to multiple approaches towards its negation. Delivery of tissue response modifiers, such as corticosteroids, NSAIDs, antifibrotic agents, and siRNAs, has been used to prevent or minimize fibrosis. Of these, delivery of dexamethasone throughout the implantation period is the most common method to prevent inflammation and fibrosis. More recent approaches employ surface modifications to minimize protein adsorption to 'ultra-low' levels and reduce fibrosis. However, the diverse nature of the processes involved in the foreign body reaction favor the use of corticosteroids due to their wide spectrum action compared to other approaches. To date, combination approaches, such as hydrophilic coatings that reduce protein adsorption combined with delivery of dexamethasone are the most effective. PMID:26306445

  15. The need for chemical compatibility studies of subcutaneous medication combinations used in palliative care.

    PubMed

    Rose, Marie; Currow, David C

    2009-01-01

    When a person with a life-limiting illness is unable to swallow, the subcutaneous route of administration is a widely used way of administering many medications, either as repeated bolus injections or by continuous infusions to complement transdermal, sublingual, or rectal routes of administration. To optimize symptom control as changes are made from other routes of administration to subcutaneous delivery, basic principles for ensuring optimal net clinical benefit (therapeutic benefit and minimizing side effects) must be understood as fully as science will allow. Despite the widespread use of combinations of injectable medications in this clinical setting and the availability of the technology to do the studies, the limited work done suggests that there may be significant drug loss with some combinations of medications without any visual or physical changes apparent. Work needs to be done urgently to evaluate a wide range of medication combinations used extensively in hospice and palliative care for chemical compatibility, while ensuring the work that has been done in other areas (anesthetics, chronic pain) is adopted into practice as results become available. Almost all of these medications are off-patent and there is therefore no financial incentive for the pharmaceutical industry to do the studies on medications now produced generically. Other sources of funding need to be identified. At best, it is likely that optimal symptom control is at times compromised in palliative care without chemical compatibility data for combinations of injectable medications and, at worst, toxicity is generated unknowingly. PMID:19670019

  16. A novel in vitro method to model the fate of subcutaneously administered biopharmaceuticals and associated formulation components.

    PubMed

    Kinnunen, Hanne M; Sharma, Vikas; Contreras-Rojas, Luis Rodrigo; Yu, Yafei; Alleman, Chlöe; Sreedhara, Alavattam; Fischer, Stefan; Khawli, Leslie; Yohe, Stefan T; Bumbaca, Daniela; Patapoff, Thomas W; Daugherty, Ann L; Mrsny, Randall J

    2015-09-28

    Subcutaneous (SC) injection is becoming a more common route for the administration of biopharmaceuticals. Currently, there is no reliable in vitro method that can be used to anticipate the in vivo performance of a biopharmaceutical formulation intended for SC injection. Nor is there an animal model that can predict in vivo outcomes such as bioavailability in humans. We address this unmet need by the development of a novel in vitro system, termed Scissor (Subcutaneous Injection Site Simulator). The system models environmental changes that a biopharmaceutical could experience as it transitions from conditions of a drug product formulation to the homeostatic state of the hypodermis following SC injection. Scissor uses a dialysis-based injection chamber, which can incorporate various concentrations and combinations of acellular extracellular matrix (ECM) components that may affect the release of a biopharmaceutical from the SC injection site. This chamber is immersed in a container of a bicarbonate-based physiological buffer that mimics the SC injection site and the infinite sink of the body. Such an arrangement allows for real-time monitoring of the biopharmaceutical within the injection chamber, and can be used to characterize physicochemical changes of the drug and its interactions with ECM components. Movement of a biopharmaceutical from the injection chamber to the infinite sink compartment simulates the drug migration from the injection site and uptake by the blood and/or lymph capillaries. Here, we present an initial evaluation of the Scissor system using the ECM element hyaluronic acid and test formulations of insulin and four different monoclonal antibodies. Our findings suggest that Scissor can provide a tractable method to examine the potential fate of a biopharmaceutical formulation after its SC injection in humans and that this approach may provide a reliable and representative alternative to animal testing for the initial screening of SC formulations

  17. Aluminium in allergen-specific subcutaneous immunotherapy--a German perspective.

    PubMed

    Kramer, Matthias F; Heath, Matthew D

    2014-07-16

    We are living in an "aluminium age" with increasing bioavailability of the metal for approximately 125 years, contributing significantly to the aluminium body burden of humans. Over the course of life, aluminium accumulates and is stored predominantly in the lungs, bones, liver, kidneys and brain. The toxicity of aluminium in humans is briefly summarised, highlighting links and possible causal relationships between a high aluminium body burden and a number of neurological disorders and disease states. Aluminium salts have been used as depot-adjuvants successfully in essential prophylactic vaccinations for almost 100 years, with a convincing positive benefit-risk assessment which remains unchanged. However, allergen-specific immunotherapy commonly consists of administering a long-course programme of subcutaneous injections using preparations of relevant allergens. Regulatory authorities currently set aluminium limits for vaccines per dose, rather than per treatment course. Unlike prophylactic vaccinations, numerous injections with higher proportions of aluminium-adjuvant per injection are applied in subcutaneous immunotherapy (SCIT) and will significantly contribute to a higher cumulative life dose of aluminium. While the human body may cope robustly with a daily aluminium overload from the environment, regulatory cumulative threshold values in immunotherapy need further addressing. Based on the current literature, predisposing an individual to an unusually high level of aluminium, such as through subcutaneous immunotherapy, has the potential to form focal accumulations in the body with the propensity to exert forms of toxicity. Particularly in relation to longer-term health effects, the safety of aluminium adjuvants in immunotherapy remains unchallenged by health authorities - evoking the need for more consideration, guidance, and transparency on what is known and not known about its safety in long-course therapy and what measures can be taken to prevent or

