Статті в журналах: "After Injection"

1

Abbate, Angelica, Piero Luigi Almasio, Martina Mongitore, Gaetano Di Vita, and Rosalia Patti. "Necrotizing Soft Tissue Fasciitis after Intramuscular Injection." Case Reports in Surgery 2018 (2018): 1–3. http://dx.doi.org/10.1155/2018/3945497.

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Necrotizing soft tissue fasciitis (NSTIs) or necrotizing fasciitis is an infrequent and serious infection. Herein, we describe the clinical course of a female patient who received a diagnosis of NSTIs after gluteus intramuscular injection. We also report the results of our review of published papers from 1997 to 2017. Since now, 19 cases of NSTIs following intramuscular injections have been described. We focus on the correlation between intramuscular injection and NSTIs onset, especially in immunosuppressed patients treated with corticosteroids, suffering from chronic diseases or drug addicted. Intramuscular injections can provoke severe tissue trauma, representing local portal of infection, even if correctly administrated. Otherwise, it is important not to inject drug in subcutaneous, which is a less vascularized area and therefore more susceptible to infections. Likewise, a proper injecting technique and aspiration prior to injection seem to be valid measure to prevent intra-arterial or para-arterial drug injection with the consequent massive inflammatory reaction. Necrosis at the infection site appears to be independent of the drug, and it is a strong additional risk factor for NSTIs.

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2

Seki, Chie, Jeff Kershaw, Paule-Joanne Toussaint, Kenichi Kashikura, Tetsuya Matsuura, Hideaki Fujita, and Iwao Kanno. "15O Radioactivity Clearance is Faster after Intracarotid Bolus Injection of 15O-Labeled Oxyhemoglobin than after 15O-Water Injection." Journal of Cerebral Blood Flow & Metabolism 23, no. 7 (July 2003): 838–44. http://dx.doi.org/10.1097/01.wcb.0000071889.63724.1f.

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The authors tested the hypothesis that the oxygen content of brain tissue is negligible by injecting an intracarotid bolus of 15O-labeled tracer into rats. Under the hypothesis, the clearance rates of 15O radioactivity from the brain after injections of both 15O-labeled water (H215O) and 15O-labeled oxyhemoglobin (HbO15O) should be identical. However, the logarithmic slope of the 15O radioactivity curve after HbO15O injection (0.494 ± 0.071 min-1) was steeper than that after H215O injection (0.406 ± 0.038 min−1) ( P<0.001, n = 13), where the time range used in the comparison was between 60 and 120 seconds after the injection. A possible interpretation of this result is that nonmetabolized O15O may dwell in the brain tissue for a finite period of time before it is eventually metabolized or returned to the blood stream unaltered. These findings contradict assumptions made by models currently used to measure cerebral oxygen metabolism.

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3

Li, Sean S., Suellen S. Li, and Reid A. Abrams. "Heterotopic ossification after local steroid injection." BMJ Case Reports 13, no. 12 (December 2020): e235371. http://dx.doi.org/10.1136/bcr-2020-235371.

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Pachydermodactyly (PDD) is a rare, benign disease associated with progressive swelling of the periarticular soft tissue of phalangeal hand joints typically treated with local steroid injections. We present a case of a 37-year-old man with PDD treated with local steroid injections. He later developed heterotopic ossification and para-articular calcifications in the injection sites. Heterotopic ossification is not associated with PDD nor is it a recognised complication of local steroid injections. This is the first case in literature of heterotopic ossification occurring after local steroid injection and brings to attention a new potential complication of a widely performed procedure.

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4

Grandizio, Louis C., Amy Speeckaert, Justin Brothers, Jove Graham, and Joel C. Klena. "Predictors of Recurrence After Corticosteroid Injection for Trigger Digits." HAND 12, no. 4 (September 16, 2016): 352–56. http://dx.doi.org/10.1177/1558944716668862.

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Background: We aimed to identify risk factors for recurrence of trigger digit following corticosteroid injection. Methods: A retrospective review identified patients 18 years and older who presented to a single fellowship-trained hand surgeon with a symptomatic trigger digit during a 1-year period. Baseline demographic data were recorded. Patients with persistent trigger digit after a single injection were offered a second injection. Patients refusing a second injection were excluded from our analysis. Patients with persistent symptoms after 2 injections were offered surgery. For patients with diabetes mellitus, additional information regarding method of disease control and hemoglobin A1c level was recorded. Results: The overall success of corticosteroid injection was 84% with 16% of patients requiring surgical release. Of the 240 patients successfully treated with injection, 99 (41%) required a second injection. Injections resulted in persistent triggering in 15% of patients with diabetes and 17% of patients without diabetes. A multivariate regression analysis revealed that the 2 strongest risk factors for requiring surgical release were patient age and patients whose fourth digit of the right hand was injected. Diabetes was not a risk factor for persistent triggering after corticosteroid injection. Conclusions: Our findings can be used to counsel patients prior to their initial injection and suggest that patients with diabetes can be managed with corticosteroid injection with equal efficacy compared with patients without diabetes.

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Gundle, Kenneth R., Etasha M. Bhatt, Stephanie E. Punt, Viviana Bompadre, and Ernest U. Conrad. "Injection of Unicameral Bone Cysts with Bone Marrow Aspirate and Demineralized Bone Matrix Avoids Open Curettage and Bone Grafting in a Retrospective Cohort." Open Orthopaedics Journal 11, no. 1 (May 31, 2017): 486–92. http://dx.doi.org/10.2174/1874325001711010486.

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Background:Many treatment options exist for unicameral bone cysts (UBC), without clear evidence of superiority. Meta-analyses have been limited by small numbers of patients in specific anatomic and treatment subgroups. The purpose of this study was to report the outcomes of injecting bone marrow aspirate and demineralized bone matrix (BMA/DBM) for the treatment of proximal humerus UBC.Methods:Fifty-one patients with proximal humerus lesions treated by BMA/DBM injection were retrospectively reviewed from a single academic medical center.Results:The mean number of injections performed per patient was 2.14 (range 1-5). Eleven patients underwent only one injection (22%), an additional 19 patients completed treatment after two injections (37%), four patients healed after three injections (8%), and one patient healed after four injections (2%). The cumulative success rate of serial BMA/DBM injections was 22% (11/51), 58% (30/51), 67% (34/51), and 69% (35/51). Eleven patients (22%) ultimately underwent open curettage and bone grafting, and five patients (10%) were treated with injection of calcium phosphate bone substitute.Conclusion:A BMA/DBM injection strategy avoided an open procedure in 78% of patients with a proximal humerus UBC. The majority of patients underwent at least 2 injection treatments.Level of Evidence:Level IV retrospective cohort study.

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6

Chen, Yicheng, Gaurav K. Shah, Vaishali Shah, Kevin J. Blinder, Abdallah M. Jeroudi, Anthony Leonard, Marina Gilca, et al. "Outcomes and Practice Preferences After Endophthalmitis Following Anti-VEGF Intravitreal Injection." Journal of VitreoRetinal Diseases 3, no. 6 (August 30, 2019): 411–19. http://dx.doi.org/10.1177/2474126419858492.

