المؤلفون: Valerio Sveva, Giacomo Farì, Annatonia Fai, Alessio Savina, Mattia Giuseppe Viva, Francesco Agostini, Maurizio Ranieri, Marisa Megna, Massimiliano Mangone, Marco Paoloni, Andrea Bernetti

المصدر: Journal of Personalized Medicine, Vol 14, Iss 2, p 154 (2024)

مصطلحات موضوعية: ultrasound-guided hydrodissection, carpal tunnel syndrome, entrapment mononeuropathy, median nerve, ultrasound-guided injections, neuropathic pain, Medicine

الوصف: Ultrasound-guided perineural hydrodissection (HD) is a novel technique that has been found to be effective in providing mechanical release of perineural adhesions and decompression of the nerve, reducing inflammation and edema and restoring its physiological function. It has a significant impact on chronic neuropathic pain (20 ± 4 weeks with VAS < 5 or VAS diminished by 2 points after the procedure). Carpal tunnel syndrome (CTS) is a common entrapment mononeuropathy, and its distribution is typically innervated by the median nerve. Patients with mild or moderate CTS may benefit from nonsurgical treatments or conservative therapies. This review was conducted following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement guidelines. Four investigators assessed each title, abstract, and full-text article for eligibility, with disagreements being resolved by consensus with two experienced investigators. The qualitative assessment of the studies was carried out using the modified Oxford quality scoring system, also known as the modified Jadad score. Furthermore, risk of possible biases was assessed using the Cochrane collaboration tool. The results of this review suggest that US-guided HD is an innovative, effective, well-tolerated, and safe technique (11 out of 923 patients had collateral or side effects after the procedure). However, further studies comparing all drugs and with a larger sample population are required to determine the most effective substance.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2075-4426/14/2/154Test; https://doaj.org/toc/2075-4426Test

الوصول الحر: https://doaj.org/article/d60bbb49e5b74e809611cb050408388cTest

المؤلفون: Tumpaj Tilen, Potocnik Tumpaj Vesna, Albano Domenico, Snoj Ziga

المصدر: Radiology and Oncology, Vol 56, Iss 1, Pp 14-22 (2022)

مصطلحات موضوعية: carpal tunnel syndrome, ultrasound-guided injections, injection approach, needle positioning, corticosteroid, local anaesthetics, Medical physics. Medical radiology. Nuclear medicine, R895-920

الوصف: Carpal tunnel syndrome (CTS), one of the most common entrapment neuropathies, can, in fact, be considered as a socio-economic issue that reduces work productivity, increases disability, and requires prolonged rehabilitation. The imaging modality of choice in CTS imaging is the ultrasound (US), as several morphological parameters can be used in CTS diagnosis and follow-up. In recent years, US-guided CTS injection therapy has become an established treatment option for mild to moderate CTS. The authors of this review performed a literature search that revealed several differences in US-guided carpal tunnel injection in an attempt to unify individual stages of CTS injections protocol for future guidance: patient preparation, injection approach, needle positioning, injected medications, and injectate volume. The three approaches to carpal tunnel injections described in the literature, that is, the ulnar, radial, and longitudinal, can be implemented with single or multiple deposits and different injection volumes. Medications used for injections are corticosteroids, local anaesthetics, dextrose, saline, platelet-rich plasma, and progesterone.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1581-3207Test

الوصول الحر: https://doaj.org/article/9add8446c54f41d4b9e7c45a288b0a57Test

المؤلفون: Christelle Darrieutort-Laffite, Louis J. Soslowsky, Benoit Le Goff

المصدر: International Journal of Molecular Sciences; Volume 21; Issue 19; Pages: 7000

مصطلحات موضوعية: Achilles tendinopathy, ultrasound-guided injections, platelet-rich plasma, stem cells, dry needling