  18. Subcutaneous mycoses. Part 1: subcutaneous mycoses due to non-dermatophytes.

    PubMed

    Romano, C

    2013-12-01

    Subcutaenous mycoses are increasingly reported in the literature for various reasons. Firstly, life expectancy has increased and even patients with cancer and/or immunodepression live longer, making them susceptible to these infections. Secondly, diagnostic techniques for mycoses have improved. Dermatologists have now begun to suspect subcutaneous mycoses when faced with certain clinical pictures and are aware of the need for histopathological examination and culture of lesion biopsy material on appropriate culture media. This review considers the clinical, histopathological and mycological aspects of the most common subcutaneous mycoses and outlines how to treat them. A better understanding of these mycoses enables early diagnosis and treatment of infections that are sometimes life-threatening. PMID:24442042

  19. Perforated diverticulitis of the sigmoid colon causing a subcutaneous emphysema

    PubMed Central

    Kassir, Radwan; Abboud, Karine; Dubois, Joelle; Baccot, Sylviane; Debs, Tarek; Favre, Jean-Pierre; Gugenheim, Jean; Gastaldi, Pauline; Amor, Imed Ben; Tiffet, Olivier

    2014-01-01

    INTRODUCTION Although diverticular disease of the colon is frequent, perforated diverticulitis causing subcutaneous emphysema is a uncommon entity. We wish to present this extremely rare case of perforated colonic diverticulum in the subcutaneous tissue, which is the first one that we have encountered in our practice, along with the accompanying diagnostic and therapeutic issues and a review of the literature. PRESENTATION OF CASE We report the case of an 83-year-old man who admitted to the emergency room due to an abdominal subcutaneous emphysema. Physical examination revealed a severe subcutaneous emphysema especially in the left iliac fossa and abdominal pain. An urgent contrast enhanced abdominal CT scan showed multiple diverticula in the sigmoid colon and multiple air bubbles in the subcutaneous tissue. The exploratory laparotomy identified a perforation of diverticular in subcutaneous tissue. Forty centimeters of colon were resected. The subcutaneous emphysema resolved without specific treatment. The postoperative period was uncomplicated. DISCUSSION Subcutaneous emphysema of anterior abdomen wall is an obvious physical sign but its etiology is complex to determine and may be potentially lethal. The pathophysiological mechanism involved is the emergence of a pressure gradient between the peritoneum and surrounding structures, causing rupture of the anterior abdominal wall, allowing gas from a perforation to diffuse along tissue planes. CONCLUSION This physical sign may be of especial value in elderly patient groups amongst whom perforation may be less clinically obvious. General surgeons should bear in mind this rare complication of colonic diverticulosis. PMID:25437673

  20. Evaluation of the analgesic effect of subcutaneous methadone after cesarean section

    PubMed Central

    Jabalameli, Mitra; Kalantari, Forough

    2014-01-01

    Background: Inadequate pain control has a significant role in maternal and neonatal health in early post-partum period which interferes with breastfeeding and has a negative influence on child normal growth. The aim of this study is evaluation of subcutaneous methadone effectiveness on post-operative pain control. Materials and Methods: Double blind randomized prospective clinical trial involving 60 term pregnancy patients through 2008 to 2009 Undergo cesarean. Inclusion criteria: Prime gravid candidate of elective cesarean and spinal anesthesia class 1 or 2. Known case of drug allergy and methadone interaction, addiction, uncontrolled medical disease excluded. Case group injected 10 mg of subcutaneous methadone in the site of incision before final suture. Morphine was a pain reliever in follow up examination. Data include mean of pain, nausea and vomiting, MAP, etc., collected and analyzed by independent-T test and Man Whitney test. Results: Although mean usage of morphine between groups was not significant statistically but the mean pain severity (P value < 0.05) and mean satisfactory (P value = 0.02) was statistically significant between groups. Other parameters were not statistically significant. Conclusion: We suggest subcutaneous methadone as a safe pain reliever in post cesarean section patients. PMID:25337527

  1. Excess subcutaneous tissue may preclude intramuscular delivery when using adrenaline autoinjectors in patients with anaphylaxis.