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Purpose: This study examines treatment-based outcomes of endophthalmitis due to antivascular endothelial growth factor (anti-VEGF) intravitreal injection and its effect on subsequent management of neovascular disease. Methods: A retrospective multicenter study was conducted of 157 patients with a diagnosis of endophthalmitis following anti-VEGF intravitreal injection at 10 major ophthalmic centers. Results: The median number of injections before endophthalmitis was 10 (range, 1 to 84 injections). Initial treatment with tap and inject with or without subsequent vitrectomy trended toward smaller visual acuity changes from baseline (4 ETDRS [Early Treatment Diabetic Retinopathy Study] letter difference vs 19 ETDRS letter difference) compared with initial vitrectomy, but the difference was not statistically significant. There was no significant change in medication choice among injections after endophthalmitis. There was a statistically significant shift away from regular interval (1- to 2-month) injections and a shift toward treat-and-extend and as-needed injection algorithms. Conclusions: The visual outcomes were not significantly different between patients who initially underwent tap and injection of antibiotics and those who underwent vitrectomy. There was no significant change in medication choice before and after endophthalmitis but there was a shift toward lower-frequency injection algorithms after postintravitreal injection endophthalmitis compared with prior.

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7

Betz, Steinbauer, Uhl, and Toepel. "Necrosis of the leg after intraarterial drug injection." Vasa 40, no. 2 (March 1, 2011): 163–66. http://dx.doi.org/10.1024/0301-1526/a000088.

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Inadvertent intraarterial injections in the context of drug abuse can cause damage to the vascular system. The clinical picture depends on the drug properties and ranges from partial ischemia to necrosis of the affected extremity. There are no current evidence-based guidelines regarding the management of intraarterial drug injections. In many cases the concept of solving vasospasm after injection is based on the use of intraarterial application of prostaglandins. We report a case in which a mixture of drugs was injected into the left femoral artery. The patient arrived 24 hours later with ischemia of the left leg at our emergency department. Angiography showed that there was no blood flowing in the leg. Despite intraarterial application of vasodilatators, regional neurolysis and thrombolyis with urokinase major amputation was unavoidable. The outcome after inadvertent injection depends on certain drug properties and the delay between injection and the beginning of therapy.

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8

Varady, Nathan, Troy Ameen, Ahab Chopra, Michael Kucharik, Paul Abraham, David Freccero, Eric Smith, and Scott Martin. "Image-guided Intraarticular Hip Injections and Risk of Infection After Hip Arthroscopy (141)." Orthopaedic Journal of Sports Medicine 9, no. 10_suppl5 (October 1, 2021): 2325967121S0028. http://dx.doi.org/10.1177/2325967121s00280.

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Objectives: Intraarticular injections are fundamental in the diagnosis and treatment of many types of hip pathology. However, there are conflicting data about their safety ≤3 months prior to hip arthroscopy. One large database study demonstrated over a two-fold increase in infection risk (with infection rates far higher than what is typically seen clinically [>1-2%]), while a recent institutional study reported 0 infections in a series of 500 patients undergoing injection within 3 months of arthroscopy. An important difference between these works was the use of image-guidance, with the former not evaluating this factor and the latter including only ultrasound (US)-guided injections. In fact, despite the growing use of US-guided hip injections, no prior study has compared the risk of complications, including infection, between US and fluoroscopic (FL)- guided hip injections prior to hip surgery. Therefore, the purposes of this study were to assess the risk of infection associated with image-guided intraarticular injections prior to hip arthroscopy and compare that risk between US and FL- guidance. Methods: This was a retrospective cohort study of patients undergoing hip arthroscopy in a large commercial claims database (MarketScan) from 2007-2017. Patients were required to have 1-year of continuous enrollment prior to and 6-months after hip arthroscopy. Patient age, sex, geographic region, medical history, surgical details, and hip injections (including image- guidance, timing, and laterality) were collected. For both the US and FL cohort, patients who underwent injection ≤3 months preoperatively and >3-12 months preoperatively were compared to those who did not undergo preoperative injection. Patients with both types of injections, with an infection diagnosis at the time of index injection, or with missing laterality data were excluded. The primary outcome of this study was surgical site infection within 6 months of surgery. Chi-squared or Fisher’s exact tests and multivariable logistic regressions were used to assess the association between preoperative hip injection and infection. Finally, we performed sensitivity analyses that did not exclude patients with an infection at time of hip arthroscopy. Results: We identified 17,093 hip arthroscopy patients (mean [SD] age 37.2 [14.0] years; 14,685 [85.9%] no injection control patients and 2,408 [14.1%] patients who underwent hip arthroscopy within 12-months of image-guided hip injection) (Table 1). In the FL cohort (n=1,219 [50.7%]), 673 (55.2%) patients underwent hip arthroscopy ≤3 months after hip injection, while 546 (44.8%) patients underwent hip arthroscopy >3-12 months following hip injection. Similarly, for the US cohort, 673 (56.6%) patients underwent hip arthroscopy ≤3 months after their hip injection, while 516 (43.4%) patients underwent hip arthroscopy >3-12 months following hip injection. Patients undergoing FL-guided (0.55%) and US-guided (0.58%) hip injection >3-12 months prior to hip arthroscopy had similar infection rates as those who did not undergo intraarticular injection in the 12 months prior to hip arthroscopy (0.50%, p=0.76 and p=0.75, respectively) (Table 1). Similarly, the infection rates for patients undergoing US-guided (0.45%) and FL-guided (0.45%) injections in the 3-months prior to arthroscopy were not significantly different from control patients who did not undergo preoperative hip injection (0.50%, p=1 for both). Results held in adjusted analysis controlling for age, sex, geography, year, smoking, and comorbidities. In reference to the no injection cohort, the adjusted odds ratio (95% CI) of postoperative infection for patients undergoing FL-guided injection ≤3 months and >3-12 months prior to hip arthroscopy were 0.90 (0.28-2.94, p=0.87) and 1.17 (0.36-3.84, p=0.80), respectively. For US-guided injection, the adjusted odds ratios at ≤3 months and >3-12 months were 0.89 (0.28-2.87, p=0.84) and 1.11 (0.34-3.60, p=0.86), respectively. Notably, infection rates in the arthroscopy ≤3 months cohort were substantially higher when including patients with an infection at the time of hip arthroscopy (FL 1.18%, US 0.74%). Conclusions: Postoperative infection following intraarticular hip injection ≤3 months prior to hip arthroscopy is rare (<0.5%) and no more common than in patients who did not undergo preoperative injection. Moreover, there do not appear to be substantial differences in infection risk between imaging-modalities. Notably, postoperative infection rates were substantially higher in sensitivity analyses where we did not exclude patients who had an infection at the time of the hip injection/aspiration. As the common procedural code for hip injections also includes aspirations, the elevated rates seen in the prior large database study were likely due to the ‘injections’ being aspirations of infected joints that then underwent arthroscopy[VNH1] . In conclusion, in the largest ever sample of patients undergoing hip injections prior to hip arthroscopy, hip injection ≤3 months prior to hip arthroscopy was not associated with increased infection risk for either US- or FL-guided injections.

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9

Katagiri, Hideki, Kentaro Yoshikawa, Alan Kawarai Lefor, Tadao Kubota, and Ken Mizokami. "Massive Preperitoneal Hematoma after a Subcutaneous Injection." Case Reports in Surgery 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/7013708.

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Preperitoneal hematomas are rare and can develop after surgery or trauma. A 74-year-old woman, receiving systemic anticoagulation, developed a massive preperitoneal hematoma after a subcutaneous injection of teriparatide using a 32-gauge, 4 mm needle. In this patient, there were two factors, the subcutaneous injection of teriparatide and systemic anticoagulation, associated with development of the hematoma. These two factors are especially significant, because they are widely used clinically. Although extremely rare, physicians must consider this potentially life-threatening complication after subcutaneous injections, especially in patients receiving anticoagulation.

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10

Boijsen, M., G. Granerus, L. Jacobsson, L. Björneld, M. Aurell, and U. Tylén. "Glomerular Filtration Rate Estimated after Multiple Injections of Contrast Medium during Angiography." Acta Radiologica 29, no. 6 (November 1988): 669–74. http://dx.doi.org/10.1177/028418518802900612.