جغرافية الموضوع: agris

الوصف: Achilles tendinopathy (AT) is a common problem, especially in people of working age, as well as in the elderly. Although the pathogenesis of tendinopathy is better known, therapeutic management of AT remains challenging. Various percutaneous treatments have been applied to tendon lesions: e.g., injectable treatments, platelet-rich plasma (PRP), corticosteroids, stem cells, MMP inhibitors, and anti-angiogenic agents), as well as percutaneous procedures without any injection (percutaneous soft tissue release and dry needling). In this review, we will describe and comment on data about the molecular and structural effects of these treatments obtained in vitro and in vivo and report their efficacy in clinical trials. Local treatments have some impact on neovascularization, inflammation or tissue remodeling in animal models, but evidence from clinical trials remains too weak to establish an accurate management plan, and further studies will be necessary to evaluate their value.

وصف الملف: application/pdf

العلاقة: Molecular Pathology, Diagnostics, and Therapeutics; https://dx.doi.org/10.3390/ijms21197000Test

الإتاحة: https://doi.org/10.3390/ijms21197000Test

مصطلحات موضوعية: ultrasound-guided injections, syringe, repurposing, sterilization, 3D printing, medical devices

الوصف: My thesis portfolio consists of a technical project paper and a sociotechnical research paper. My technical paper describes my group’s work on our Fourth Year Capstone Project under the guidance of our advisor, Dr. Jeremy Kent, M.D. of UVA Family Medicine and UVA Athletics. We were tasked with designing a double-barreled syringe device to aid in ultrasound-guided musculoskeletal injections for athletic injuries. We iterated through several design concepts, and ultimately manufactured a prototype for a device that met the majority of our design requirements. One of these requirements was that the device would be disposable after single-use in a clinical setting. Many medical devices are single-use to preserve sterility and prevent infection among patients. My sociotechnical research paper investigates the utilization of single-use and reused devices in medical settings. The lifecycle of medical devices is regulated by the Food and Drug Administration (FDA), which affects how medical device companies manufacture their devices and establish indicated use directions for hospitals and clinicians. With patient safety at the forefront of medical decisions, environmental effects and cost are also important factors to consider when developing and using medical devices. My sociotechnical research paper explores the key participants involved in medical device use, manufacturing, and regulation, and highlights recycling solutions to preserve sterility, cost, and the environment. In order to design a double-barreled syringe device, my group needed to understand the current processes and user needs for an improved design. This process of ultrasound-guided injections involves drawing up and injecting two disparate solutions (a local anesthetic and a steroid), while also holding an ultrasound probe. Currently, Dr. Kent and other clinicians draw up each solution into two different syringes and inject the anesthetic into the patient after attaching a needle. Then, the needle remains inside the patient, while the anesthetic syringe is swapped out for the steroid syringe. This is very challenging for clinicians to perform, as they may only use one hand to operate the syringe while the other hand is occupied with the ultrasound probe. The current injection method causes significant discomfort for patients, and procedural inefficiency for clinicians. With the help of Dr. Kent, we determined design specifications for ergonomic factors, leakage, and intermixing. Our group developed a device to interface with existing syringes that allows solutions to be drawn up or injected from one syringe, while blocking the other. This device uses a rotating rod design, which was 3D printed using a combination of flexible resins and hard plastic resins. Overall, the device was able to meet the ergonomic design specifications, perform with minimal leakage, and achieve no intermixing of solutions. Because medical devices, such as syringes, interface with patients, they attract microorganisms that may form biofilms on the surface of the device depending on the level of interaction between the device and human tissue. For this reason, many medical devices are single-use, especially those used internally within patients. In order to combat the environmental and financial costs of using a new device for each patient, some hospitals and medical device manufacturers are developing reuse strategies. The FDA has responded to these efforts by categorizing devices based on their level of contamination and establishing guidelines for the level of sterilization needed to reuse the device in order to provide the best care to patients. For critical devices that require the highest level of sterilization, medical device manufacturers have also considered repurposing strategies that involve recycling the device for a different application. Looking forward, in order to maintain patient safety, along with sustainability and low cost, it is essential that medical devices are classified accurately based on their material properties and use in patients in order to determine the action that can be taken after use. Working on designing the double-barreled syringe device for my capstone project allowed me to view medical devices through the lens of a clinician and medical device manufacturing company. I am very appreciative for the opportunity to work with Dr. Kent on this project, which aided in my understanding of the clinician perspective in my thesis paper. Additionally, I used literature to better understand medical waste and potential solutions to preserve the environment, while also preventing contamination across patients. Based on the FDA’s guidelines, a device such as the double-barreled syringe device could likely be reused after disinfecting, as long as a new needle was used for each patient. The device designed by my capstone group was successful in terms of meeting the needed design requirements to achieve a more comfortable and efficient device for ultrasound-guided injections. This device was intended for single-use only, however, if manufactured using more durable and antimicrobial materials, it could be developed into a reusable device to reduce cost and environmental effects using the strategies discussed in the research paper. My research paper may serve as a resource for clinicians, hospital administration, and medical device companies looking to limit the waste caused by single-use medical devices as well as cost to patients. I would like to acknowledge Dr. Kent for his help and guidance throughout my capstone project. I am thankful for Dr. Barker, Dr. Allen, Noah Perry, and Vignesh Valaboju for all of their help throughout the technical portion of my thesis. I would also like to thank Professor Norton and Professor Wayland for their insight and support in developing my research for the sociotechnical research paper.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::dd5f5273d00160624181647690b41769Test