    PubMed

    Johnstone, J; Hobbins, S; Parekh, D; O'Hickey, S

    2015-06-01

    Intramuscular adrenaline is the gold standard treatment for anaphylaxis. Intramuscular injection provides more rapid and higher plasma concentrations than subcutaneous routes. Given the increasing epidemic of obesity patients are at increased risk of subcutaneous delivery, we therefore assessed the depth of subcutaneous tissue in a population of patients with anaphylaxis. Patients already prescribed adrenaline autoinjectors (AAIs) for anaphylaxis were examined with ultrasound, and measurements of skin-to-muscle depth (STMD) at anterolateral thigh and anterior thigh were performed. Twenty-eight patients (23 female, 5 male) with an age range of 18-75 took part in the study, and in 68%, the STMD was greater than AAI needle length (15.02 mm), using the anterolateral thigh as the recommended administration site. The key predictors for increased STMD were female gender (P=0.0003) and a BMI > 30 (P=0.04). AAIs require longer needles to ensure intramuscular administration, and ultrasound at point of prescription would aid needle length selection. PMID:25676800

  2. Cutaneous manifestations of injectable drug use: hidden secrets.

    PubMed

    Barańska-Rybak, Wioletta; Błażewicz, Izabela; Kąkol, Monika; Roter, Mirosław; Nowicki, Roman

    2014-04-01

    Abscesses related to drug use are the most common cutaneous manifestations among injection drug users, often occurring when the veins become less accessible. In these cases, other techniques may be used to administer drugs, such as skin popping (subcutaneous injection) or muscle popping (intramuscular injection). The main risk factors for abscess formation include skin popping, use of unsterilized needles, and injection of speedball (a mixture of cocaine and heroin). We present a case of recurrent abscesses accompanied by fever, hypersomnia alternating with insomnia, diaphoresis, fatigue, recent weight loss, and agitation following subcutaneous injection of a tramadol, opipramol, and clonazepam mixture. Differential diagnoses included pyoderma gangrenosum on the basis of hepatitis C virus, skin lesions connected with human immunodeficiency virus infection, vasculitis, endocarditis, and serotonin syndrome. The patient was treated with oral antibiotics, surgical incision, and drainage of the abscesses, with consequent improvement. PMID:24818177

  3. Phase 1 Study of VEGF Trap (Aflibercept) Administered Subcutaneously to Patients with Advanced Solid Tumors

    PubMed Central

    Tew, William P.; Gordon, Michael; Murren, John; Dupont, Jakob; Pezzulli, Sandra; Aghajanian, Carol; Sabbatini, Paul; Mendelson, David; Schwartz, Lawrence; Gettinger, Scott; Psyrri, Amanda; Cedarbaum, Jesse M.; Spriggs, David R.

    2014-01-01

    Purpose To determine the maximum tolerated dose (MTD) or maximal administered dose (MAD) and pharmacokinetic and safety profiles of subcutaneously administered VEGF Trap (aflibercept), a novel anti-angiogenic agent. Experimental Design In this open-label, dose-escalation study, patients with advanced solid tumors were treated with subcutaneous doses of aflibercept at seven dose levels. Patients received a single dose of aflibercept and then underwent safety and pharmacokinetic assessments over the next 4 weeks. Patients then received weekly or bi-weekly treatment over the subsequent 6 weeks. Patients tolerating and benefiting could continue on aflibercept at the same dose and schedule until progression of disease. Results Thirty-eight patients received at least one dose of aflibercept. MTD was not reached. Due to solubility/dosing limits with the subcutaneous formulation, 1600mcg/kg/week was the MAD. The most common toxicities were proteinuria (37%), fatigue (32%), injection site reactions (18%), nausea (17%), myalgia and anorexia (16% each), hypertension (13%), and voice hoarseness (11%). Drug-related grade 3–4 toxicity was uncommon (7%) and reversible: dehydration, cerebral ischemia, proteinuria, hypertension, leukopenia, and pulmonary embolism. We identified dose-proportional increases in plasma concentrations of aflibercept bound to VEGF with a t1/2 of 18 days. No anti-aflibercept antibodies were detected. Stable disease was maintained for at least 10 weeks in 18 patients (47%), and 2 patients maintained on study for more than 1 year. Conclusion Subcutaneous aflibercept was well-tolerated and had manageable side effects. Its favorable pharmacokinetic profile and potential antitumor activity warrants further evaluation. PMID:20028764

  4. Effect of plantar subcutaneous administration of bergamot essential oil and linalool on formalin-induced nociceptive behavior in mice.

    PubMed

    Katsuyama, Soh; Otowa, Akira; Kamio, Satomi; Sato, Kazuma; Yagi, Tomomi; Kishikawa, Yukinaga; Komatsu, Takaaki; Bagetta, Giacinto; Sakurada, Tsukasa; Nakamura, Hitoshi

    2015-01-01

    This study investigated the effect of bergamot essential oil (BEO) or linalool, a major volatile component of BEO, on the nociceptive response to formalin. Plantar subcutaneous injection of BEO or linalool into the ipsilateral hindpaw reduced both the first and late phases of the formalin-induced licking and biting responses in mice. Plantar subcutaneous injection of BEO or linalool into the contralateral hindpaw did not yield an antinociceptive effect, suggesting that the antinociceptive effect of BEO or linalool in the formalin test occurred peripherally. Intraperitoneal and plantar subcutaneous injection pretreatment with naloxone hydrochloride, an opioid receptor antagonist, significantly attenuated both BEO- and linalool-induced antinociception. Pretreatment with naloxone methiodide, a peripherally acting opioid receptor antagonists, also significantly antagonized the antinociceptive effects of BEO and linalool. Our results provide evidence for the involvement of peripheral opioids in antinociception induced by BEO and linalool. These results suggest that activation of peripheral opioid receptors may play an important role in reducing formalin-induced nociception. PMID:25749150

  5. Continuous subcutaneous insulin infusion: practical issues

    PubMed Central

    Saboo, Banshi D.; Talaviya, Praful A.

