Injections

注射
  • 文章类型: Journal Article
    注射剂的使用可以有效地治疗男性面部美学最关注的区域。由于与女性相比,男性的面部解剖结构存在显着差异,治疗策略,剂量,和技术不同。本文将回顾药理学,准备,相关的解剖学,技术,风险,以及与强调男性解剖学和美学独特差异的注射剂相关的不良事件。
    The use of injectables can effectively treat the areas of greatest facial esthetic concern in males. Due to significant differences in the facial anatomy of men compared to women, treatment strategy, dosage, and technique differs. This article will review the pharmacology, preparation, pertinent anatomy, technique, risks, and adverse events associated with injectable agents emphasizing unique differences in male anatomy and esthetics.
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  • 文章类型: Systematic Review
    牙周炎非手术治疗的金标准是刮削和牙根平整(SRP)。近年来,自体血小板浓缩物的使用已经遍布牙科的许多专业,因此,在牙周治疗中也越来越受欢迎。它的两个主要部分是富血小板血浆(PRP)和富血小板纤维蛋白(PRF),which,自2014年起,也可以通过注射作为可注射的富血小板纤维蛋白(i-PRF)使用。作者根据PRISMA2020指南进行了全面的系统评价。它涉及搜索PubMed,Embase,Scopus,和GoogleScholar数据库使用短语(“根平整”或“牙龈下刮治”或“牙周清创”)和(“富含血小板的血浆”)。根据作者的纳入和排除标准,12个结果包括在审查中,在1170个总结果中。本综述的目的是确定在SRP中使用PRP和i-PRF的影响。结果表明,发现PRP和i-PRF的掺入与牙龈袋深度和临床附着水平的差异显着相关;然而,i-PRF在改善临床参数方面显示出优越性。此外,i-PRF对牙龈卟啉单胞菌表现出明显的杀菌效果。另一方面,PRP在临床参数改善方面被证明不如Nd:YAG激光;但是,它也表现出显著的效率。这篇文献综述使作者得出结论,自体血小板浓缩物可能是改善SRP治疗效果的有效药物。
    The gold standard in the non-surgical treatment of periodontitis is scaling and root planing (SRP). In recent years, the use of autogenous platelet concentrates has spread over many specialties in dentistry and, thus, has also been gaining popularity in periodontal treatment. Its two main fractions are platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), which, since 2014, can also be used via injection as injectable platelet-rich fibrin (i-PRF). The authors conducted a comprehensive systematic review in accordance with the PRISMA 2020 guidelines. It involved searching PubMed, Embase, Scopus, and Google Scholar databases using the phrases (\"Root Planing\" OR \"Subgingival Curettage\" OR \"Periodontal Debridement\") AND (\"Platelet-Rich Plasma\"). Based on the authors\' inclusion and exclusion criteria, 12 results were included in the review, out of 1170 total results. The objective of this review was to ascertain the impact of utilizing PRP and i-PRF in SRP. The results revealed that both the incorporation of PRP and i-PRF were found to be significantly associated with are duction in gingival pocket depth and again in clinical attachment level; however, i-PRF demonstrated superiority in improving clinical parameters. Furthermore, i-PRF demonstrated notable bactericidal efficacy against Porphyromonas gingivalis. On the other hand, PRP proved inferior to an Nd:YAG laser in clinical parameter improvement; however, it demonstrated significant efficiency as well. This literature review led the authors to the conclusion that autologous platelet concentrates might be competent agents for improving the therapeutic outcomes of SRP.
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  • 文章类型: Journal Article
    肌筋膜疼痛综合征(MPS)是一种常见的肌肉骨骼疾病,以肌肉疼痛为特征,压痛,和触发点。超声检查已成为诊断和治疗MPS的关键工具,因为它能够提供精确的,微创引导。这篇综述讨论了超声检查在各种评估和管理MPS方法中的应用。研究表明,剪切波超声弹性成像可以有效评估肌肉弹性,并提供对MPS患者斜方肌僵硬的见解。超声引导筋膜水分离术,尤其是视觉反馈,已证明在治疗斜方肌MPS方面有效。同样,超声引导下菱形干涉筋膜平面阻滞和后肩MPS的周围膜剥离术显著减轻了疼痛,提高了生活质量。体外冲击波疗法与超声引导的利多卡因注射的组合在减轻斜方肌MPS的疼痛和僵硬方面特别成功。关于各种引导注射的研究,包括干针刺,干涉平面块,筋膜水解剖,强调超声检查对准确性和安全性的重要性。此外,超声引导下将局部麻醉药和类固醇递送至腰方肌显示出持续6个月的疼痛缓解.总的来说,这些发现突出了超声检查在MPS的评估和治疗中的关键作用.
    Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.
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  • 文章类型: Journal Article
    递送治疗性干细胞以治疗骨组织损伤是一种有希望的策略,其面临许多阻碍临床转化的障碍。其中包括促进新骨形成所需细胞行为的递送载体的设计。在这项工作中,我们描述了可注射微孔水凝胶的使用,由交联明胶微凝胶制成,用于人类间充质干细胞(MSC)的封装和递送,并将其与传统的无孔可注射水凝胶进行比较。包封在微孔水凝胶中的MSC显示出具有直接细胞-细胞连接的快速细胞扩散,而无孔水凝胶中的MSC被周围的聚合物网截留并彼此分离。在每个细胞的基础上,与无孔水凝胶相比,在微孔水凝胶中的封装会导致碱性磷酸酶(ALP)活性和钙矿物质沉积增加4倍,通过ALP和钙测定法测量,这表明更强大的成骨分化。RNA-seq证实了与细胞扩散和细胞-细胞连接相关的基因和途径的上调,以及微孔水凝胶中的成骨作用。这些结果表明,基于微凝胶的可注射水凝胶可以是用于骨组织修复的治疗性细胞递送的有用工具。
    Delivery of therapeutic stem cells to treat bone tissue damage is a promising strategy that faces many hurdles to clinical translation. Among them is the design of a delivery vehicle which promotes desired cell behavior for new bone formation. In this work, we describe the use of an injectable microporous hydrogel, made of crosslinked gelatin microgels, for the encapsulation and delivery of human mesenchymal stem cells (MSCs) and compared it to a traditional nonporous injectable hydrogel. MSCs encapsulated in the microporous hydrogel showed rapid cell spreading with direct cell-cell connections whereas the MSCs in the nonporous hydrogel were entrapped by the surrounding polymer mesh and isolated from each other. On a per-cell basis, encapsulation in microporous hydrogel induced a 4 × increase in alkaline phosphatase (ALP) activity and calcium mineral deposition in comparison to nonporous hydrogel, as measured by ALP and calcium assays, which indicates more robust osteogenic differentiation. RNA-seq confirmed the upregulation of the genes and pathways that are associated with cell spreading and cell-cell connections, as well as the osteogenesis in the microporous hydrogel. These results demonstrate that microgel-based injectable hydrogels can be useful tools for therapeutic cell delivery for bone tissue repair.
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  • 文章类型: Journal Article
    背景:儿科牙医的主要目标之一是提供无痛的麻醉体验。激光光生物调节是减少注射疼痛的建议策略之一。所以,本研究旨在评估激光光生物调节对儿童局部麻醉(LA)注射疼痛的影响,以及其在开腹手术和SSC手术中对LA疗效的影响.
    方法:本研究是一项随机对照临床试验,采用两个平行组设计。它涉及64名合作健康儿童,年龄从5岁到7岁,每个都有至少一个上颌磨牙指示进行牙髓切除术。根据使用的麻醉前组织管理技术,将儿童随机分为两组:实验组接受激光光生物调节,对照组给予局部麻醉凝胶。注射时疼痛,牙髓切除术,和SSC程序使用生理测量(心率(HR))进行评估,主观评价(改良面部疼痛量表(FPS),和客观分析(声-眼-运动量表(SEM))。
    结果:共有64名平均年龄为6.23±0.78的儿童参加了这项研究。在颊部和腭部浸润注射期间,激光PBM组的平均HR评分显着降低。在两次注射期间,激光PBM组的SEM平均得分显著较低。对于FPS量表,在激光PBM组中,在注射过程中记录到满意度的儿童数量显著高于对照组.在牙髓切除术和SSC手术期间,两组之间的平均HR以及SEM和FPS评分没有统计学上的显着差异。使用独立样本-和Mann-WhitneyU检验进行两个研究组之间的比较。显著性设定为p值<0.05。
    结论:激光光生物调节是一种有前途的非药物麻醉前儿童组织管理技术,与局部麻醉凝胶相比,注射疼痛更少,而不会损害LA的有效性。
    背景:ClinicalTrials.gov标识符:NCT05861154。注册于2023年5月16日。
    BACKGROUND: One of the main goals for pediatric dentists is to offer a painless anesthesia experience. Laser photobiomodulation is among the suggested strategies to decrease injection pain. So, this study aimed to assess the impact of laser photobiomodulation on local anesthesia (LA) injection pain in children and its effect on the efficacy of LA during pulpotomy and SSC procedures.