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In twenty-six patients referred for angiography, clearance of contrast medium was determined with x-ray fluorescence analysis after multiple injections of contrast medium. A formula for correction of the injected amount, which takes into consideration the different times of contrast medium injections, approximating the total injected amount into one injection, was used. A single injection clearance of 51Cr-EDTA was determined at the same time. The results showed a good correlation between the clearance of contrast medium after multiple injections and the 51Cr-EDTA clearance after a single injection (r=0.945). The correlation between contrast medium clearance calculated without correction for the different injection times, and “Cr-EDTA clearance was the same (r=0.946), due to short angiography time and rather low clearance values in our patients. It is concluded that total plasma clearance of contrast medium can easily be estimated after multiple injections. In this way patients with a risk of developing post-angiographic renal failure can be found.

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11

Giorgi, M., S. Del Carlo, B. Łebkowska-Wieruszewska, C. Kowalski, and G. Saccomanni. "Pharmacokinetics of tramadol and metabolites after injective administrations in dogs." Polish Journal of Veterinary Sciences 13, no. 4 (December 1, 2010): 639–44. http://dx.doi.org/10.2478/v10181-010-0027-y.

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Pharmacokinetics of tramadol and metabolites after injective administrations in dogs The aim of this study was to determine the pharmacokinetics of tramadol and its main metabolites after IV and IM injections. The pharmacokinetic cross-over study was carried out on 6 healthy male beagle dogs. Tramadol was administered by intravenous (IV) and intramuscular (IM) injection at 4 mg/kg. Tramadol and its main metabolites O-desmethyl-tramadol (M1), N-,N-didesmethyl-tramadol (M2) and N-,O-didesmethyl-tramadol (M5) concentrations were measured in plasma samples by a HPLC coupled with fluorimetric detection; pharmacokinetic evaluations were carried out with a compartmental and non-compartmental model for tramadol and its metabolites, respectively. The bioavailability of the drug, ranging between 84-102% (mean 92%), was within the generally accepted values for a positive bioequivalence decision of (80-125%). After the IM injection the mean plasma drug concentration peak was reached after a Tmax of 0.34 h with a Cmax of 2.52 μg/mL. No therapeutic relevant differences were observed between IM and IV administration. The minimal effective plasma concentration was reached after a few minutes and maintained for about 6-7 h in both administrations. M1 plasma concentration was low and the amounts of the other metabolites produced were analogous in both routes of administration. In conclusion, tramadol was rapidly and almost completely absorbed after IM administration and its systemic availability was equivalent to the IV injection. The different onset time and duration of action observed were very small and probably therapeutically irrelevant. The IM injection is a useful alternative to IV injection in the dog.

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12

Emad, Mohammad Reza, Sharareh Roshanzamir, Mohsen Zafar Ghasempoor, and Shahriar Mirshamsand Parisa Sedaghat. "EFFECTIVENESS OF STRETCHING AFTER TRIGGER POINT INJECTIONS." Journal of Musculoskeletal Research 14, no. 02 (September 2011): 1250002. http://dx.doi.org/10.1142/s0218957712500029.

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Background: One of the causes of musculoskeletal pain is trigger points. Trigger point injection is one of the acceptable methods to inactivate the trigger points and provide symptomatic relief. The goal of our study was to compare the effectiveness of the injection without muscle stretching versus stretching immediately after injection of methylprednisolon in the treatment of trigger points. Methods: Seventy patients with pain in the gluteal muscles due to trigger points were recruited after explanation regarding their treatment method. A written consent was collected from the patients prior to their participation in the study. The patients had two office visits and two phone follow-ups. All the patients were treated with injections of Lidocaine and Methylprednisolon. In group (A), injection was administered without stretching. In group (B), stretching of the muscle was performed immediately after the injection. The evaluation tools were Numeric Pain Intensity Scale (NPS), Visual Analogue Scale (VAS) and Brief Pain Inventory Scale (BPI). Results: Results from VAS showed significant difference between the two groups after one month. Significant difference was seen between groups, one month and two months after the injection according to NRS. However, no significant difference was detected between two groups in BPI, except in mood. Conclusion: This study, based upon follow-ups in two months upon injection, highlights the effectiveness of muscle stretching immediately after the injection in the treatment of symptomatic gluteal trigger points.

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13

Mehta, Nishit. "Intracranial Hemorrhage and Pneumocephaly After Cervical Epidural Injection." Clinical Practice and Cases in Emergency Medicine 3, no. 4 (October 14, 2019): 369–71. http://dx.doi.org/10.5811/cpcem.2019.7.43859.

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Cervical epidural injections are commonly used to treat patients with radicular neck pain. The following is a description of a case of subarachnoid hemorrhage, subdural hemorrhage, and pneumocephaly following cervical epidural injection.

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14

Wasniewski, Therese, William Chaney, and Harvey Holt. "Hole Angle for Trunk Injection of Tree Growth Regulators and Its Effect on Weeping, Wound Closure and Wood Discoloration." Arboriculture & Urban Forestry 19, no. 3 (May 1, 1993): 131–38. http://dx.doi.org/10.48044/jauf.1993.022.

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The effects of gibberellin synthesis inhibitors injected into tree trunks on wound exudation, wound closure, and wood discoloration were determined at various times up to 23 months after treatment. Plantation grown Liriodendron tulipifera trees located in Tippecanoe County, Indiana received fourtreatments; injection of CutlessTP or Clipper 20 UL in holes drilled at an angle (45°) or straight into the tree. A special injector tip was created for the straight injections. Injection holes drilled at 45° began weeping sooner and tended to have a higher percentage of weeping during nondormancy periods than those drilled straight into trees. Holes injected with Cutless began weeping sooner and a higher percentage wept than holes injected with Clipper. Less than one percent of the total volume of wood in tree trunks was discolored by injection treatment. The amount of wood discolored was not influenced by the compass orientation of the injection hole and was the same for treatment with either Clipper or Cutless. Straight-in injections caused more discolored wood than angle injections only in trees sampled 12 months after treatment. No difference was found in wound closure rates due to the different tree growth regulators or the angle of injection. The only benefit of making injection wounds straight into trees was a slight reduction in weeping.

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15

Epözdemir, Serdar, Deniz Turan, Fatma Ulus, and Ali Alagöz. "Comparison of Single-Injection and Multiple-Injection Thoracic Paravertebral Block in Preventing Pain after Video-Assisted Thoracoscopic Surgery." Biomedical Research and Clinical Reviews 6, no. 2 (January 24, 2022): 01–06. http://dx.doi.org/10.31579/2692-9406/093.

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Aim: In our study, we aimed to compare the effect of single and multiple thoracic paravertebral block (TPVB) patients who underwent video asisted thoracoscopic surgery (VATS) on hemodynamic parameters, postoperative visual analog scale (VAS) and sedation scores, and total analgesic consumption. Materials and Method: The ASA II-III, age between 18 to 65 years, and body mass index lower than thirty, 60 patients who underwent elective VATS were included to this study. Patients were divided into two groups as single (Group S), (n:30) and multiple (Group M), (n:30) TPVB. Block was performed at T6 level in Group S and at T4, T6, T8 levels in Group M by using 21 mL 0.5 % bupivacaine. Intravenous patient controlled analgesia (PCA) was performed for both groups after surgery. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), Ramsay sedation score (RSS), tramadol consumption during 24 hours, resting and coughing VAS scores were recorded before PCA and at 30th, first, second, 6th, 12th, 20th, and 24th hours of postoperative periods. 50 mg iv dexketoprophene was administered when coughing VAS score above the 4. Despite the iv dexketoprophene, in case of consistent pain 1 gr iv paracetamol was given to the patients, and all additional analgesic requirement was recorded. Results: Hemodynamic parameters were similar in both groups during postoperative period (p>0.05). VAS scores were higher in Group M but there were not statistically significant (p>0.05). Additional analgesic requirement was significantly higher in Group M, (p>0.04). Cumulative tramadol consumption was comparable between the groups, (p>0.05). Conclusion: In TPVB, it was observed that single and multiple injections provided similar postoperative pain scores and postoperative cumulative tramadol consumption, but we observed a high additional analgesic requirement in multiple injection group. Based on this result, we concluded that there would be no need to disturb patient comfort and prolong the procedure by applying multiple injections.