    2012-01-01

    The growing number of individuals with diabetes mellitus has prompted new way of treating these patients, continuous subcutaneous insulin infusion (CSII) or insulin pump therapy is an increasingly form of intensive insulin therapy. An increasing number of individuals with diabetes mellitus individuals of all ages have started using insulin pump therapy. Not everyone is a good candidate for insulin pump therapy, and the clinician needs to be able to determine which patients are able to master the techniques required and to watch for the adverse reactions that may develop. Insulin pump increases quality of life of patient with diabetes mellitus with increasing satisfaction with treatment and decrease impact of diabetes mellitus. Manual errors by insulin pump users may lead to hypo or hyperglycemia, resulting into diabetic ketoacidosis (DKA) sometimes. Some of practical aspect is associated with insulin pump therapy such as selection of candidates, handling of pump and selection of site, and pump setting, henceforth this review is prepared to explore and solve the practical problems or issues associated with pump therapy. PMID:23565394

  6. Sublingual or subcutaneous immunotherapy for allergic rhinitis?

    PubMed

    Durham, Stephen R; Penagos, Martin

    2016-02-01

    Allergen immunotherapy is effective in patients with allergic rhinitis (AR) and, unlike antiallergic drugs, has been shown to modify the underlying cause of the disease, with proved long-term benefits. Subcutaneous immunotherapy (SCIT) has been the gold standard, whereas sublingual immunotherapy (SLIT) has emerged as an effective and safe alternative. Previous Cochrane systematic reviews and meta-analyses have confirmed that both SLIT and SCIT are effective in patients with seasonal AR, whereas evidence for their efficacy in patients with perennial disease has been less convincing. Recent large, adequately powered trials have demonstrated reductions in both symptoms and use of rescue medication in patients with seasonal and those with perennial AR. Here we appraise evidence for SCIT versus SLIT based on indirect evidence from Cochrane reviews and recent well-powered double-blind, randomized controlled trials versus placebo and the limited direct evidence available from randomized blind head-to-head comparisons. At present, based on an overall balance of efficacy and side effects, the patient is in equipoise. Pending definitive comparative trials, choice might be determined largely by the local availability of SCIT and SLIT products of proved value and personal (patient) preference. PMID:26853126

  7. Carcinogenicity of airborne combustion products observed in subcutaneous tissue and lungs of laboratory rodents.

    PubMed Central

    Pott, F; Stöber, W

    1983-01-01

    Most air pollution in West Germany is caused by combustion products. Particulate organic matter released by incomplete combustion is suspected to contribute to the "urban factor" of lung cancer frequency in urban-industrial centers. The carcinogenic potential of single components, groups of compounds and total source emissions of combustion processes was investigated in laboratory animals by subcutaneous injection, intratracheal instillation or inhalation. Tests by subcutaneous injection of condensates of automobile exhaust, extracts of coal furnace emissions and of airborne particles and different fractions of these extracts showed that the polycyclic aromatic hydrocarbons (PAH) with four to six benzene rings have the strongest experimental carcinogenicity. However, polar compounds (heterocyclic nitrogen-containing PAH, phenols, and others) also show remarkable carcinogenic potency. There were large differences between the dose-response relationships of several PAHs. In the subcutaneous tissue, benzo(a)pyrene and dibenz(a,h)anthracene are the most carcinogenic of the tested airborne PAHs. Furthermore, they can induce high tumor rates in the lung after subcutaneous injection in newborn mice and after intratracheal instillation of mice or hamsters. The tumor rate of benzo(a)pyrene did not further increase after simultaneous instillation of carbon black, but lead chloride may have a promoting effect. Far more than 100 PAHs are found in the urban atmosphere. However, because of the remarkable similarity of the PAH profiles in the examined samples, it may be sufficient to measure just a few stable PAHs in the urban air in order to facilitate an assessment of the carcinogenic potency of the PAH content in the atmosphere. To examine the carcinogenic or cocarcinogenic effects of gas and vapor emissions, studies with a two-phase model were carried out: phase 1 relates to the induction of a basic tumor rate in the lung by a well known carcinogen, while phase 2 is

  8. High-Dose Subcutaneous Immunoglobulins for the Treatment of Severe Treatment-Resistant Polymyositis

    PubMed Central

    Patrick, Cherin; Jean-Christophe, Delain; Jean-Charles, Crave; Odile, Cartry

    2014-01-01

    Polymyositis is a rare debilitating condition characterized by chronic inflammation and muscle weakness. Standard treatments include corticosteroids and immunosuppressants; however, resistance to these regimens may develop. Intravenous immunoglobulins (IVIg) are thus recommended for patients with drug-resistant polymyositis. The patient presented a resistant polymyositis with severe muscle weakness, increasing dysphagia, and significant loss in weight. Subcutaneous immunoglobulins (SCIg) were initiated after failure of steroids and immunosuppressive drugs. SCIg was given twice per week (2 then 1.3 g/kg/month). Clinical recovery was observed within 2 months after the SCIg initiation. After several injections, the patient showed a progressive improvement in muscle strength. Serum creatine kinase activity decreased to normal levels, and dysphagia was resolved. The SC injections were generally well tolerated and good patient satisfaction was reported. This promising observation suggests that SCIg may be useful in active and refractory polymyositis. PMID:25140268

  9. Subcutaneous administration of paclitaxel in dogs with cancer: A preliminary study

    PubMed Central

    Silva, Daniella M.; Franciosi, Aline I.; Pezzini, Paula C.F.; Guérios, Simone D.