    METHODS: The research was carried out as a randomized controlled clinical trial with two parallel group design. It involved 64 cooperative healthy children, age range from 5 to 7 years, each having at least one maxillary molar indicated for pulpotomy. Children were randomly allocated to one of the two groups based on the pre-anesthetic tissue management technique used: test group received laser photobiomodulation, while control group received topical anesthetic gel. Pain during injection, pulpotomy, and SSC procedures was assessed using physiological measures (Heart Rate (HR)), subjective evaluation (modified Face-Pain-Scale (FPS), and objective analysis (Sound-Eye-Motor scale (SEM)).
    RESULTS: A total of 64 children with mean age 6.23 ± 0.78 participated in this research. The mean HR scores were significantly lower in the laser PBM group during buccal and palatal infiltration injections. The SEM mean scores were significantly lower in the laser PBM group during both injections. For the FPS scale, the number of children who recorded satisfaction during injection was significantly higher in laser PBM group. There was no statistically significant difference in mean HR as well as in SEM and FPS scores between the two groups during pulpotomy and SSC procedures. Comparisons between the two study groups were performed using independent samples t- and Mann-Whitney U tests. Significance was set at p value < 0.05.
    CONCLUSIONS: Laser photobiomodulation is a promising non-pharmacological pre-anesthetic tissue management technique in children that offered less painful injection compared to topical anesthetic gel without compromising the effectiveness of LA.
    BACKGROUND: ClinicalTrials.gov Identifier: NCT05861154. Registered on 16/5/2023.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    腰椎间盘突出症(HLDs)引起的下腰痛和坐骨神经痛是就诊于疼痛诊所的患者常见的主诉。在各种治疗方法中,盘内臭氧注射已成为HLDs的有效替代或额外治疗选择。
    这项荟萃分析旨在研究椎间盘内注射臭氧治疗HLDs的有效性。
    我们搜索了PubMed,Embase,科克伦图书馆,以及截至2024年1月25日发表的相关研究的Scopus数据库。我们纳入了研究盘内臭氧注射对HLDs患者的疗效的研究。我们使用Cochrane协作工具评估了各个研究的方法学质量。
    治疗后6个月,对患有HLDs的患者进行盘内臭氧注射的治疗效果大于类固醇注射的治疗效果(治疗成功率,6个月:比值比=3.95,95%置信区间[CI][2.44,6.39],P<0.01)或常规药物(视觉模拟量表[VAS]的变化,6个月:标准化平均差[SMD]=1.65,95%CI[1.08,2.22],P<0.01;12个月:SMD=1.52,95%CI[0.96,2.08],P<0.01),但与显微椎间盘切除术相似(VAS的变化,18个月:SMD=-0.05,95%CI[-0.67,0.57],P=0.87)。治疗后<6个月,盘内臭氧注射后VAS评分的降低高于类固醇注射后(VAS的变化,1个月:SMD=2.53,95%CI[1.84,3.21],P<0.01)。
    盘内臭氧注射可能是HLDs患者的有用治疗工具。与类固醇注射和口服药物等其他常规治疗方法相比,盘内臭氧注射有很大的长期(6个月)的有效性。
    UNASSIGNED: Low back pain and sciatica caused by herniated lumbar discs (HLDs) are common complaints among patients visiting pain clinics. Among the various therapeutic methods, intradiscal ozone injections have emerged as an effective alternative or additional treatment option for HLDs.
    UNASSIGNED: This meta-analysis aimed to investigate the effectiveness of intradiscal ozone injections in the treatment of HLDs.
