Injection Of Different Drugs Research Articles

A comparative study of the efficacy of intra-articular injection of different drugs in the treatment of mild to moderate knee osteoarthritis: A network meta-analysis.

Knee osteoarthritis (KOA) has a high clinical prevalence and frequently interferes with patients normal lives. In KOA patients, evidence suggests that intra-articular (IA) injection improves joint function and decreases discomfort. Several IA injection treatments are used in daily practice to improve symptomatic control of knee osteoarthritis, but their efficacy is frequently disputed. This network meta-analysis compares the efficacy of different IA injections for mild to moderate knee osteoarthritis. Seven databases (PubMed, EMBASE, Web of Science, Cochrane Library, China Biology Medicine disc, WanFang, and China National Knowledge Infrastructure) were searched for randomized controlled trials published up to and including December 20, 2021, and final follow up indicators were used. Visual analogue scale (VAS) score and The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index (WOMAC) score change from baseline were the primary outcomes. We used the Cochrane risk of bias tool to assess the quality and risks of biases of papers. We calculated the weighted mean difference (WMD) and 95% confidence interval (CI) for each outcome. State (Version 15.1, Texas, USA) and SPSS (Version 20, Chicago, USA) was used in all statistical analyses, and Review Manager (version 5.4) was used in assessing the risks of biases. Our study included 16 randomized controlled trials with a total of 1652 patients. platelet-rich plasma (PRP) IA injection therapy had the highest likelihood of being the best intervention in reducing WOMAC pain (surface under the cumulative ranking area [SUCRA] 84.7%), stiffness (SUCRA 95.1%), and function (SUCRA 98.5%) scores, according to the SUCRA. The best measures for lowering the WOMAC total and VAS scores were IA injection platelet-rich plasma-derived growth factor (SUCRA 84.9%) and hyaluronic acid and platelet-rich plasma (SUCRA 84.9%). In the VAS score group, PRP outperformed hyaluronic acid (HA) (WMD 1.3, 95% CI 0.55-2.55) and corticosteroids (CS) (WMD 4.85, 95% CI 4.02-5.08), according to the forest map results. PRP also outperformed CS (WMD 14.76, 95% CI 12.11-17.41), ozone (WMD 9.16, 95% CI 6.89-11.43), and PRP + HA (WMD 2.18, 95% CI 0.55-3.81) in the WOMAC total score group. Furthermore, PRP outperforms other drugs in terms of reducing WOMAC function, stiffness, and function score. In patients with mild to moderate KOA, IA injection PRP outperformed IA injection ozone, HA, CS, platelet-rich plasma-derived growth factor, and hyaluronic acid and platelet-rich plasma in terms of pain, stiffness, and dysfunction.

Intramural injection of pluronic gel loaded with drugs to alleviate arterial injury.

Balloon angioplasty, stent implantation, and application of an arterial clamp during surgery can induce artery injury such as elastin breaks and endothelium injury, but there is little research focused on the injury induced by these therapeutic manipulations. We established a simple and reproducible small animal aortic injury model and examined intramural injection as a potential therapeutic method to alleviate injury. The abdominal aorta of male Sprague Dawley (SD) rats or C57BL/6J mice was clamped sequentially throughout its length. Transforming growth factor β1 (TGFβ1), SB431542, lipopolysaccharide (LPS), Necrostatin-1 (Nec-1), rapamycin, or MHY1485 contained in Pluronic gel was injected intramurally at day 0 or day 7. Animals were fed with chow containing 0.25% beta-aminopropionitrile (BAPN) to evaluate the influence of BAPN. All samples were harvested and examined by immunohistochemistry and immunofluorescence. The clamped rat aorta showed luminal dilation, elastin fiber breaks, neointimal hyperplasia, and dissection (days 0-90). Intramural injection of TGFβ1, rapamycin and Nec-1 showed a protective effect on the injured aorta, whereas SB431542, MHY1485 and LPS showed more severe wall damage. The aortic lumen in rats fed with BAPN was significantly larger than in control rats (day 7). Mouse aorta showed similar injury with neointimal hyperplasia and elastin fiber breaks. The rodent arterial injury model is reproducible and may mimic early changes of arterial injury. The model accommodates intramural injection of different drugs that may show mechanisms of arterial injury. Although this is a preliminary animal model, the intramural injection method may have potential clinical application in the future.