    2015-01-01

    Intravenous paclitaxel has been underused in dogs due to severe and acute hypersensitivity reactions. Subcutaneous (SC) administration of paclitaxel and its safety are unknown. In this preliminary study, SC administration of paclitaxel was evaluated for hypersensitivity reactions and toxicity in 21 dogs with advanced cancer. Dogs received 1 to 5 paclitaxel doses, ranging from 85 to 170 mg/m2, SC every 14 or 21 days. A total of 40 paclitaxel doses were administered and none of the 21 dogs developed systemic or acute local hypersensitivity reactions. Severe skin lesions at the injection site developed in 2 dogs after the 4th injection at the same location. Grade 4 neutropenia was observed in 50% of the dogs 5 days after the first treatment at 115 mg/m2 (n = 14). Two animals developed Grade 5 diarrhea and died likely due to hemodynamic failure or sepsis. Paclitaxel can be administered SC in dogs with no hypersensitivity reaction. PMID:26246628

  10. Lacosamide Injection

    MedlinePlus

    ... may be prescribed for other uses; ask your doctor or pharmacist for more information. ... Before using lacosamide injection,tell your doctor and pharmacist if you are allergic to lacosamide, any other medications, or any of the ingredients in lacosamide injection. Ask your pharmacist for a ...

  11. Dexamethasone Injection

    MedlinePlus

    ... lines under the skin skin depressions at the injection site increased body fat or movement to different areas of your body inappropriate happiness difficulty falling asleep or staying asleep extreme ... increased appetite injection site pain or redness Some side effects can ...

  12. Etanercept Injection

    MedlinePlus

    ... and colorless. The liquid may contain small white particles, but should not contain large or colored particles. Do not use a syringe or dosing pen ... liquid is cloudy or contains large or colored particles.The best place to inject etanercept injection is ...

  13. Pralatrexate Injection

    MedlinePlus

    ... you that you will need to receive a vitamin B12 injection no more than 10 weeks before your first ... tests to check your body's response to pralatrexate injection.Ask your ... such as vitamins, minerals, or other dietary supplements. You should bring ...

  14. Leucovorin Injection

    MedlinePlus

    ... lack of vitamin B12 or inability to absorb vitamin B12. Your doctor will not prescribe leucovorin injection to treat this type of anemia.tell your ... tests to check your body's response to leucovorin injection.It is ... such as vitamins, minerals, or other dietary supplements. You should bring ...

  15. Subcutaneous Phaeohyphomycosis Due to Pyrenochaeta romeroi Mimicking a Synovial Cyst

    PubMed Central

    Dinh, Aurélien; Levy, Bruno; Bouchand, Frédérique; Davido, Benjamin; Duran, Clara; Cristi, Marin; Felter, Adrien; Salomon, Jérôme; Ait Ammar, Nawel

    2016-01-01

    Opportunistic subcutaneous fungal infections are increasing nowadays due to the growing number of medical conditions causing immunosuppression, especially organ transplant. The incidence rate of subcutaneous phaeohyphomycosis is very low. Most studies found are case reports. They showed a wide variation of clinical presentations. Pyrenochaeta romeroi, a fungus from the Dematiaceae group is a saprophyte found in soil and plants and a possible causative agent of phaeohyphomycosis. We present a rare case of subcutaneous phaeohyphomycosis caused by P. romeroi mimicking a synovial cyst in a diabetic patient.

  16. Extensive subcutaneous emphysema complicating a percutaneous Mumford procedure.

    PubMed

    Saseendar, Shanmugasundaram; Tan, Si Heng Sharon; Vijayan, Sandeep; Pawaskar, Aditya; Kumar, Veerasingam Prem

    2016-06-01

    Subcutaneous emphysema may be a part of a life-threatening pneumomediastinum or pneumothorax and usually does not occur alone. A case of a 75-year-old lady who underwent a percutaneous Mumford procedure for acromioclavicular osteoarthrosis has been reported. She developed extensive subcutaneous emphysema of the neck, chest, bilateral shoulders, and upper arms, in the absence of pneumomediastinum or pneumothorax, during the procedure. Isolated subcutaneous emphysema as a complication of a percutaneous Mumford procedure has not been reported so far in the English literature. The possible mechanism of this complication is discussed. Understanding the mechanism is essential in avoiding this preventable complication. PMID:25059337

  17. Musculoskeletal Injection

    PubMed Central

    Wittich, Christopher M.; Ficalora, Robert D.; Mason, Thomas G.; Beckman, Thomas J.