المؤلفون: Carstensen, Stine M.D., Velander, Marie Juul, Konge, Lars, Østergaard, Mikkel, Pfeiffer Jensen, Mogens, Just, Søren Andreas, Terslev, Lene

المصدر: Carstensen , S M D , Velander , M J , Konge , L , Østergaard , M , Pfeiffer Jensen , M , Just , S A & Terslev , L 2022 , ' Training and assessment of musculoskeletal ultrasound and injection skills-a systematic review ' , Rheumatology , vol. 61 , no. 10 , pp. 3889-3901 . https://doi.org/10.1093/rheumatology/keac119Test

مصطلحات موضوعية: assessment, medical education, musculoskeletal ultrasound, technical skills, training, ultrasound-guided injections

الوصف: OBJECTIVES: To examine how residents are trained and assessed in musculoskeletal US (MSUS), MSUS-guided and landmark-guided joint aspiration and injection. Additionally, to present the available assessment tools and examine their supporting validity evidence. METHODS: A systematic search of PubMed, Cochrane Library and Embase was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and studies published from 1 January 2000 to 31 May 2021 were included. Two independent reviewers performed the search and data extraction. The studies were evaluated using the Medical Education Research Quality Instrument (MERSQI). RESULTS: A total of 9884 articles were screened, and 43 were included; 3 were randomized studies, 21 pre- and post-test studies, 16 descriptive studies and 3 studies developing assessment tools. The studies used various theoretical training modalities, e.g. lectures, anatomical quizzes and e-learning. The practical training models varied from mannequins and cadavers to healthy volunteers and patients. The majority of studies used subjective 'comfort level' as assessment, others used practical examination and/or theoretical examination. All training programs increased trainees' self-confidence, theoretical knowledge, and/or practical performance, however few used validated assessment tools to measure the effect. Only one study met the MERSQI high methodical quality cut-off score of 14. CONCLUSION: The included studies were heterogeneous, and most were of poor methodological quality and not based on contemporary educational theories. This review highlights the need for educational studies using validated theoretical and practical assessment tools to ensure optimal MSUS training and assessment in rheumatology.