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Varady, Nathan H., Troy B. Amen, Paul F. Abraham, Ahab Chopra, David M. Freccero, Eric L. Smith, and Scott D. Martin. "Image-Guided Intra-articular Hip Injections and Risk of Infection After Hip Arthroscopy." American Journal of Sports Medicine 49, no. 9 (June 23, 2021): 2482–88. http://dx.doi.org/10.1177/03635465211022798.

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Background: Although intra-articular injections are important in the management of patients who may later undergo hip arthroscopy, conflicting data are available regarding the safety of such injections when administered within 3 months of surgery. Furthermore, despite the increasing use of image-guided intra-articular hip injections, it is unknown whether the type of imaging modality used is associated with infection after hip arthroscopy. Purpose: To assess the risk of infection associated with image-guided intra-articular injections before hip arthroscopy and, secondarily, compare that risk between ultrasound (US) and fluoroscopic (FL) guidance. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective cohort study of patients in a large national insurance database who underwent hip arthroscopy between 2007 and 2017. Patients were required to have continuous enrollment from at least 1 year before to 6 months after hip arthroscopy. Patient age, sex, geographic region, medical history, surgical details, and hip injections were collected. Patients who underwent injection ≤3 months preoperatively and >3 to ≤12 months preoperatively were compared with patients who did not undergo preoperative injection. Bivariate analyses and multivariable logistic regressions were used to assess the association between ipsilateral preoperative hip injection and surgical site infection within 6 months of surgery. Results: We identified 17,987 patients (36.3% female; mean ± SD age, 37.6 ± 14.0 years) undergoing hip arthroscopy, 2276 (12.7%) of whom had an image-guided hip injection in the year preceding surgery (53.0% FL). Patients who underwent intra-articular injection ≤3 months preoperatively had similar infection rates to patients who did not undergo preoperative injection in the year before surgery for both the FL (0.46% vs 0.46%; P≥ .995) and the US cohorts (0.50% vs 0.46%; P = .76). Results persisted in adjusted analysis (FL ≤3 months: OR, 1.04; 95% CI, 0.32-3.37; P = .94; US ≤3 months: OR, 1.19; 95% CI, 0.36-3.90; P = .78). Similar results were seen for patients undergoing injections >3 to ≤12 months preoperatively. Conclusion: Postoperative infection was rare in patients undergoing intra-articular hip injection ≤3 months before hip arthroscopy and was no more common than in patients not undergoing preoperative injection. Moreover, no differences were seen in infection risk between US and FL guidance. Although intra-articular hip injections should always be administered with careful consideration, these results do not suggest that these injections are uniformly contraindicated in the 3 months preceding hip arthroscopy.

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Park, Joseph S., Kivanc Atesok, Jennifer Pierce, Benjamin Small, Venkat Perumal, and M. Truitt Cooper. "The Course of Tarsal Tunnel Syndrome after Ultrasound-Guided Injections." Foot & Ankle Orthopaedics 7, no. 1 (January 2022): 2473011421S0038. http://dx.doi.org/10.1177/2473011421s00389.

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Category: Other; Ankle; Hindfoot; Midfoot/Forefoot; Sports Introduction/Purpose: Local ultrasound (US)-guided injections of anesthetics with corticosteroids are commonly performed for the conservative treatment of tarsal tunnel syndrome (TTS). This retrospective study aimed to investigate the course of TTS after US-guided injections. Methods: The study included patients who were diagnosed with TTS and received US-guided injections as their initial conservative treatment. The patients' pain levels were noted on a scale between zero and ten before and after each injection. The patients were divided into two groups: nonsurgical and surgical groups. The nonsurgical group included patients who had received US-guided injections and were not treated surgically, and the surgical group included those who received US-guided injections and ultimately underwent surgical tarsal tunnel release (TTR). The two groups were compared in terms of age, gender, post-injection follow-up time, and the amount of pain reduction immediately after injection (ΔPN). In the surgical group, the presence or absence of additional foot and ankle pathologies requiring operative treatment during TTR, and outcomes of surgical treatment were also assessed. Results: 218 patients were diagnosed with TTS and received US-guided injections as their initial treatment. After the injections, 169 patients (77.5%) required no TTR (nonsurgical group) and 49 patients (22.5%) underwent TTR (surgical group). The average ages for the nonsurgical and surgical groups were 53.8 and 48.9 years (P = 0.03). The average time between the injection and final follow-up for the nonsurgical group was 339 days. The average time between the injection and TTR for the surgical group was 145 days. There were no differences in pain relief after the injections between the nonsurgical and surgical groups (mean ΔPN: 3.6 and 3.8, respectively). In the surgical group, 16 patients (32%) presented with additional foot and ankle pathologies that were surgically treated during TTR. The average post-surgical follow up time was 117 days. At final follow up, 41 patients (84%) in the surgical group had no pain or functional impairment. Conclusion: US-guided injection can be an effective conservative treatment option for patients with TTS. Surgical release of tarsal tunnel may improve and resolve the overall symtoms of TTS in majority of the patients who do not respond to nonsurgical treatment. Younger age and additional foot and ankle pathologies appear to be associated with greater likelihood of undergoing TTR.

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Hüzmeli, Can, Mustafa Sağlam, Bariş Döner, Serkan Çağlar, and Özkan Güngör. "Pseudohypercreatininemia after Sustanon Injection." SM Journal of Nephrology and Kidney Diseases 1, no. 2 (2017): 1–2. http://dx.doi.org/10.36876/smjnkd.1005s.

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Hwang, Catherine J., Brian H. Chon, and Julian D. Perry. "Blindness After Filler Injection." Facial Plastic Surgery Clinics of North America 29, no. 2 (May 2021): 359–67. http://dx.doi.org/10.1016/j.fsc.2021.02.002.

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Nentwich, Martin M., Yazmin Yactayo-Miranda, Fabian Schwarzbach, Armin Wolf, Anselm Kampik, and Herminia Mino de Kaspar. "ENDOPHTHALMITIS AFTER INTRAVITREAL INJECTION." Retina 34, no. 5 (May 2014): 943–50. http://dx.doi.org/10.1097/iae.0000000000000011.

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Li, Alexa L., Charles C. Wykoff, Rui Wang, Eric Chen, Matthew S. Benz, Richard H. Fish, Tien P. Wong, et al. "ENDOPHTHALMITIS AFTER INTRAVITREAL INJECTION." Retina 36, no. 7 (July 2016): 1349–56. http://dx.doi.org/10.1097/iae.0000000000000901.

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Mathen, M. K. "Monitoring after Retrobulbar Injection." Ophthalmology 95, no. 5 (May 1988): 709–10. http://dx.doi.org/10.1016/s0161-6420(88)33126-x.