    2009-01-01

    Patients commonly present to primary care physicians with musculoskeletal symptoms. Clinicians certified in internal medicine must be knowledgeable about the diagnosis and management of musculoskeletal diseases, yet they often receive inadequate postgraduate training on this topic. The musculoskeletal problems most frequently encountered in our busy injection practice involve, in decreasing order, the knees, trochanteric bursae, and glenohumeral joints. This article reviews the clinical presentations of these problems. It also discusses musculoskeletal injections for these problems in terms of medications, indications, injection technique, and supporting evidence from the literature. Experience with joint injection and the pharmacological principles described in this article should allow primary care physicians to become comfortable and proficient with musculoskeletal injections. PMID:19720781

  18. Midfacial rejuvenation by hyaluronic acid fillers and subcutaneous adipose tissue--a new concept.

    PubMed

    Wollina, Uwe

    2015-04-01

    In midface rejuvenation, hyaluronic acid (HA) fillers are commonly used as a versatile tool to improve appearance and to correct V-deformities and loss of volume. The induction of collagen as a major constituent of extracellular matrix (ECM) has been considered to be a basic effect of the rejuvenation procedure. Although commonly described as "dermal" soft fillers, histologic studies localized HA filler in the subcutaneous adipose tissue. Deep injection whenever possible lead to prolonged efficacy. Since volumizing HA filler induce mechanical stress not only to fibroblasts but adipocytes and deep injection itself causes minor trauma in the subcutaneous adipose tissue we suggest that the activation of adipose tissue-derived mesenchymal stem cells (ADMSC) is responsible for the observed clinical effects. We present a concept of filler action that discusses interactions of HA with adipocytes, ECM fiber network and ADMSC. Such a concept can explain the prolonged efficacy of deep midfacial filler placement and offers a new understanding to tailor HA fillers in the future. PMID:25665858

  19. Hyaluronidase facilitated subcutaneous immunoglobulin in primary immunodeficiency

    PubMed Central

    Jolles, Stephen

    2013-01-01

    Immunoglobulin (Ig)-replacement therapy represents the mainstay of treatment for patients with primary antibody deficiency and is administered either intravenously (IVIg) or subcutaneously (SCIg). While hyaluronidase has been used in clinical practice for over 50 years, the development of a high-purity recombinant form of this enzyme (recombinant human hyaluronidase PH20) has recently enabled the study of repeated and more prolonged use of hyaluronidase in facilitating the delivery of SC medicines. It has been used in a wide range of clinical settings to give antibiotics, local anesthetics, insulin, morphine, fluid replacement, and larger molecules, such as antibodies. Hyaluronidase has been used to help overcome the limitations on the maximum volume that can be delivered into the SC space by enabling dispersion of SCIg and its absorption into lymphatics. The rate of facilitated SCIg (fSCIg) infusion is equivalent to that of IVIg, and the volume administered at a single site can be greater than 700 mL, a huge increase over conventional SCIg, at 20–40 mL. The use of fSCIg avoids the higher incidence of systemic side effects of IVIg, and it has higher bioavailability than SCIg. Data on the long-term safety of this approach are currently lacking, as fSCIg has only recently become available. fSCIg may help several areas of patient management in primary antibody deficiency, and the extent to which it may be used in future will depend on long-term safety data and cost–benefit analysis.

  20. Application of subcutaneous talc in hernia repair and wide subcutaneous dissection dramatically reduces seroma formation and postoperative wound complications.

    PubMed

    Klima, David A; Brintzenhoff, Rita A; Tsirline, Victor B; Belyansky, Igor; Lincourt, Amy E; Getz, Stanley; Heniford, B Todd

    2011-07-01

    Wound complications after large ventral hernia repairs when combined with wide subcutaneous dissection (OVHR/WSD) are common (33 to 66%). We evaluate a novel technique of applying talc to wound subcutaneous tissues to decrease wound complications. We accessed our prospectively collected surgical outcomes database for OVHR/WSD procedures performed. Patients were divided into those that did and did not receive subcutaneous talc (TALC vs NOTALC). Demographics intraoperative and outcomes data were collected and analyzed. The study included 180 patients (n = 74 TALC, n = 106 NOTALC). Demographics were all similar, but hernias were larger in the TALC group. TALC patients had their drains removed earlier (14.6 vs 25.6 days; P < 0.001) with dramatic reduction in postoperative seromas requiring intervention (20.8 to 2.7%; P < 0.001) and cellulitis (39.0 to 20.6%; P = 0.007). Short-term follow-up demonstrates significantly higher recurrence rates in the NOTALC group with each recurrence related to infection. The use of talc in the subcutaneous space of OVHR/WSD results in significantly earlier removal of subcutaneous drains, fewer wound complications, and a decrease in early hernia recurrence. Use of talc in the subcutaneous space at the time of wound closure is an excellent technique to decrease wound complications in large subcutaneous dissections. PMID:21944353

  1. Acute toxicity of subcutaneously administered depleted uranium and the effects of CBMIDA in the simulated wounds of rats.

