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Intramyocardial and intracoronary autologous bone marrow-derived mesenchymal stromal cell treatment in chronic severe dilated cardiomyopathy

Chin SP, Poey AC, Wong CY, Chang SK, Tan CS, Ng MT, et al.

Cytotherapy, 2011 Aug;13(7):814-21.
PMID: 21526902 DOI: 10.3109/14653249.2011.574118

BACKGROUND AIMS: Mesenchymal stromal cells (MSC) may improve cardiac function following myocardial infarction. MSC can differentiate into cardiomyocytes and endothelial cells while exerting additional paracrine effects. There is limited information regarding the efficacy of route for MSC treatment of severe dilated cardiomyopathy (DCM). The aim of this study was to demonstrate the clinical safety, feasibility and efficacy of direct intramyocardial and intracoronary administration of autologous bone marrow-derived MSC treatment for no-option patients with chronic severe refractory DCM.
METHODS: Ten symptomatic patients with DCM and refractory cardiac function, despite maximum medical therapy, were selected. Five had ischemic DCM deemed unlikely to benefit from revascularization alone and underwent bypass operations with concurrent intramyocardial MSC injection (group A). Two patients had previous revascularization and three had non-ischemic DCM and received intracoronary MSC injection (group B).
RESULTS: Group A and B patients received 0.5-1.0 × 10(6) and 2.0-3.0 × 10(6) MSC/kg body weight, respectively. All patients remained alive at 1 year. There were significant improvements from baseline to 6 and 12 months in left ventricular ejection fraction and other left ventricular parameters. Scar reduction was noted in six patients by 12 months.
CONCLUSIONS: Autologous bone marrow MSC treatment is safe and feasible for treating chronic severe refractory DCM effectively, via intracoronary or direct intramyocardial administration at prescribed doses.

Matched MeSH terms: Injections/methods
Endoscopic ultrasound-guided injection therapy for hepatobiliary disease

Ponnudurai R, Sachithanandan S, George A

J Hepatobiliary Pancreat Sci, 2011 May;18(3):311-8.
PMID: 21468788 DOI: 10.1007/s00534-010-0354-5

Endoscopic ultrasound (EUS)-guided injection therapy is the new frontier in the management of patients with hepatobiliary disease. Celiac plexus block/neurolysis was the first form of injection therapy and has been validated in many subsequent trials. Cyst ablation therapy, fiducial insertion, angiography, portal hypertensive therapy, endoscopic portosystemic shunt creation, portal vein embolization and injection of chemotherapeutic/biologic agents for antitumor therapy are more recent uses and will be discussed. Celiac plexus neurolysis is currently well established in providing adjunct pain control in patients with advanced malignancy. There are limited data available for its use in benign conditions. EUS-guided ablative therapy for pancreatic cysts remains an area for future research but seems to have a role for small thin-walled non-septated cysts. EUS-guided implantation of fiducials is technically feasible but its exact impact on tumor regression is unknown. Several case reports have documented EUS-guided alcohol and thrombin injection into pseudoaneurysms and cyanoacrylate and coil embolization for variceal therapy. Injection of viral vectors and immunomodulating cell cultures as antitumor therapy has been described but the evidence is still preliminary and further data are awaited.

Matched MeSH terms: Injections/methods*
Perineural Injection Therapy in the Management of Complex Regional Pain Syndrome: A Sweet Solution to Pain

Thor JA, Mohamed Hanapi NH, Halil H, Suhaimi A

Pain Med, 2017 10 01;18(10):2041-2045.
PMID: 28460075 DOI: 10.1093/pm/pnx063
Matched MeSH terms: Injections/methods
Fulltext Worldwide Injection Technique Questionnaire Study: Population Parameters and Injection Practices

Frid AH, Hirsch LJ, Menchior AR, Morel DR, Strauss KW

Mayo Clin Proc, 2016 Sep;91(9):1212-23.
PMID: 27594185 DOI: 10.1016/j.mayocp.2016.06.011