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Chacko, Jerel, Kelly Levis, and Barry Hahn. "Pneumocephalus after Epidural Injection." Journal of Emergency Medicine 54, no. 3 (March 2018): e45-e47. http://dx.doi.org/10.1016/j.jemermed.2017.12.003.

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Chen, Eric, Michael Y. Lin, Joel Cox, and David M. Brown. "ENDOPHTHALMITIS AFTER INTRAVITREAL INJECTION." Retina 31, no. 8 (September 2011): 1525–33. http://dx.doi.org/10.1097/iae.0b013e318221594a.

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Okubo, Masatomo, Hiko Hyakusoku, Kouji Kanno, and Masatoshi Fumiiri. "Complications after injection mammaplasty." Aesthetic Plastic Surgery 16, no. 2 (1992): 181–87. http://dx.doi.org/10.1007/bf00450611.

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ROBERTSON, CHARLES R. "Hallucinations After Penicillin Injection." Archives of Pediatrics & Adolescent Medicine 139, no. 11 (November 1, 1985): 1074. http://dx.doi.org/10.1001/archpedi.1985.02140130012011.

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Hassan, Hatem E. "Office-based Injection Laryngoplasty: Outcome after Hydroxylapatite Injection." International Journal of Phonosurgery & Laryngology 9, no. 1 (2019): 1–5. http://dx.doi.org/10.5005/jp-journals-10023-1165.

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Ayintap, Emre, Uğurcan Keskin, Fariz Sadigov, Mesut Coskun, Nilufer İlhan, Sedat Motor, Hilal Semiz, and Nihan Parlakfikirer. "The Injection of Air/Oxygen Bubble into the Anterior Chamber of Rabbits as a Treatment for Hyphema in Patients with Sickle Cell Disease." Journal of Ophthalmology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/696302.

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Анотація:

Purpose.To investigate the changes of partial oxygen pressure (PaO2) in aqueous humour after injecting air or oxygen bubble into the anterior chamber in sickle cell hyphema.Methods.Blood samples were taken from the same patient with sickle cell disease. Thirty-two rabbits were divided into 4 groups. In group 1 (n=8), there was no injection. Only blood injection constituted group 2 (n=8), both blood and air bubble injection constituted group 3 (n=8), and both blood and oxygen bubble injection constituted group 4 (n=8).Results.The PaO2in the aqueous humour after 10 hours from the injections was 78.45 ± 9.9 mmHg (Mean ± SD) for group 1, 73.97 ± 8.86 mmHg for group 2, 123.35 ± 13.6 mmHg for group 3, and 306.47 ± 16.5 mmHg for group 4. There was statistically significant difference between group 1 and group 2, when compared with group 3 and group 4.Conclusions.PaO2in aqueous humour was increased after injecting air or oxygen bubble into the anterior chamber. We offer to leave an air bubble in the anterior chamber of patients with sickle cell hemoglobinopathies and hyphema undergoing an anterior chamber washout.

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Wehrlin, Chloé, Diane Picard, Frederic Tankéré, Rémi Hervochon, and Claire Foirest. "Pain in Patients with Post Paralytic Hemifacial Spasm: Before, during and after Botulinum Toxin Injections." Toxins 14, no. 1 (December 27, 2021): 20. http://dx.doi.org/10.3390/toxins14010020.

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It is well-established that botulinum toxin (BT) injections improve quality of life in patients with postparalytic hemifacial spasm. Nevertheless, injection-related pain and contracture-related pain have not yet been studied. The primary objective of our study was to evaluate injection-related pain in patients with facial palsy sequelae, and to compare the standard technique (syringe) with the Juvapen device. The secondary objective was to evaluate the improvement of contracture-related pain one month after BT injection. Methods: We conducted an observational, prospective, monocentric study based on 60 patients with facial palsy sequelae who received BT injections in our university ENT (ear, nose throat) department. There were 30 patients in the Juvapen group (J) and 30 in the standard technique group (ST). All patients completed Numerical Rating Scale (NRS) questionnaires immediately after the injections and one month later. Results: The average NRS score was 1.33/10 with Juvapen and 2.24/10 with the standard technique (p = 0.0058; Z = 2.75). In patients with contracture-related pain, the average NRS score was 3.53 before BT injection, and 0.41 one month after BT injection (p = 0.0001). Conclusions: Juvapen is a less-painful injection technique than the standard one. BT reduces contracture-related pain one month after injection.

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Gordin, Vitaly. "Gadolinium Encephalopathy After Intrathecal Gadolinium Injection." Pain Physician 5;13, no. 5;9 (September 14, 2010): E321—E326. http://dx.doi.org/10.36076/ppj.2010/13/e321.

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Background: Gadolinium-induced encephalopathy is a well documented complication due to the inadvertent entrance of a high dose of gadolinium into the intrathecal compartment. In lab animals, injecting gadolinium into the intrathecal compartment resulted in neurotoxicity and seizures. It is also well recognized that the presence of autologous blood in the intrathecal compartment can cause a broad range of neurological changes that can include seizures and mental status changes. At the time of writing this report, there were no references in the literature of simultaneous injection of gadolinium and blood into the subarachnoid space. Case: We present a case of a patient who received a high dose of gadolinium in the epidural space for needle placement confirmation during a fluoroscopically-guided epidural steroid injection for the treatment of lumbar radiculopathy. The injection was complicated by a wet tap necessitating an epidural blood patch for post-dural puncture headache. Shortly after the injection of the autologous blood, the patient developed grand-mal seizures and mental status changes requiring endotracheal intubation and admission to an intensive care unit. We describe the clinical course and management, as well as brain MRI findings and cerebrospinal fluid (CSF) changes. The patient made a complete recovery and was discharged. Conclusion: This case reinforces the need for using a low dose of gadolinium for the confirmation of needle placement in the epidural space, especially in procedures that carry the risk of inadvertent intrathecal injection. We attribute these findings to inadvertent simultaneous intrathecal injection of high dose gadolinium and autologous blood. A literature review of the cases of gadolinium-induced encephalopathy is provided followed by discussion. Key words: Postdural puncture headache, epidural blood patch, intrathecal gadolinium, seizures, mental status changes, encephalopathy

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Huang, Ko-Jung, Cheng-Han Li, Ping-Kun Tsai, Chia-Chun Lai, Yu-Ren Kuo, Ming-Kun Hsieh, and Ching-Wei Cheng. "Electromagnetic Force-Driven Needle-Free in Ovo Injection Device." Veterinary Sciences 9, no. 3 (March 21, 2022): 147. http://dx.doi.org/10.3390/vetsci9030147.

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Needle-free injections are mainly used for administering human or mammalian vaccines or drugs. However, poultry vaccines, in ovo injections to embryos, subcutaneous injections to chickens, and intramuscular injections are administered using needle injections. This article presents a new needle-free in ovo injection device method that uses push-pull solenoids to eject liquid jets, mainly for embryonic eggs of chickens. Furthermore, our study investigated the suitable jet pressures for using this method and the post-injection hatching rates in 18-day-old embryonic eggs. Using this method, we could deliver the liquid to the allantoic and amniotic cavities or the muscle tissue through the egg membrane of the air chamber using a jet pressure of ~6–7 MPa or ~8 MPa. After injecting 0.25 mL of 0.9% saline into 18-day-old Lohmann breed layer embryonic eggs and specific pathogen-free (SPF) embryonic eggs at a jet pressure of ~7 MPa, we observed hatching rates of 98.3% and 85.7%, respectively. This study’s electromagnetic needle-free in ovo injection device can apply vaccine or nutrient solution injection for embryo eggs and serve as a reference for future studies on needle-free in ovo injection automation systems, jet pressure control, and injection pretreatment processes.