    PubMed

    Fukuda, Satoshi; Ikeda, Mizuyo; Nakamura, Mariko; Yan, Xueming; Xie, Yuyuan

    2009-04-01

    We examined the acute toxicity of depleted uranium (DU) after subcutaneous injection as a simulated wound model (experiment I), and the effects of a chelating agent, catechol-3,6-bis(methyleiminodiacetic acid) (CBMIDA), on the removal and damages caused by uranium by local treatment for wounds in rats (experiment II). Experiment I: To examine the initial behavior and toxicity of uranium of different chemical forms, male Wistar rats were subcutaneously injected with 4 and 16 mg kg-1 DU in a solution of pH 1 and 7. The rats were killed 1, 3, 6, and 24 h after DU injection. The DU (pH 1) injection site on the skin was altered markedly by acid burn, and the chemical action of uranium compared with that of DU (pH 7). After the injection of 4 mg kg-1 DU (pH 1), about 60% of the uranium was retained 1-3 h at the injected sites and then decreased to 16% at 24 h. However, the concentration of uranium in the injected site after 16 mg kg-1 DU (pH 1) injection did not change significantly. Urinary excretion rates of uranium (pH 1) increased in a time-independent manner after the injection. Depositions of uranium in the liver, kidneys and femur were found at 1 h after DU injection, and the results of serum and urinary examinations indicated that severe damage in the organs, including the kidney, was induced. The results of the DU (pH 7) were useful for estimating the chemical toxicity of uranium. Experiment II: The effects of CBMIDA by local treatment for wounds with DU were examined. CBMIDA (480 mg kg-1) was infused into the DU-injected site 0, 10, 30, 60, 120 min, and 24 h after the subcutaneous injection of 4 mg kg-1 DU (pH 1 and 7). The uranium at the injected sites decreased to 4-17% of that at 24 h in the DU (pH 1) group without CBMIDA treatment in experiment I, when it was administered within 120 min after DU injection. In addition, CBMIDA had excellent efficacy in excreting the uranium in urine and feces and decreasing the concentrations of uranium in the kidneys and

  2. Pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum and subcutaneous emphysema following diagnostic colonoscopy.

    PubMed

    Marwan, K; Farmer, K C; Varley, C; Chapple, K S

    2007-07-01

    Colonic perforation is an unusual complication of colonoscopy. We present a case of pneumothorax, pneumomediastinum, pneumoperitoneum and extensive subcutaneous emphysema resulting from a diagnostic colonoscopy. To our knowledge, only two such cases have been described previously. PMID:17688713

  3. Fuel injection

    SciTech Connect

    Iiyoshi, A.; Vogoshi, S.

    1983-12-01

    The Plasma Physics Laboratory and the Dept. of Electrical Engineering report on three types of pellet injectors which have different applications: injection of a pellet into a magnetic bottle for magnetic confinement; injection of a pellet into a vacuum chamber for an inertial confinement experiment; and injection of a pellet into a magnetic bottle where the pellet is ionized by high-power laser irradiation for target plasma production. The requirements of pellet injectors are summarized in a table. Theoretical studies on pellet ablation in hot plasma and ablated particle diffusion are underway.

  4. Michaelis-Menten elimination kinetics of etanercept, rheumatoid arthritis biologics, after intravenous and subcutaneous administration in rats.

    PubMed

    Lee, Byung-Yo; Kwon, Kwang-Il; Kim, Min-Soo; Baek, In-Hwan

    2016-08-01

    Etanercept was approved by the Food and Drug Administration (FDA) in 2010 as a biologic agent for the treatment of rheumatoid arthritis (RA). The aim of the study was to investigate the pharmacokinetic properties of etanercept after intravenous and subcutaneous injection in rats. The plasma concentration of etanercept was determined using an enzyme-linked immunosorbent assay (ELISA). Intravenous and subcutaneous administration of 2 mg/kg of etanercept to rats showed that etanercept was slowly absorbed (time to reach the peak drug concentration [T max] = 1.60 days, bioavailability [F] = 47.18 %) and slowly eliminated (half-life [t 1/2], 2.33 days after intravenous administration and 3.31 days after subcutaneous administration). The area under the curve values on day 13 (AUC13day) were 121.25 ± 14.37 and 48.56 ± 6.78 μg day/mL after intravenous and subcutaneous administration, respectively. A two-compartment model with Michaelis-Menten elimination kinetics (V max = 94.28 µg/day; K m = 10.88 µg/mL) was used to describe the pharmacokinetic profile of etanercept. Our results describe the pharmacokinetic profile of etanercept, and these results could be used for the development of etanercept biosimilars. PMID:25725773