From February 1, 2014, through June 30, 2015, 13,289 insulin-injecting patients from 423 centers in 42 countries took part in one of the largest surveys ever performed in diabetes. The goal was to assess patient characteristics, as well as historical and practical aspects of their injection technique. Results show that 4- and 8-mm needle lengths are each used by nearly 30% of patients and 5- and 6-mm needles each by approximately 20%. Higher consumption of insulin (as measured by total daily dose) is associated with having lipohypertrophy (LH), injecting into LH, leakage from the injection site, and failing to reconstitute cloudy insulin. Glycated hemoglobin values are, on average, 0.5% higher in patients with LH and are significantly higher with incorrect rotation of sites and with needle reuse. Glycated hemoglobin values are lower in patients who distribute their injections over larger injection areas and whose sites are inspected routinely. The frequencies of unexpected hypoglycemia and glucose variability are significantly higher in those with LH, those injecting into LH, those who incorrectly rotate sites, and those who reuse needles. Needles associated with diabetes treatment are the most commonly used medical sharps in the world. However, correct disposal of sharps after use is critically suboptimal. Many used sharps end up in public trash and constitute a major accidental needlestick risk. Use of these data should stimulate renewed interest in and commitment to optimizing injection practices in patients with diabetes.
Study sites: 423 centers in 42 countries (Malaysia contributed 51 patients from two hospital study sites)

Matched MeSH terms: Injections/methods*
Antiapoptotic effect of taurine against NMDA-induced retinal excitotoxicity in rats

Lambuk L, Iezhitsa I, Agarwal R, Bakar NS, Agarwal P, Ismail NM

Neurotoxicology, 2019 01;70:62-71.
PMID: 30385388 DOI: 10.1016/j.neuro.2018.10.009

OBJECTIVE: N-methyl-D-aspartate (NMDA) excitotoxicity has been proposed to mediate apoptosis of retinal ganglion cells (RGCs) in glaucoma. Taurine (TAU) has been shown to have neuroprotective properties, thus we examined anti-apoptotic effect of TAU against retinal damage after NMDA exposure.
METHODOLOGY: Sprague-Dawley rats were divided into 5 groups of 33 each. Group 1 was administered intravitreally with PBS and group 2 was similarly injected with NMDA (160 nmol). Groups 3, 4 and 5 were injected with TAU (320 nmol) 24 hours before (pre-treatment), in combination (co-treatment) and 24 hours after (post-treatment) NMDA exposure respectively. Seven days after injection, rats were sacrificed; eyes were enucleated, fixed and processed for morphometric analysis, TUNEL and caspase-3 staining. Optic nerve morphology assessment was done using toluidine blue staining. The estimation of BDNF, pro/anti-apoptotic factors (Bax/Bcl-2) and caspase-3 activity in retina was done using ELISA technique.
RESULTS: Severe degenerative changes were observed in retinae after intravitreal NMDA exposure. The retinal morphology in the TAU pre-treated group appeared more similar to the control retinae and demonstrated a higher number of nuclei than the NMDA group both per 100 μm length (by 1.5-fold, p

Matched MeSH terms: Intravitreal Injections/methods*
Vaccination of Tilapia against Motile Aeromonas Septicemia: A Review

Shirajum Monir M, Yusoff SM, Mohamad A, Ina-Salwany MY

J Aquat Anim Health, 2020 06;32(2):65-76.
PMID: 32331001 DOI: 10.1002/aah.10099

The production of tilapia Oreochromis spp. is rapidly growing throughout the world, but atypical motile aeromonad septicemia (MAS) is a current threat to the tilapia farming industry. The etiological agent of this disease is usually Aeromonas hydrophila. Mortality rates due to MAS are frequently high, resulting in a devastating negative impact on this industry worldwide; therefore, proper control measures regarding both prevention and treatment are necessary. Although vaccines against MAS for tilapia are available, their effectiveness is entirely dependent on the specific strain of problematic bacteria. Until now, whole-cell inactivated A. hydrophila vaccines for tilapia have exhibited the highest level of protection over live attenuated and recombinant vaccines. Among the various vaccine administration systems, only intraperitoneal (i.p.) injections of the A. hydrophila vaccine into tilapia were found to provide prominent immune protection. Vaccine efficacy was primarily measured by using the i.p. injection challenge model and estimating the relative percent survival of the immunized tilapia. Freund's incomplete adjuvant showed to be the most effective for tilapia MAS vaccines. In this review, multiple factors that directly or indirectly influence the efficacy of MAS vaccines for tilapia (adjuvants, challenge models, immunization doses and duration, and size of vaccinated fish) are discussed.