Drug use practices among people who inject drugs in a context of drug market changes: Challenges for optimal coverage of harm reduction programs

BackgroundUntil the early 2000s, people who inject drugs (PWID) in Québec had mainly been injecting powder cocaine and heroin. Since then, ethnographic studies have shown that the drug market has diversified, with crack and prescription opioids (PO) becoming increasingly available. This could have led to changes in drug use practices among PWID. The objectives of our study were to examine annual trends in injection of different drugs, crack smoking and frequent injection (FI), as well as relationships between injected drugs and FI. MethodsPWID are participants in the ongoing Québec SurvUDI surveillance system. PWID (past 6 months) were recruited in 2 urban and 6 semi-urban/rural sites. Each visit included a structured interview addressing drug use behaviours. Analyses were carried out using GEE methods. For trend analyses (2003–2014) on drugs and FI (number of injections≥upper quartile, previous month), the first annual interview was selected for PWID with multiple participations per year. Analyses on associations between FI and types of injected drugs were based on all interviews (2004–2014). ResultsCrack/cocaine and heroin injection declined significantly, with prevalence ratios (PR) per year of 0.983 [95% confidence interval (CI): 0.980–0.986] and 0.979 (95% CI: 0.969–0.990), while PO injection [PR=1.052 (1.045–1.059)], crack smoking [PR=1.006 (1.001–1.012)], and FI (≥120 injections, previous month) significantly increased [PR=1.015 (1.004–1.026)]. Compared to PWID who injected crack/cocaine±other drugs, the proportion of PWID reporting FI was higher among those who injected PO+heroin/speedball, crack/cocaine or other drugs (adjusted PR 2.29; 95% CI: 2.07–2.53) or PO only (aPR 1.72; 95%CI: 1.47–2.01). ConclusionsChanges that have occurred in the drug market are reflected in PWID’s practices. The high frequency of injection observed among PO injectors is of particular concern. Drug market variations are a challenge for health authorities responsible for harm reduction programs.

Clinical observation on intracorneal injection of different anti-fungal drugs for the treatment of fungal keratitis caused by injury due to chestnut

Objective To observe the clinical efficacy of injection of different anti-fungal drugs in corneal stroma for the treatment of fungal keratitis caused by injury due to chestnut stab. Methods Eighty-three eyes of 83 cases of fungal keratitis caused by chestnut were randomly divided into three groups. The etiological results of all cases were obtained by fungal culture. After corneal debridement, patients in group A, group B and group C received the injection of fluconazole, amphotericin B and voriconazole in corneal stroma respectively on the basis of using 5% natamycin eye drops. The effect of the treatments for the three groups were observed. Results The first pathogenic bacteria was the Alternaria of the pathogen accounting for 34.9% (29 cases), followed by Fusarium 30.1% (25 cases) and Aspergillus 15.7% (13 cases). The cure rates of three groups were 70.3% (19/27), 76% (18/25) and 90.3% (28/31) respectively. The average cure rate of group C was higher than that of group A and B, and the differences were statistically significant (χ2=5.349, 4.895; P=0.021, 0.027). There was no statistically significant difference in the cure rate between group A and B (χ2=0.027, P=0.869). The cure time of group C was (22.48±8.36)d which was shorter than that of group A (27.40±3.97)d and group B (28.76±5.12)d and the differences were statistically significant (t=2.544, 3.006; P=0.014, 0.004). There was no statistically significant difference in the cure time between group A and B (t=1.069, P=0.290). Two cases in group B suffered eye irritation symptoms, and the symptom disappeared after the use of Diclofenac Sodium eye drops for two days. No adverse reactions during the treatment occurred in the remaining cases. All cases were followed up for 1-3 months and no puncture tract scar formed or no recurrent case happened. Conclusion The main pathogenic bacteria of fungal keratitis by chestnut stab are Alternaria and Fusarium. The injection of fluconazole, amphotericin B and voriconazole respectively in corneal stroma can bring better curative effect, especially the voriconazole and for severe cases the curative effect of voriconazole is better than that of fluconazole and amphotericin B. Key words: Keratitis, fungal; Chestnut stab; Etiological examination; Antifungal drugs; Injection, in corneal stroma

The results of pars plana vitrectomy and silicone oil tamponade for endophthalmitis after intravitreal injections

To report the role of early vitrectomy and silicone oil tamponade in acute endophthalmitis following intravitreal injection. Medical records of eight patients who presented with acute endophthalmitis after intravitreal injection of different drugs were retrospectively reviewed. Initial treatment consisted of vitreous tap with cultures and injection of intravitreal antibiotics, with the patients subsequently undergoing pars plana vitrectomy and silicone oil tamponade within 24h following initial vitreous tap. The mean time to presentation was 1.7days (1-3days). The initial best-corrected visual acuity was hand motion to 0.05 before treatment and 0.05-0.8 (Snellen) after treatment. Vitreous cultures were obtained from all patients, of which four were culture positive. Endophthalmitis was controlled in all patients. There was no retinal detachment or phthisis bulbi during the follow-up period (1-4years). Acute endophthalmitis following intravitreal injection occurs rapidly and requires urgent treatment. If intravitreal antibiotics fail to control inflammation, early pars plana vitrectomy and silicone oil tamponade would be an appropriate option.