الإتاحة: https://doi.org/10.1093/rheumatology/keac119Test
https://curis.ku.dk/portal/da/publications/training-and-assessment-of-musculoskeletalTest-ultrasound-and-injection-skillsa-systematic-review(4f5a6c4c-68c5-48aa-9117-1c837df8a300).html

المؤلفون: Marco Romanelli, Riccardo Morganti, Giulia Tonini, Teresa Oranges, Agata Janowska, Michela Iannone, Saverio Vitali, Bianca Benedetta Benincasa, Lorenzo Balderi, Valentina Dini

المصدر: Dermatologic Therapy. 34

مصطلحات موضوعية: medicine.medical_specialty, Triamcinolone acetonide, Dermatology, Injections, Intralesional, Triamcinolone, Severity of Illness Index, intralesional steroids, Lesion, Edema, medicine, Humans, HS flares, Hidradenitis suppurativa, Prospective Studies, Prospective cohort study, Adverse effect, Ultrasonography, Interventional, acute flare management, hidradenitis suppurativa, ultrasound guided injections, business.industry, Ultrasound, General Medicine, Dermatology Life Quality Index, medicine.disease, medicine.symptom, business, medicine.drug

الوصف: Background The management of hidradenitis suppurativa (HS) flares with intralesional steroids lacks strong scientific evidence but limited data suggest that it may be useful. Objective To assess the clinical and ultrasound responses of HS flares to ultrasound-guided injections of intralesional triamcinolone (40 mg/mL) with a dilution 1:4 vs 1:2 at 30-day (t1), 60-day (t2) and 90-day (t3) follow-up. Materials and methods We recruited patients with ≤3 acute lesions, unresponsive to topical therapy. At baseline we assessed lesions clinically and by ultra-high frequency ultrasound (48 or 70MHz) and randomly performed an ultrasound-guided injection of triamcinolone. Assessments were repeated at t1, t2 and t3 follow-up, re-injecting the lesion in the case of no or partial response. Results We treated 49 lesions: 38.8% showed improvements at t1; 46.9% at t2; 6% at t3; and 8.3% showed no clinical and ultrasound improvements. Long-term follow-up data confirmed a statistically significant reduction in VAS-pain, Dermatology Life Quality Index (DLQI), and HS-Physician Global Assessment (HS-PGA), as well as edema and vascular signals. No adverse effects were reported. Conclusions Our study suggests that ultrasound-injections with a 1:2 dilution are beneficial for HS flares that do not respond to topical treatment and should be included in the therapeutic algorithm. The preliminary results of this study were presented during the European Hidradenitis Suppurativa Foundation 2020 meeting in Athens and the abstract will be published in the supplements of Experimental Dermatology. This article is protected by copyright. All rights reserved.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::342cac190982d509d0838b29bb5603eeTest
https://doi.org/10.1111/dth.15068Test

المؤلفون: Sveva Maria Nusca, Alessandra Lacopo, Flavia Santoboni, Donatella Trischitta, Maria Chiara Vulpiani, Enrico Roberto Curci, Mario Vetrano, Francesca Musa, Eleonora Latini

المصدر: Medical Gas Research

مصطلحات موضوعية: musculoskeletal diseases, medicine.medical_specialty, Facet (geometry), facet joint syndrome, Neuroscience (miscellaneous), Review, Zygapophyseal Joint, Facet joint, facet joint injection, Lumbar, Physical medicine and rehabilitation, facet joint, medicine, Humans, oxygen-ozone, Ultrasonography, Interventional, ozone therapy, ultrasound-guided oxygen-ozone therapy, facet joint management, facet joint ultrasound-guided injections, low back pain, ozone, business.industry, Facet joint injection, Ozone therapy, musculoskeletal system, Low back pain, Arthralgia, humanities, Review article, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Action (philosophy), medicine.symptom, business, Low Back Pain

الوصف: Facet joint osteoarthritis is the most prevalent source of facet joint pain and represents a significant cause of low back pain. Oxygen-ozone therapy has been shown to have positive results in acute and chronic spinal degeneration diseases and it could be a safe and efficacious alternative to traditional facet joint conservative treatments. This review article explains the interventional facet joint management with ultrasound-guided oxygen-ozone therapy, providing an anatomy/sonoanatomy overview of lumbar facet joints and summarizing the potential mechanism of action of oxygen-ozone in the treatment of facet joint osteoarthritis, not yet fully understood.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::05a2121a6eb8a296d54e5419f0deca93Test
https://pubmed.ncbi.nlm.nih.gov/34213496Test