Matched MeSH terms: Injections/methods
Ultrasound-guided botulinum toxin A injection: an alternative treatment for dribbling

Marina MB, Sani A, Hamzaini AH, Hamidon BB

J Laryngol Otol, 2008 Jun;122(6):609-14.
PMID: 17640435

Dribbling (sialorrhoea) affects about 10 per cent of patients with chronic neurological disease. The variety of treatments currently available is unsatisfactory. This study was a clinical trial of the efficacy of ultrasound-guided, intraglandular injection of botulinum toxin A for dribbling, performed within the otorhinolaryngology department of the National University of Malaysia. Both pairs of parotid and submandibular glands received 25 U each of botulinum toxin A. Twenty patients were enrolled in the study. The median age was 15 years. All 20 patients (or their carers) reported a distinct improvement in symptoms after injection. Using the Wilcoxon signed rank test, there were significant reductions in dribbling rating score, dribbling frequency score, dribbling severity score, dribbling visual analogue score and towel changes score, comparing pre- and post-injection states (p<0.001). There were no complications or adverse effects during or after the injection procedure. Intraglandular, major salivary gland injection of botulinum toxin A is an effective treatment to reduce dribbling. Ultrasound guidance enhances the accuracy of this procedure and minimises the risk of complication.

Matched MeSH terms: Injections/methods
Fulltext Worldwide Injection Technique Questionnaire Study: Injecting Complications and the Role of the Professional

Frid AH, Hirsch LJ, Menchior AR, Morel DR, Strauss KW

Mayo Clin Proc, 2016 Sep;91(9):1224-30.
PMID: 27594186 DOI: 10.1016/j.mayocp.2016.06.012

From February 1, 2014, through June 30, 2015, 13,289 insulin-injecting patients from 423 centers in 42 countries participated in one of the largest surveys ever performed in diabetes. The first results of this survey are published elsewhere in this issue. Herein we report that the most common complication of injecting insulin is lipohypertrophy (LH), which was self-reported by 29.0% of patients and found by physical examination in 30.8% by health care professionals (HCPs). Patients with LH consumed a mean of 10.1 IU more insulin daily than patients without LH. Glycated hemoglobin levels averaged 0.55% higher in patients with vs without LH. Lipohypertrophy was associated with higher rates of unexplained hypoglycemia and glycemic variability as well as more frequent diabetic ketoacidosis, incorrect rotation of injection sites, use of smaller injection zones, longer duration of insulin use, and reuse of pen needles (each P

Matched MeSH terms: Injections/methods*
A proposal for needle projections in transcutaneous injection laryngoplasty using three-dimensionally reconstructed CT scans

Nasir ZM, Azman M, Baki MM, Mohamed AS, Kew TY, Zaki FM

Surg Radiol Anat, 2021 Aug;43(8):1225-1233.
PMID: 33388863 DOI: 10.1007/s00276-020-02639-9

PURPOSE: This study aims to determine laryngeal dimension in relation to all three transcutaneous injection laryngoplasty (TIL) approaches (thyrohyoid, transthyroid and cricothyroid) using three-dimensionally reconstructed Computed Tomography (CT) scan and compare the measurements between sex, age group and ethnicity.
METHODS: CT scans of the neck of two hundred patients were analysed by two groups of raters. For thyrohyoid approach, mean distance from the superior border of the thyroid cartilage to the laryngeal cavity (THd) and mean angle from the superior border of the thyroid cartilage to mid-true cords (THa) were measured. For transthyroid approach, mean distance from mid-thyroid cartilage to mid-true cords (TTd) and Hounsfield unit (HU) at mid-thyroid cartilage (TTc) were measured. For cricothyroid approach, mean distance from the inferior border of the thyroid cartilage to the laryngeal cavity (CTd) and mean angle from the inferior border of the thyroid cartilage to mid-true cords (CTa) were measured.
RESULTS: There were statistically significant differences between males and females for all measurements except for CTa (p 0.05). There was a significant fair positive correlation between age and TTc (p = 0.0002). For all measurements obtained, there were moderate to excellent inter-group consistency and intra-rater reliability.
CONCLUSION: This study demonstrated a significant sex dimorphism that may influence the three TIL approaches except for needle angulation in the cricothyroid approach. The knowledge of laryngeal dimension is important to increase success in TIL procedure.

Matched MeSH terms: Injections/methods