Separating physiological from pathological effects of drugs tested for retinal toxicity in animal models

Abstract Purpose Drugs tested for retinal toxicity in animal models frequently induce physiological effects with or without pathological effects. The physiological effects may be interpreted to reflect toxic action. Here, different experimental approaches and modes of data analysis are described to separate physiological from pathological effects of drugs on retinal function and structure in laboratory animals. Methods The flash electroretinogram (ERG) and the visual evoked potential (VEP) were used to assess respectively the functional integrity of the distal and proximal parts of the retina following intravitreal administration of drugs. Histology at the light microscopic level and immunocytochemistry were used to evaluate structural damage and to localize the site/s of action of the drugs. Results The ERG responses and the VEP were recorded at different time intervals after intravitreal injection of different drugs in order to assess short‐term and long‐term retinal effects. In some cases severe functional deficit was identified, but it was transient in nature, and partial or even complete recovery was observed during a follow‐up period of at least 4 weeks. Different modes of data analysis were applied in order to separate physiological effects from pathological ones. Conclusion Drugs, used in the ophthalmic clinic, can be retinotoxic and induce permanent retinal damage, or may exert transient changes that can reflect drug interference with the normal physiological function of the retina. Data are analyzed to separate these possibilities in order to allow accurate assessment of drug toxicity. Furthermore, drugs exerting transient physiological effects can be used to study the normal mechanisms of visual information processing in the retina.

HIV and intravenous drug use.

There is now evidence from a wide variety of geographic areas that many intravenous drug users will change their behavior in order to reduce their risk of developing AIDS. There is even evidence from some areas that the behavior change has led to relative stabilization of seroprevalence rates, although longer-term studies will be needed to establish this definitively. AIDS behavior change in the area of sexual risk reduction appears to be much more difficult than change of drug injection behavior. Conceptual models of AIDS-related behavior change are needed, particularly models that can incorporate the injection of different drugs and variation in social and psychological characteristics among drug injectors. There is increasing evidence for a wider spectrum of HIV-related morbidity and mortality among intravenous drug users than is captured by the current surveillance definition for AIDS, again emphasizing the need for effective prevention programs.

Distinct sites of functional interaction between dopamine, acetylcholine and γ-aminobutyrate within the neostriatum: An electromyographic study in rats

In order to study the functional interaction between dopamine, acetylcholine and γ-aminobutyrate within the rat neostriatum, we investigated the effect of intrastriatal injection of different drugs acting on these transmitter systems on muscle tone measured as tonic activity in the electromyogram of the gastrocnemius muscle. Bilateral injection of haloperidol (500 ng) into the rostral neostriatum (rostral injection; A8920-9650 46) induced tonic activity m the electromyogram, whereas injection into the intermediate part (intermediate injection; A7020-7890 46) was ineffective. Muscimol (25 ng) induced tonic activity in the electromyogram, when injected into the intermediate part and not into the rostral part, while bethanechol (1μg) was effective when injected into either site. Haloperidol-induced tonic activity in the electromyogram was prevented by coadministration of apomorphine (500 ng) or scopolamine (1μg), but not of bicuculline (300 ng). Haloperidol-induced tonic activity in the electromyogram was also reduced by subsequent intermediate injection of scopolamine or bicuculline, while apomorphine was ineffective. Tonic activity in the electromyogram induced by rostral injection of bethanechol was prevented by coadministration of scopolamine, but not of apomorphine. Intermediate injection of scopolamine or bicuculline reduced the tonic activity in the electromyogram after rostral or intermediate injection of bethanechol. Tonic activity in the electromyogram induced by intermediate injection of muscimol was prevented by coadministration of bicuculline, but not of scopolamine. Rostral injection of apomorphine or scopolamine failed to alter the tonic activity in the electromyogram induced by intermediate injection of bethanechol or muscimol. These results point to the existence of: (1) a functional interaction between dopamine and acetylcholine in the rostral neostriatum; (2) a functional interaction between acetylcholine and γ-aminobutyrate in the intermediate neostriatum, and (3) a functional flow of information from the rostral to the intermediate neostriatum.