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Nozaki, Kazuhiko, Yoshihiko Uemura, Shinichiro Okamoto, Haruhiko Kikuchi, and Noboru Mizuno. "Relaxant effect of calcitonin gene-related peptide on cerebral arterial spasm induced by experimental subarachnoid hemorrhage in dogs." Journal of Neurosurgery 71, no. 4 (October 1989): 558–64. http://dx.doi.org/10.3171/jns.1989.71.4.0558.

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✓ This study examines the relaxant effect of calcitonin gene-related peptide (CGRP), a 37-amino acid peptide with a potent vasodilator action, on cerebral arterial spasm after subarachnoid hemorrhage (SAH). The spasm was induced by injecting autologous arterial blood percutaneously into the cisterna magna in adult mongrel dogs. The single-injection model of SAH was produced by injection of 1.0 ml/kg body weight of blood (on Day 0), and the double-injection model involved two successive injections of 0.5 ml/kg body weight of blood made 48 hours apart (on Day 0 and Day 2). On vertebral angiograms, arterial narrowing of the major cerebral arteries was most prominent on Day 3 after SAH in the single-injection model and on Day 7 in the double-injection model. When 10−10 mol/kg of CGRP was administered intracisternally in the single-injection model on Day 3, the diameter of the spastic cerebral arteries, as determined by angiography, recovered to normal. After intracisternal administration of 10−11 to 2 × 10−10 mol/kg of CGRP on Day 7 in double-injection models, spastic cerebral arteries dilated in a dose-dependent manner. The dilatory effect of CGRP continued for a few hours after administration. The results suggest that CGRP injected intracisternally may reverse cerebral arterial spasm after SAH.

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An, T. W., S. L. Boone, M. I. Boyer, R. H. Gelberman, D. A. Osei, and R. P. Calfee. "Effect of ice on pain after corticosteroid injection in the hand and wrist: a randomized controlled trial." Journal of Hand Surgery (European Volume) 41, no. 9 (September 28, 2016): 984–89. http://dx.doi.org/10.1177/1753193416657678.

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This prospective, randomized controlled study was designed to determine if applying ice to the site of corticosteroid injections in the hand and wrist reduces post-injection pain. Patients receiving corticosteroid injections in the hand or wrist at a tertiary institution were enrolled. Subjects were randomized to apply ice to the injection site and take scheduled over-the-counter analgesics ( n = 36) or take scheduled over-the-counter analgesics alone ( n = 32). There were no significant differences in the mean pain score between the two groups at any time-point (pre-injection or 1–5 days post-injection). In regression modelling, the application of ice did not predict pain after injection. Visual analogue pain scores increased at least 2 points (0–10 scale) after injection in 17 out of 36 patients in the ice group versus ten out of 32 control patients. We conclude that the application of ice in addition to over-the-counter analgesics does not reduce post-injection pain after corticosteroid injection in the hand or wrist. Level of Evidence: I Therapeutic Study

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P. S, Khatavkar, Dawane J. S. Dawane J. S, Pandit V. A. Pandit V. A, and Suryawanshi S. P. Suryawanshi S. P. "Assessing the Understanding and Perfection in Performing the Injection Techniques after Exposure to Mannequins." Biomedical and Pharmacology Journal 15, no. 3 (September 29, 2022): 1407–13. http://dx.doi.org/10.13005/bpj/2477.

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Unsafe injection practices put patients and healthcare providers at risk of infectious and other complications. Giving injection by correct technique is an important skill. In the present undergraduate curriculum, teaching is based on making the medical graduates, a competent doctors and giving injections safely is a must know competency. We have given them the exposure through different methods and tried to evaluate the impact of it. Objectives: To assess the knowledge of 2nd phase MBBS students about the proper techniques of injections and to assess confidence level and skill of performing these injections. Method: After obtaining the ethical committee approval, a cross sectional questionnaire based study was conducted in the Department of Pharmacology. Undergraduate students of phase 2 MBBS were included in the study. The background and purpose of the study was explained. Information about the correct methods of different injection techniques were already provided to them by different modules - Lecture, Routes display, videos and Demonstration on mannequins. The actual training of techniques on mannequins. A predesigned, validated, structured questionnaire was used for data collection. After hands - on training, the questionnaire was applied. Data obtained was analysed with Graph pad prism 6. Results-As per the students Intravenous (52.1%) and Intramuscular (30.3%) injections are most commonly used techniques. (97.5%) say aspiration is must to confirm the needle in vein and (95.8%) appearance of bleb for intradermal injection. Tuberculosis-(77.3%) spreads with unsafe injection. Only (45.4%) think injection file should be used for ampoule cutting. Conclusion: The Students definitely showed confidence in injection techniques on mannequins. Still small number of students look confused, require more practice sessions. Attention need to be given for understanding along with the practice to reduce the misconceptions.

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Enomoto, Hiroko, Masahiko Sugimoto, Shin Asami, and Mineo Kondo. "Progress of Diabetic Macular Edema after Loading Injection of Anti-Vascular Endothelial Growth Factor Agents in Real-World Cases." Medicina 58, no. 10 (September 21, 2022): 1318. http://dx.doi.org/10.3390/medicina58101318.

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Background and Objectives: To evaluate the recurrence of diabetic macular edema (DME) after loading an injection of anti-VEGF agents by a pro re nata (PRN) protocol using central retinal thickness (CRT) as a re-injection criterion. Materials and Methods: This is a retrospective, observational single-center study. DME patients with a central retinal thickness (CRT) over 350 μm received a PRN injection of anti-VEGF agents following one to three consecutive monthly loading injections (bevacizumab, ranibizumab, and aflibercept) for 6 months from January 2012 to June 2019. Results: We enrolled a total of 72 eyes for loading injections and the mean CRT improved from 434.04 ± 139.4 μm (before treatment) to 362.9 ± 125.0 μm after the loading injection. One week after injection, 36 eyes (50%) obtained a CRT of ≤350 μm. Fourteen eyes (19.4%) remained with a CRT of ≤350 μm for 6 months without additional injections. A total of 22 eyes (30.6%) had a CRT of >350 μm at 6 months. Fifteen eyes did not receive additional injections because of visual improvement. Conclusions: About 20% of DME patients can be maintained at a CRT of ≤350 μm for 6 months with only a loading injection. However, there is a tendency to delay additional injections for patients with recurrences using PRN protocol.

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Deckers, Nynke, Catharina A. Ruigrok, Hans Peter Verhoeve, and Nicky Lourens. "Comparison of pain response after subcutaneous injection of two maropitant formulations to beagle dogs." Veterinary Record Open 5, no. 1 (February 2018): e000262. http://dx.doi.org/10.1136/vetreco-2017-000262.

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The antiemetic maropitant, with metacresol as preservative (Cerenia, Zoetis), has been associated with pain after subcutaneous injection in dogs and cats. Recently, a generic formulation containing benzyl alcohol was authorised (Prevomax, Le Vet). Benzyl alcohol is reported to have local anaesthetic properties and reduce injection pain. This study compared local pain after subcutaneous injection of the two maropitant formulations, administered at approximately 4°C and 25°C, to dogs. Thirty-two healthy beagle dogs were enrolled into a blinded, randomised, cross-over study. Dogs received subcutaneous injections of maropitant injection containing metacresol as preservative and maropitant injection containing benzyl alcohol as preservative, both at approximately 4°C and 25°C, with at least three days in between treatments. Injection pain was evaluated by two blinded observers using a visual analogue scale immediately after injection and a simple descriptive scale at two minutes after injection. In healthy beagle dogs, subcutaneous injection of maropitant with benzyl alcohol is significantly less painful than injection of maropitant with metacresol.