المؤلفون: O. A. Klochkova, A. L. Kurenkov, H. M. Karimova, B. I. Bursagova, L. S. Namazova-Baranova, L. M. Kuzenkova, A. M. Mamedyarov, G. M. Dvoryakovskaya, О. А. Клочкова, А. Л. Куренков, Х. М. Каримова, Б. И. Бурсагова, Л. С. Намазова-Баранова, Л. М. Кузенкова, А. М. Мамедьяров, Г. М. Дворяковская

المصدر: Pediatric pharmacology; Том 12, № 4 (2015); 398-406 ; Педиатрическая фармакология; Том 12, № 4 (2015); 398-406 ; 2500-3089 ; 1727-5776

مصطلحات موضوعية: шкала GMFCS, drooling, botulinum toxin A therapy, sialorrhea, drooling impact scale, GMFCS, ultrasound-guided injections, сиалорея, слюнотечение, ботулинический токсин типа А, ботулинотерапия, Шкала оценки слюнотечения

الوصف: Background. Drooling (sialorrhea) is a complex medical and social problem of patients with cerebral palsy (CP). During the last decade many methods for drooling correction in CP are under active development.Aim: to evaluate the effectiveness and safety of the first and repeated injections of botulinum toxin A (BTA) for correcting drooling in children with CP.Methods. 13 children (2 years — 14 years 7 months) with spastic forms of CP and drooling resistant to non-drug treatment. Drooling was evaluated with the Drooling Impact Scale — DIS before, 1, 3 and 6 months after the BTA injections. Parotid and submandibular salivary glands were injected under ultrasound control with Dysport — 1 group (5 children) or Botox — 2 group (8 children). The total dose of Dysport for the all glands was 120–320 U (3,8–14,5 U/kg), Botox — 30–100 U (2,5–4,5 U/kg). The median of the basic DIS index was 77 (64–90) points in the first group and 58 (53–66) points in the second group.Results. One month after the BTA injections the DIS index decreased by 20 and more points in 6 (42,2%) patients, by 10–19 points in 7 (53,8%) children. There were no persistent side effects and no difference in the BTA effectiveness between the two groups. The mean decrease of DIS was 30% in both groups. 3 months after the injections 2 patients (15,4%) kept 20 points decrease of the DIS index, 6 patients (46,2%) demonstrated 10 points decrease. 6 months after injections nearly all patients returned to the basic level of drooling. Repeated injections of the BTA demonstrated the same tendency and duration of the DIS changes. There was no significant correlation between the GMFCS level and the drooling intensity.Conclusion. BTA injections into salivary glands of children with CP was an effective and safe method of drooling correction with the maximum effect taking place 2–4 weeks after the injections and a stable effect — 3 months after the injections. ; Обоснование. Избыточное слюнотечение (сиалорея) — значимая медицинская и социальная проблема пациентов с ...