    UNASSIGNED: We searched the PubMed, Embase, Cochrane Library, and Scopus databases for relevant studies published until January 25, 2024. We included studies that investigated the efficacy of intradiscal ozone injections in patients with HLDs. We evaluated the methodological quality of individual studies using the Cochrane Collaboration tool.
    UNASSIGNED: At ⩾ 6 months after treatment, the therapeutic effect of intradiscal ozone injections in patients with HLDs was greater than that of steroid injections (treatment success rate, 6 months: odds ratio = 3.95, 95% confidence interval [CI] [2.44, 6.39], P< 0.01) or conventional medications (changes in the Visual Analog Scale [VAS], 6 months: standardized mean difference [SMD] = 1.65, 95% CI [1.08, 2.22], P< 0.01; 12 months: SMD = 1.52, 95% CI [0.96, 2.08], P< 0.01) but similar to that of microdiscectomy (changes in VAS, 18 months: SMD =-0.05, 95% CI [-0.67, 0.57], P= 0.87). At < 6 months after treatment, the reduction in the VAS score after intradiscal ozone injections was higher than that after steroid injections (changes in VAS, 1 month: SMD = 2.53, 95% CI [1.84, 3.21], P< 0.01).
    UNASSIGNED: Intradiscal ozone injections may be a useful therapeutic tool in patients with HLDs. Compared with other conventional treatment methods such as steroid injections and oral medications, intradiscal ozone injection has great long-term (⩾ 6 months) effectiveness.
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  • 文章类型: Editorial
    超声内镜与内镜治疗1型胃底静脉曲张出血的结合可能会提高未来研究结果的稳健性和普适性。此外,在后续研究的疗效评估中,也应包括食管静脉曲张,以得出更有说服力的结论.
    The combination of endoscopic ultrasound with endoscopic treatment of type 1 gastric variceal hemorrhage may improve the robustness and generalizability of the findings in future studies. Moreover, the esophageal varices should also be included in the evaluation of treatment efficacy in subsequent studies to reach a more convincing conclusion.
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  • 文章类型: Journal Article
    可注射水凝胶由于其最小的侵入性和复杂场景的适应性而在生物医学领域引起了极大的兴趣。在这里,我们通过用悬垂的PEG调节分段组分的亲水-疏水平衡,开发了可注射的基于聚氨酯的热凝胶平台。热胶凝行为通过来自亲水性PEG的桥接和来自疏水性胶束核的渗透网络的组合来实现。首先,通过DPD模拟和实验研究证明了该系统的热胶凝机理。可以通过改变固体含量来调节胶凝温度,软段的组成部分,和悬垂的PEG的长度。我们进一步应用3D打印技术制备个性化水凝胶结构。这种整合突出了我们的热凝胶用于制造复杂和患者特异性构建体的适应性,在再生医学和组织工程领域取得了重大进展。随后,体外细胞实验表明,该热凝胶具有良好的细胞相容性,能促进L929细胞的增殖和迁移。令人印象深刻的是,A549细胞可以方便地原位包裹在热凝胶中进行三维培养,并在7天后获得终生的3D细胞球。Further,体内实验表明,热凝胶可以促进毛细血管和毛囊的再生,促进伤口愈合。最终,我们的研究证明了水凝胶通过3D打印技术制备个性化水凝胶结构的潜力,为复杂的生物医学应用提供创新的解决方案。这项工作不仅为可注射热凝胶的设计提供了新的视角,而且为开发用于各种医疗应用的热响应水性聚氨酯提供了有希望的途径。
    Injectable hydrogels have attracted significant interest in the biomedical field due to their minimal invasiveness and accommodation of intricate scenes. Herein, we developed an injectable polyurethane-based thermogel platform by modulating the hydrophilic-hydrophobic balance of the segmented components with pendant PEG. The thermogelling behavior is achieved by a combination of the bridging from the hydrophilic PEG and the percolated network from the hydrophobic micelle core. Firstly, the thermogelation mechanism of this system was demonstrated by both DPD simulation and experimental investigation. The gelling temperature could be modulated by varying the solid content, the component of soft segments, and the length of the pendant PEG. We further applied 3D printing technology to prepare personalized hydrogel structures. This integration highlights the adaptability of our thermogel for fabricating complex and patient-specific constructs, presenting a significant advance in the field of regenerative medicine and tissue engineering. Subsequently, in vitro cell experiments demonstrated that the thermogel had good cell compatibility and could promote the proliferation and migration of L929 cells. Impressively, A549 cells could be expediently in situ parceled in the thermogel for three-dimensional cultivation and gain lifeful 3D cell spheres after 7 days. Further, in vivo experiments demonstrated that the thermogel could promote wound healing with the regeneration of capillaries and hair follicles. Ultimately, our study demonstrates the potential of hydrogels to prepare personalized hydrogel structures via 3D printing technology, offering innovative solutions for complex biomedical applications. This work not only provides a fresh perspective for the design of injectable thermogels but also offers a promising avenue to develop thermoresponsive waterborne polyurethane for various medical applications.