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Andre, Anthony, Nicholas Squittieri, and Satyashodhan Patil. "Evaluation of the Octreotide Acetate Pen Injector in a Formative Human Factors Study." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A1018. http://dx.doi.org/10.1210/jendso/bvab048.2083.

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Abstract Introduction: Subcutaneous injection of octreotide acetate is indicated to treat adults with acromegaly and diarrhea associated with carcinoid tumors or vasoactive intestinal peptide tumors. In this formative human factors study, we evaluated the readability and comprehension of the instructions for use (IFU) and ease of use of the octreotide pen injector. Methods: The study enrolled patients and healthcare practitioners who would be using the pen injector. The IFU contained a stepwise process with illustrations to detail injection administration and safe storage of the octreotide pen injector. Participants read the IFU and familiarized themselves with the device. Participants administered 2 unaided injections into skin-like pads. Injection success was defined as an attempt that delivered the correct dose into the pad. Each injection was evaluated by objective performance and subjective measures. Objective performance measures included assessment of steps necessary to deliver the correct medication dose and ensure user safety. Subjective measures included soliciting participant feedback on perceived success and difficulties administering a dose with the octreotide pen injector, as well as suggestions for improvements. Additional goals included evaluation of the IFU and octreotide pen injector usability aspects. Results: A total of 8 patients and 3 healthcare practitioners enrolled in the study. All (n = 11) participants successfully administered both injections, leading to an overall injection success rate of 100% across twenty-two injections. Subtask errors included participants priming the pen injector with the incorrect dose (n = 1) and not holding the injection button for 10 seconds after the injection (n = 2), but neither error resulted in dosing failure. Participant suggestions for improving the IFU included changes to the illustration of the plunger, reordering statements to clarify the priming process, and detailing how long to let the pen injector come to room temperature. Conclusion: Overall, participants felt the octreotide pen injector was easy to use and the instructions were clearly written and illustrated. Participant feedback and observations by moderators of the study led to recommendations for improvements to the clarity of the IFU.

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EJ, Cuadra. "Effects of Injecting GnRH 48 Hours after PGF2α on the Dynamic Follicular and Luteal Endocrine Cells in Post - Pubertal Holstein Heifers". Open Access Journal of Veterinary Science & Research 4, № 3 (2019): 1–5. http://dx.doi.org/10.23880/oajvsr-16000186.

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Eighteen cycling Holstein heifers were allotted at random by weight and body condition score to one of two treatments to evaluate the effects of GnRH on luteal response when injected 48 hours (h) after the first injection in a 10 day interval between two i njections of PGF2α . Heifers in the control group (n=9) received an injection of saline 48 h after the first injection of PGF2α; however, heifers in the μg) 48treatmenthafter group n=9) received an injection of GnRH (100 the first injection of PGF2α. Heife rs were checked for estrus 3 times daily for 60 minutes each time. Blood samples were collected for analysis of progesterone on d ays 0 (first injection of PGF2α), 2 (48 h after the fi rst injection), 10 ( at the second injection of PGF2) and at day 17 (7 days a fte r the second injection of PGF2α ). Plasma samples were analyzed fo r concentration of progesterone via radioimmunoassay to evaluate luteal cell function. Concentrations of progesterone did not differ between the control heifers and treatment animals at any day of the study. However, heifers treated with GnRH showed a significant decline in concentration of progesterone from day 0 to day 2 in a luteal response to the injection; nevertheless, concentrations of progesterone increased significantly from day 2 t o day 10. Thus, this data demonstrated that injecting GnRH 48 h after PGF2α either speeds up formation of new corpus luteum or prevents full regression of the corpus luteum present prior to the first injection of PGF2α.

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Manning, C. J., R. Delaney, and M. J. Hayton. "Efficacy and tolerability of Day 2 manipulation and local anaesthesia after collagenase injection in patients with Dupuytren’s contracture." Journal of Hand Surgery (European Volume) 39, no. 5 (May 29, 2013): 466–71. http://dx.doi.org/10.1177/1753193413490899.

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In clinical trials, treating Dupuytren’s contracture with collagenase injection involves manipulation the day after injection, without local anaesthesia. We evaluated the efficacy and tolerability of manipulation 2 days after injection with local anaesthesia. Forty-five patients received 50 injections into cords contracting metacarpophalangeal and proximal interphalangeal joints; follow-up visits were at 3 and 14 weeks. For the metacarpophalangeal joints there were >90% reduction in contracture at both visits. The proximal interphalangeal joints that improved spontaneously after metacarpophalangeal injection or received direct injections showed 51–55% reduction in contracture. Changes in scores on the Patient Evaluation Measure suggest that patients perceived improvements in their hand function was good and they were satisfied with the procedure. Collagenase and local anaesthesia injections were well tolerated; adverse events were localized to the injection site and were mild and transient in nature. These findings provide another viable option for practising surgeons and may help with the logistics of patient care.

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Simopoulos, Thomas T. "Vertebral Osteomyelitis: A Potentially Catastrophic Outcome after Lumbar Epidural Steroid Injection." October 2008 5;11, no. 10;5 (October 14, 2008): 693–97. http://dx.doi.org/10.36076/ppj.2008/11/693.

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Background and Objective: Epidural steroid injections are commonly used to palliate the symptoms of spinal stenosis. Deep tissue infection is a known potential complication of these injections. There have been no previous published cases of osteomyelitis without epidural abscess after such injections. We present a case in an elderly patient who presented only with persistent axial low back pain following a lumbar epidural steroid injection (LESI). We emphasize early patient evaluation, consideration of infectious predisposing factors, sterile technique, and skin disinfectant. Design: Open-label case report. Case description: A 77-year-old diabetic male with a history of radicular pain related to lumbar spinal stenosis was treated successfully several years prior with a series of lumbar epidural steroid injections (LESI) and was re-treated with LESIs for recurrent symptoms. Following his second epidural injection, he presented with back pain and induration at the injection site without fever or neurological deficits. Urgent magnetic resonance imaging (MRI) revealed a soft tissue abscess extending close to the epidural space around the corresponding L4/L5 vertebral level. The patient recovered after incision and drainage of the abscess which was associated with an osteomyelitis of the L4 and L5 vertebral spine. The causative organism was methicillin-resistant Staphylococcus Aureus. Conclusion: This case demonstrates that even with proper aseptic techniques, immune-compromised patients who are colonized with an aggressive micro-organism may develop a potentially catastrophic infectious complication if subtle persistent symptomatic complaints are not promptly and carefully evaluated. Key words: osteomyelitis, epidural steroid injection, methicillin-resistant staphylococcus aureus (MRSA)

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Tsimkhes, I. "Gas gangrene after drug injections. Dr. Herbert lunghans (Deutsch.medic. Wochenschr. 1933. No. 22)." Kazan medical journal 29, no. 10 (January 12, 2022): 837. http://dx.doi.org/10.17816/kazmj90161.

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Gas gangrene after drug injections. Dr. Herbert liinghans (Deutsch.medic. Wochenschr. 1933. No. 22), after analyzing his case of gas gangrene after an injection of digipurate, cites from the literature 60 cases where gas gangrene developed at the injection site of the same medicinal substances.

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Wyssmüller, Iris, Karen Schaal, Sebastian Wolf, and Martin Zinkernagel. "Recurrent Blood Pressure Rise after Treatment with Anti-vascular Endothelial Growth Factor Agents." Klinische Monatsblätter für Augenheilkunde 237, no. 04 (February 24, 2020): 454–57. http://dx.doi.org/10.1055/a-1081-1635.