  5. Use of subcutaneous immunoglobulin in primary immune deficiencies

    PubMed Central

    Aydıner, Elif Karakoç; Kıykım, Ayça; Barış, Safa; Özen, Ahmet; Barlan, Işıl

    2016-01-01

    Aim: Immunoglobulin replacement therapy is required to reduce the frequency and severity of infections in patients with primary antibody deficiencies. Immunoglobulin G (IgG) can be administered intramuscularly, intravenously or subcutaneously. We aimed to evaluate the efficacy, dose adjustment and adverse events in subcutaneous immunoglobulin therapy by retrospectively presenting the records of 16 patients who received subcutaneous immunoglobulin therapy. Material and Methods: The demographic findings, clinical and laboratory findings, subcutaneous immunoglobulin dosage and dose frequency, infusion time, area and methods, adverse events and frequency of infections were obtained from patient files and recorded. Results: Sixteen patients (seven female, nine male) aged between 0–33 years who were diagnosed with primary immune deficiency and treated with subcutaneous immunoglobulin were enrolled. All patients had been receiving intravenous imunoglobulin (5–10%) at a dose of 0.33–1.25 gr/kg/dose with two-four week intervals before subcutaneous immunoglobulin. Subcutaneous immunoglobulin (10%) was administered at a dose of 0.03–0.43 gr/kg/dose with one-two week intervals. No significant difference was found between serum through IgG levels before administration of intravenous imunoglobulin and steady state IgG levels during subcutaneous immunoglobulin therapy. When five patients whose serum through IgG levels were below 600 mg/dL were evaluated, however, a significant increase was found in steady state IgG levels with subcutaneous immunoglobulin therapy (p=0.043). In a ten-month follow-up period, seven infections were observed in four patients (three upper respiratory infectons, two lower respiratory tract infections and three acute gastroenteritis). No acute severe bacterial infection was observed. Local advers reaction was reported in only 10 of 180 infusions (6%). No serious adverse events were reported. All 16 patients were willing to continue IgG replacement

  6. Identification of Mouse Mesenteric and Subcutaneous in vitro Adipogenic Cells

    PubMed Central

    Miyata, Yugo; Otsuki, Michio; Kita, Shunbun; Shimomura, Iichiro

    2016-01-01

    Fat accumulation and the dysfunction of visceral white adipose tissue (WAT), but not subcutaneous WAT, cause abnormalities in whole body metabolic homeostasis. However, no current drugs specifically target visceral WAT. The primary reason for this is that a practical in vitro culture system for mesenteric adipocytes has not been established. To resolve this issue, we sought to identify in vitro adipogenic cells in mesenteric and subcutaneous WATs. First, we examined the expression pattern of surface antigens in stromal-vascular fraction (SVF) cells from mouse mesenteric and subcutaneous WATs, and found the expression of 30 stem cell-related surface antigens. Then, to evaluate the adipogenic ability of each fraction, we performed in vitro screening, and identified five candidate markers for mesenteric adipogenic cells and one candidate marker for subcutaneous adipogenic cells. To investigate whether in vitro adipogenic ability accurately reflects the conditions in vivo, we performed transplantation experiments, and identified CD9− CD201+ Sca-1− cells and CD90+ cells as mesenteric and subcutaneous in vitro adipogenic cells, respectively. Furthermore, mature adipocytes derived from mesenteric and subcutaneous adipogenic cells maintained each characteristic phenotype in vitro. Thus, our study should contribute to the development of a useful culture system for visceral adipocytes. PMID:26884347

  7. Subcutaneous sarcoidosis: a clinical analysis of nine patients.

    PubMed

    Ando, Masaru; Miyazaki, Eishi; Hatano, Yutaka; Nishio, Suehiro; Torigoe, Chihiro; Yamasue, Mari; Mukai, Yutaka; Nureki, Shin-Ichi; Kadota, Jun-Ichi

    2016-09-01

    Subcutaneous sarcoidosis is the specific subset of cutaneous sarcoidosis frequently associated with systemic disease. However, the disease activity, severity, and prognosis have not yet been elucidated due to the limited number of reported cases. The purpose of this study was to identify the clinical, laboratory, and prognostic differences between subcutaneous sarcoidosis and other type of cutaneous sarcoidosis. All patients with sarcoidosis diagnosed histopathologically from 2000 to 2012 at our institution were enrolled. The clinical, laboratory, chest X-ray, and pulmonary function test results were retrospectively evaluated in the patients with cutaneous sarcoidosis. In the 130 patients with sarcoidosis, cutaneous sarcoidosis was diagnosed in 37 patients (28.4 %), and 9 (6.9 %) of these patients had subcutaneous sarcoidosis. The serum levels of soluble interleukin-2 receptor (sIL-2R) were significantly elevated in the group of patients with subcutaneous sarcoidosis in comparison to the patients with other types of cutaneous sarcoidosis, whereas there was no significant difference in the severity score between the two groups. Following a 2-year observation period, three patients were in remission, five patients demonstrated stable disease, and one patient had progressive disease. Subcutaneous sarcoidosis may be associated with the disease activity, although it was not found to be associated with the disease severity and it was not a predictive factor for the prognosis. Furthermore, the prevalence of subcutaneous sarcoidosis may be higher than that in previously reported series. PMID:27449952

  8. Ganciclovir Injection

    MedlinePlus

    ... injection is for intravenous (into a vein) use only. Giving ganciclovir through intramuscular (into a muscle) or ... the storage of ganciclovir solution. Store your medication only as directed. Make sure you understand what you ...

  9. Methylnaltrexone Injection

    MedlinePlus

    ... injection is used to treat constipation caused by opioid (narcotic) pain medications in patients with advanced illnesses ... a class of medications called peripherally acting mu-opioid receptor antagonists. It works by protecting the bowel ...

  10. Dexamethasone Injection

    MedlinePlus

    ... severe allergic reactions. It is used in the management of certain types of edema (fluid retention and ... needed for normal body functioning) and in the management of certain types of shock. Dexamethasone injection is ...