العلاقة: Bax M., Goldstein M., Rosenbaum P., Leviton A., Paneth N., Dan B., Jacobsson B., Damiano D. Proposed definition and classifi ca tion of cerebral palsy. Dev Med Child Neurol. 2005; 47 (8): 571–576.; Johnson H., Scott A. Saliva Management. In Dysphagia: Foundation, Theory and Practice. Eds. Cichero J. A. Y., Murdoch B. F. Chichester: J Wiley & Sons, Ltd. 2006. 126 р.; Левицкий Г. Н., Алёхин А. В., Сердюк А. В., Моргунова М. С., Коне ва О. Н., Скворцова В. И. Возможности медикаментозной терапии слюнотечения при болезни двигательного нейрона. Журнал неврологии и психиатрии им. C. C. Корсакова. 2005; 105 (3): 19–22.; Blasco P. A., Allaire J. H. Drooling in the developmentally disabled: management practices and recommendations. Consortium on Drooling. Dev Med Child Neurol. 1992; 34 (10): 849–862.; Бер М., Фротшер М. Топический диагноз в неврологии по Петеру Дуусу: анатомия, физиология, клиника. Пер. с англ. Под ред. З. А. Суслиной. 4-е изд. М.: Практическая медицина. 2009. С. 163–164.; Scully C., Limeres J., Gleeson M., Tomas I., Diz P. Drooling. J Oral Pathol Med. 2009; 38 (4): 321–327.; Erasmus C. E., Van Hulst K., Rotteveel L. J., Jongerius P. H., Van Den Hoogen F. J., Roeleveld N., Rotteveel J. J. Drooling in cerebral palsy: hypersalivation or dysfunctional oral motor control? Dev Med Child Neurol. 2009; 51 (6): 454–459.; Tahmassebi J. F., Curzon M. E. The cause of drooling in children with cerebral palsy hypersalivation or swallowing defect? Int J Paediatr Dent. 2003; 13 (2): 106–111.; Dodds W. J. Physiology of swallowing. Dysphagia. 1989; 3: 171–178.; Senner J. E., Logemann J., Zecker S., Gaebler-Spira D. Drooling, saliva production, and swallowing in cerebral palsy. Dev Med Child Neurol. 2004; 46 (12): 801–806.; Tahmassebi J. F., Curzon M. E. Prevalence of drooling in children with cerebral palsy attending special schools. Dev Med Child Neurol. 2003; 45 (9): 613–617.; Parkes J., Hill N., Platt M. J., Donnelly C. Oromotor dysfunction and communication impairments in children with cerebral palsy: a register study. Dev Med Child Neurol. 2010; 52 (12): 1113–1119.; Lin Y. C., Shieh J. Y., Cheng M. L., Yang P. Y. Botulinum toxin type A for control of drooling in Asian patients with cerebral palsy. Neurology. 2008; 70 (4): 316–318.; Lakraj A. A., Moghimi N., Jabbari B. Sialorrhea: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins (Basel). 2013; 5 (5): 1010–1031.; Fairhurst C. B., Cockerill H. Management of drooling in children. Arch Dis Child Educ. Pract Ed. 2011; 96 (1): 25–30.; Клочкова О. А., Куренков А. Л., Намазова-Баранова Л. С., Мамедъяров А. М. Паттерны спастичности мышц верхних конечностей и применение ботулинотерапии у пациентов с детским церебральным параличом с поражением рук. Педиатрическая фармакология. 2013; 10 (5): 31–39.; Reddihough D., Erasmus C. E., Johnson H., McKellar G. M., Jon gerius P. H. Cereral Palsy Institute. Botulinum toxin assessment, intervention and aftercare for paediatric and adult drooling: international consensus statement. Eur J Neurol. 2010; 17 (Suppl. 2): 109–121.; Naumann M., So Y., Argoff C. E., Childers M. K., Dykstra D. D., Gronseth G. S., Jabbari B., Kaufmann H. C., Schurch B., Silber stein S. D., Simpson D. M. Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008; 70 (19): 1707–1714.; Rodwell K., Edwards P., Ware R. S., Boyd R. Salivary gland botulinum toxin injections for drooling in children with cerebral palsy and neurodevelopmental disability: a systematic review. Dev Med Child Neurol. 2012; 54 (11): 977–987.; Naumann M., Dressler D., Hallett M., Jankovic J., Schiavo G., Segal K. R., Truong D. Evidence based review and assessment of botulinum neurotoxin for the treatment of secretory disorders. Toxicon. 2013; 67: 141–152.; Walshe M., Smith M., Pennington L. Interventions for drooling in children with cerebral palsy. Cochrane Database Syst Rev. 2012; 2: CD008624. Doi:10.1002/14651858.CD008624.pub2.; Носко А. С., Зыков В. П., Комарова И. Б. Коррекция сиалореи в нейропедиатрии. Фокус на препаратах ботулинического токсина типа А как метод первого ряда выбора. Детская и подростковая реабилитация. 2013; 2 (21): 33–38.; Palisano R., Rosenbaum P. L., Walter S., Russell D., Wood E., Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997; 39 (4): 214–223.; Reid S. M., Johnson H. M., Reddihough D. S. The Drooling Impact Scale: a measure of the impact of drooling in children with developmental disabilities. Dev Med Child Neurol. 2010; 52 (2): 23–28.; Reid S. M., Johnstone B. R., Westbury C., Rawicki B., Reddihough D. S. Randomized trial of botulinum toxin injections into the salivary glands to reduce drooling in children with neurological disorders. Dev Med Child Neurol. 2008; 50 (2):123–128.; Banerjee K. J., Glasson C., O’Flaherty S. J. Parotid and submandibular botulinum toxin A injections for sialorrhoea in children with cerebral palsy. Dev Med Child Neurol. 2006; 48 (11): 883–887.; Savarese R., Diamond M., Elovic E., Millis S. R. Intraparotid injection of botulinum toxin A as a treatment to control sialorrhea in children with cerebral palsy. Am J Phys Med Rehabil. 2004; 83 (4): 304–311.; Alrefai A. H., Aburahma S. K., Khader Y. S. Treatment of sialorrhea in children with cerebral palsy: a double blind placebo controlled trial. Clin Neurol Neurosurg. 2009; 111 (1): 79–82.; Lagalla G., Millevolte M., Capecci M., Provinciali L., Cera volo M. G. Botulinum toxin type A for drooling in Parkinson’s disease: a double blind, randomized, placebo controlled study. Mov Disord. 2006; 21 (5): 704–707.; Kalf J. G., Smit A. M., Bloem B. R., Zwarts M. J., Mulleners W. M., Munneke M. Botulinum toxin A for drooling in Parkinson’s disease: a pilot study to compare submandibular to parotid gland injections. Parkinsonism Relat Disord. 2007; 13 (8): 532–534.; Jongerius P. H., van den Hoogen F. J., van Limbeek J., Gabreels F. J., van Hulst K., Rotteveel J. J. Effect of botulinum toxin in the treatment of drooling: a controlled clinical trial. Pediatrics. 2004; 114 (3): 620–627.; Harris S. R., Purdy A. H. Drooling and its management in cerebral palsy. Dev Med Child Neurol. 1987; 29 (6): 807–811.; Erasmus C. E., Scheffer A. R., van Hulst K., van Limbeek J., van den Hoogen F. J., Rotteveel J. J., Jongerius P. H. Does motor perfor mance matter in botulinum toxin efficacy for drooling? Pediatr Neurol. 2011; 45 (2): 95–99.; https://www.pedpharma.ru/jour/article/view/508Test