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Abstract Background It has previously been shown that the process of anti-vascular endothelial growth factor (VEGF) injections can lead to a significant increase of blood pressure. The aim of this study was to investigate whether this blood pressure increase was reproducible with repeated anti-VEGF injections. Patients and Methods Patients with a systolic blood pressure of ≥ 180 mmHg during previous injections who were scheduled for further injections were asked to participate in this study. Systolic as well as diastolic blood pressure was measured before, during, and after the intravitreal injection process. Results Thirty-nine patients (21 females, 18 males) with a mean age of 75 years (range 34 – 94 years) were included in this extension of the FEAR study. At first, clinical systolic blood pressure rose from an average of 157.3 ± 5.9 mmHg to 175 ± 6.7 mmHg at the time of the injection process (p < 0.01). Diastolic blood pressure rose from an average of 75.72 ± 4.2 mmHg to 84.44 ± 7.3 mmHg (p < 0.13) at the time of the injection process. Overall, the majority of the participants (56%, N = 22) had a systolic blood pressure of ≥ 180 mmHg. Conclusions Our results show that the blood pressure increase occurs persistently during the injection process in some patients. Repeated episodes of severe hypertension may predispose patients to cardiovascular events, especially those with concomitant cardiovascular risk factors.

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Mun, Yongseok, Kyu Hyung Park, Sang Jun Park, and Se Joon Woo. "Efficacy of anti-vascular endothelial growth factor agents for treating neovascular age-related macular degeneration in vitrectomized eyes." PLOS ONE 16, no. 6 (June 10, 2021): e0252006. http://dx.doi.org/10.1371/journal.pone.0252006.

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Purpose To evaluate the efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for treatment of neovascular age-related macular degeneration (nAMD) in vitrectomized eyes. Methods The medical records were reviewed of nAMD patients treated with anti-VEGF agents who previously underwent pars plana vitrectomy (PPV). PPV was performed with complete posterior vitreous detachment induction. Results A total of 44 eyes from 44 patients were included. The mean central foveal thickness (CFT) was 478.50 ± 156.93 μm at baseline, 414.25 ± 143.55 μm (86.6% of baseline) at 1 month after first injection (P < 0.001), and 386.75 ± 141.45 μm (80.8% of baseline) after monthly multiple injections (2.30 ± 1.07; range, 1–5) (P < 0.001). The mean logarithm of the minimum angle of resolution best-corrected visual acuity visual acuity (BCVA) was 0.85 ± 0.57 at baseline, 0.86 ± 0.63 after the first injection, and 0.84 ± 0.64 after monthly multiple injections. BCVA improved in 39.5% at 1 month after first injection and 45.2% at 1 month after monthly multiple injections. In the subgroup analysis, CFT of eyes with the posterior capsule decreased significantly to 85.8% and 79.8% of baseline values at 1 month after the first injection and after monthly multiple injections, respectively. CFT of eyes without the posterior capsule decreased to 91.6% and 87.4% of baseline values at 1 month after the first injection and after monthly multiple injections, respectively, without statistical significance. Conclusion Monthly injections of Intravitreal anti-VEGF agents induced favorable anatomical improvement and vision maintenance in vitrectomized eyes with nAMD.

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Hannon, Bailey G., Stephen A. Schwaner, Elizabeth M. Boazak, Brandon G. Gerberich, Erin J. Winger, Mark R. Prausnitz, and C. Ross Ethier. "Sustained scleral stiffening in rats after a single genipin treatment." Journal of The Royal Society Interface 16, no. 159 (October 16, 2019): 20190427. http://dx.doi.org/10.1098/rsif.2019.0427.

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Scleral stiffening has been proposed as a therapy for glaucoma and myopia. Previous in vivo studies have evaluated the efficacy of scleral stiffening after multiple treatments with a natural collagen crosslinker, genipin. However, multiple injections limit clinical translatability. Here, we examined whether scleral stiffening was maintained after four weeks following a single genipin treatment. Eyes from brown Norway rats were treated in vivo with a single 15 mM genipin retrobulbar injection, sham retrobulbar injection, or were left naive. Eyes were enucleated either 1 day or four weeks post-injection and underwent whole globe inflation testing. We assessed first principal Lagrange strain of the posterior sclera using digital image correlation as a proxy for scleral stiffness. Four weeks post-injection, genipin treatment resulted in a 58% reduction in scleral strain as compared to controls ( p = 0.005). We conclude that a single in vivo injection of genipin effectively stiffened rat sclera for at least four weeks which motivates further functional studies and possible clinical translation of genipin-induced scleral stiffening.

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Thomas, Benjamin S. "Leukocytoclastic Vasculitis after Steroid Injection." Internal Medicine 51, no. 17 (2012): 2491. http://dx.doi.org/10.2169/internalmedicine.51.8238.

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46

Sanabria, Maria Rosa, Javier A. Montero, María Victoria Losada, Marta Fernández-Muñoz, Alicia Galindo, Itziar Fernández, Rosa M. Coco, and Ana Sampedro. "Ocular Pain After Intravitreal Injection." Current Eye Research 38, no. 2 (January 18, 2013): 278–82. http://dx.doi.org/10.3109/02713683.2012.758290.

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Tabs, Dunja, Tihomir Vejnovic, Vesna Kopitovic, and Nada Tabs. "Labour after intracytoplasmic sperm injection." Medical review 61, no. 1-2 (2008): 60–64. http://dx.doi.org/10.2298/mpns0802060t.

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Introduction. The aim of our study was to describe labour characteristics after intracytoplasmic sperm injection programe. This is the first study of those deliveries at the Department of Gynecology and Obstetrics in Novi Sad. Patients and methods. Subjects were 73 parturients and their babies from the intracy?toplasmic sperm injection programe (48 singletons, 22 twins and 3 triplets), delivered from January 1st, 2001 to December 31st, 2006. Results. At the Department of Gynecology and Obstetrics in Novi Sad, 0.65% of all deliveries are those from assisted reproductive programes. 30.67% of all labours after assisted reproductive programes are after intracytoplasmic sperm injection. One half of all labours after intracytoplasmic sperm injection are twins. The mean age of women is 33-34. More than 95% of all babies were delivered by Cesarean section. Discussion. The most frequent pathologies in labours after intracytoplasmic sperm injection are hypertensive disorders and premature rup?ture of membranes. There is still a matter of debate what is a real cause for those pathologies, especially for hypertension (age of woman, laboratory factors and/or induction of ovulation). Conclusion. At the Department of Gynecology and Obstetrics in Novi Sad, one third of all deliveries after assisted reproductive programe are after intracytoplasmic sperm injection. The most frequent pathologies after intracytoplasmic sperm injection are hypertensive disorders, which is similar to findings of other authors. The mean age of women is also similar to the mean European age of women after intracytoplasmic sperm injection. .

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Levy, Jaime, and Tova Lifshitz. "Lidocaine hypersensitivity after subconjunctival injection." Canadian Journal of Ophthalmology 41, no. 2 (April 2006): 204–6. http://dx.doi.org/10.1139/i06-010.

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Toklu, Yasin, Ozge Sarac, Sule Berk, and Saban Simsek. "Angioedema after intravitreal bevacizumab injection." Cutaneous and Ocular Toxicology 31, no. 1 (February 7, 2012): 85–86. http://dx.doi.org/10.3109/15569527.2011.609207.

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Leong, Rupert W. L., Yuk T. Lee, Wai K. Leung, and Joseph J. Y. Sung. "Histologic findings after cyanoacrylate injection." Gastrointestinal Endoscopy 54, no. 6 (December 2001): 751. http://dx.doi.org/10.1067/mge.2001.117963.

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