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  • 文章类型: Journal Article
    艾滋病毒感染一直是全球严重的健康负担,数百万人感染了这种病毒,每年都在继续新的感染。抗逆转录病毒疗法可以有效抑制HIV复制,但需要严格终身坚持每日口服药物治疗方案,这是一个巨大的挑战。不频繁施用的抗逆转录病毒药物的长效制剂已经成为改善治疗结果和对HIV治疗和预防的坚持的有希望的策略。长效可注射(LAI)制剂被设计为在单次注射后在延长的数周或数月的时间内逐渐释放药物。与常规口服剂型相比,LAI的关键优势包括不太频繁的给药要求,增强患者隐私,减少与每日服药方案相关的污名,和优化的药代动力学/药效学谱。一些LAI抗逆转录病毒产品最近获得了监管部门的批准,例如用于HIV暴露前预防的整合酶链转移抑制剂cabotegravir和用于HIV治疗的Cabotegravir/Rilpivirine组合。开发长效抗逆转录病毒药物库的主要方法包括将药物化合物封装在由生物相容性,可生物降解的材料,如聚(乳酸-共-乙醇酸)。这些可注射储库制剂能够实现高药物负载,具有由聚合物基质控制的可定制的延长释放动力学。与日常口服疗法相比,LAI抗逆转录病毒制剂利用可生物降解的聚合物微球提供了显着的好处,包括长期的治疗效果,减少给药频率以改善依从性,以及遏制最初HIV传播事件的可能性。本手稿旨在回顾病毒的发病机理及其进展,并提出治疗靶标和长效药物递送策略,这些策略对增强HIV治疗和预防的结果具有实质性希望。
    HIV infection has been a severe global health burden, with millions living with the virus and continuing new infections each year. Antiretroviral therapy can effectively suppress HIV replication but requires strict lifelong adherence to daily oral medication regimens, which presents a significant challenge. Long-acting formulations of antiretroviral drugs administered infrequently have emerged as a promising strategy to improve treatment outcomes and adherence to HIV therapy and prevention. Long-acting injectable (LAI) formulations are designed to gradually release drugs over extended periods of weeks or months following a single injection. Critical advantages of LAIs over conventional oral dosage forms include less frequent dosing requirements, enhanced patient privacy, reduced stigma associated with daily pill regimens, and optimised pharmacokinetic/pharmacodynamic profiles. Several LAI antiretroviral products have recently gained regulatory approval, such as the integrase strand transfer inhibitor cabotegravir for HIV preexposure prophylaxis and the Cabotegravir/Rilpivirine combination for HIV treatment. A leading approach for developing long-acting antiretroviral depots involves encapsulating drug compounds in polymeric microspheres composed of biocompatible, biodegradable materials like poly (lactic-co-glycolic acid). These injectable depot formulations enable high drug loading with customisable extended-release kinetics controlled by the polymeric matrix. Compared to daily oral therapies, LAI antiretroviral formulations leveraging biodegradable polymeric microspheres offer notable benefits, including prolonged therapeutic effects, reduced dosing frequency for improved adherence, and the potential to kerb the initial HIV transmission event. The present manuscript aims to review the pathogenesis of the virus and its progression and propose therapeutic targets and long-acting drug delivery strategies that hold substantial promise for enhancing outcomes in HIV treatment and prevention.
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