الإتاحة: https://doi.org/10.15690/pf.v12i4.1420Test
https://doi.org/10.1002/14651858.CD008624.pub2Test
https://www.pedpharma.ru/jour/article/view/508Test

المؤلفون: Skaarup, Søren Helbo, Schmid, Johannes Martin, Skjold, Tina, Graumann, Ole, Hoffmann, Hans Jürgen

المصدر: Skaarup, S H, Schmid, J M, Skjold, T, Graumann, O & Hoffmann, H J 2021, ' Intralymphatic Immunotherapy improves grass pollen allergic rhinoconjunctivitis : A three-year randomized placebo-controlled trial ', Journal of Allergy and Clinical Immunology, vol. 147, no. 3, pp. 1011-1019 . https://doi.org/10.1016/j.jaci.2020.07.002Test

مصطلحات موضوعية: intralymphatic immunotherapy, ultrasound-guided injections, combined symptom medication score, otorhinolaryngologic diseases, allergen immunotherapy, Allergic rhinoconjunctivitis, outcome parameters

الوصف: BACKGROUND: Allergic rhinoconjunctivitis is a global health problem. Different Allergen ImmunoTherapy (AIT) regimes are marketed but have low adherence because they are expensive, complex and time consuming. New AIT forms are needed.OBJECTIVE: In a three-year follow-up double-blinded randomized placebo-controlled trial we aimed to investigate effect of intralymphatic AIT (ILIT).METHODS: Patients with grass pollen rhinoconjunctivitis were treated with either three ILIT injections and an ILIT booster one year later, three ILIT injection and a placebo booster or three placebo injections and a placebo booster. Primary outcome was improvement in a combined symptom and medication score, cSMS. A novel evaluation tool with a linear regression model of cSMS and grass pollen counts was developed. Secondary outcomes were changes in grass specific immunoglobulins and skin and nasal provocation tests to grass pollen.RESULTS: 36 patients were included. Log10 transformed cSMS was reduced by 0.30 (95%CI 0.11 - 0.49), p=0.002 equalling 48.5% (95%CI 24.5% - 62%), in the entirethree-year follow-up period, significant only in the first follow-up season but not in the second and third season. The regression model showed a 37%, pCONCLUSION: Intralymphatic immune therapy gives a substantial reduction in grass pollen allergy symptoms and use of rescue medication, significant in the first season after treatment. A booster injection had no additional effect.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pure_au_____::6ccac635e186ddf66dc7850e07c99598Test
https://pure.au.dk/portal/da/publications/intralymphatic-immunotherapy-improves-grass-pollen-allergic-rhinoconjunctivitisTest(ff257410-2934-401b-86d6-1761977c4d0e).html

المؤلفون: Iannone M., Janowska A., Oranges T., Balderi L., Benincasa B. B., Vitali S., Tonini G., Morganti R., Romanelli M., Dini V.

المساهمون: Iannone, M., Janowska, A., Oranges, T., Balderi, L., Benincasa, B. B., Vitali, S., Tonini, G., Morganti, R., Romanelli, M., Dini, V.

مصطلحات موضوعية: acute flare management, hidradenitis suppurativa, HS flare, intralesional steroid, ultrasound guided injections

الوصف: The management of hidradenitis suppurativa (HS) flares with intralesional steroids lacks strong scientific evidence but limited data suggest that it may be useful. The objective of this study is to assess the clinical and ultrasound responses of HS flares to ultrasound-guided injections of intralesional triamcinolone (40 mg/ml) with a dilution 1:4 versus 1:2 at 30-day (t1), 60-day (t2), and 90-day (t3) follow-up. We recruited patients with ≤3 acute lesions, unresponsive to topical therapy. At baseline we assessed lesions clinically and by ultra-high frequency ultrasound (48 or 70 MHz) and randomly performed an ultrasound-guided injection of triamcinolone. Assessments were repeated at t1, t2, and t3 follow-up, re-injecting the lesion in the case of no or partial response. We treated 49 lesions: 38.8% showed improvements at t1; 46.9% at t2; 6% at t3; and 8.3% showed no clinical and ultrasound improvements. Long-term follow-up data confirmed a statistically significant reduction in Visual Analogue Scale (VAS)-pain, Dermatology Life Quality Index (DLQI), and HS-Physician Global Assessment (HS-PGA), as well as edema and vascular signals. No adverse effects were reported. Our study suggests that ultrasound-injections with a 1:2 dilution are beneficial for HS flares that do not respond to topical treatment and should be included in the therapeutic algorithm.

وصف الملف: ELETTRONICO

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34297465; info:eu-repo/semantics/altIdentifier/wos/WOS:000682865400001; firstpage:e15068; journal:DERMATOLOGIC THERAPY; http://hdl.handle.net/11568/1108932Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85112595698

الإتاحة: https://doi.org/10.1111/dth.15068Test
http://hdl.handle.net/11568/1108932Test