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Initial Injection (initial + injection)
Selected AbstractsCombined treatment of achalasia , botulinum toxin injection followed by pneumatic dilatation: long-term resultsDISEASES OF THE ESOPHAGUS, Issue 2 2010R. Kroupa SUMMARY Injection of botulinum toxin (BT) and pneumatic dilatation are available methods in nonsurgical treatment of achalasia. Authors anticipate beneficial effect of prior BT injection on the success of pneumatic dilatation and duration of its effect. There are no long-term data available to assess efficacy of combined treatment. From 1998 to 2007, 51 consecutive patients (20 men and 31 women, age 24,83) with achalasia were included and prospectively followed up. Each patient received injection of 200 IU of BT into the lower esophageal sphincter (LES) during endoscopy and 8 days later pneumatic dilatation (PD) under X-ray control was performed. The follow-up was established every 3 months first year and then annually. The efficacy was evaluated by a questionnaire concerning patient's symptoms and manometry. Results were compared with 40 historical controls (16 men and 24 women, age 26,80) treated by PD alone using the same method and follow-up. Fifty-one patients underwent combined treatment. Four patients failed in follow-up and were not included for analysis. The mean duration of follow-up was 48 months with range 12,96 months. Thirty-four of forty-seven (72%) patients were satisfied with results with none or very rare and mild troubles at the time of the last visit. Forty-one patients were followed up more than 2 years. Effect of therapy lasted in 75% (31/41) of them. In 17 patients, more than 5 years after treatment, effect lasted in 12 (70%). Mean tonus of LES before therapy was 29 mm Hg (10,80), 3 months after therapy decreased to 14 mmHg (5,26). The cumulative 5 years remission rate (±95% CI) in combined treated patients 69% ± 8% was higher than in controls 50% ± 9%; however it, was not statistically significant (P= 0.07). In control group 1, case of perforation (2.5%) occurred. Eight patients (17%) with relapse of dysphagia were referred to laparoscopic Heller myotomy with no surgical complication. The main adverse effect was heartburn that appeared in 17 patients (36%). Initial injection of BT followed by PD seems to be effective for long-term results with fewer complications. But the combined therapy is not significantly superior to PD alone. [source] Complications from Injectable Polyacrylamide Gel, a New Nonbiodegradable Soft Tissue FillerDERMATOLOGIC SURGERY, Issue 12p2 2004Snehal P. Amin Background. Polyacrylamide gels, containing a hydrogel composed of polyacrylamide and water, are used for soft tissue augmentation and contour correction. There are no reports of significant complications after injection of this material into the face. Objective. We report an inflammatory reaction after injection of polyacrylamide gels for zygomatic facial augmentation. Methods. A retrospective chart review of single case is presented. Results. An inflammatory reaction at the sites of polyacrylamide gels injection was noted at 1 month after initial injection. Despite two ensuing courses of broad-spectrum antibiotics, the patient presented to us with persistent draining nodules. Intralesional steroid injections resulted in prompt resolution and no recurrence. Conclusion. Inflammatory reactions have been noted in patients receiving polyacrylamide gels for breast augmentation. Facial polyacrylamide gels injections may also be associated with an inflammatory reaction that responds to intralesional steroids. With increasing availability of a variety of soft tissue fillers, dermatologists should be aware of this delayed complication from polyacrylamide gels. [source] Tolerance and safety of ocular use of recombinant human erythropoietin (rhEPO).ACTA OPHTHALMOLOGICA, Issue 2009Neuroprotective effects in ocular hypertension/glaucoma Purpose The purpose of this study was to evaluate the long-term effects of monthly intravitreal injections of rhEPO in a rabbit model. Methods Sixteen New Zealand rabbits were divided into 4 groups: control (no injection), saline injection, or rhEPO injections of 500 U and 1000 U (N=4 per group). The right eye of each animal was injected monthly over a period of 7 months. Fundus examination and electroretinography (ERG) were performed at 1 day prior, and 1 week, 1 month, and 6 months after the initial injection. After the final ERG, animals underwent fluorescein angiography and sacrifice one week later. Scotopic and photopic ERG amplitude and implicit times were analyzed by calculating a ratio between the right and the left eyes. Angiograms were graded for the presence of neovascularization or leakage. Statistical analysis was carried out using two-way ANOVA. Results Fifteen animals were used for this experiment (1 developed a traumatic cataract and was excluded). Between all groups and time points, there were no statistically significant differences in the computed right eye:left eye ratios for the scotopic or photopic ERG components (p>0.05). No evidence of neovascularization or fluorescein leakage was seen on angiography. There were no visible differences in retinal architecture or thickness in the rhEPO groups when compared to uninjected controls. Conclusion Monthly 0.1 ml intravitreal injections of rhEPO at a dose of up to 1000 U over 7 months is well-tolerated and does not cause adverse effects on retinal function, architecture, or vasculature in a rabbit model. A review of published data on rhEPO and Glaucoma will also be presented. [source] Effects of repeated injection of intravitreal triamcinolone on macular oedema in central retinal vein occlusionACTA OPHTHALMOLOGICA, Issue 3 2009Lili Wang Abstract. Purpose:, To investigate the effectiveness of repeated injections of intravitreal triamcinolone acetonide (IVTA) in the treatment of macular oedema caused by central retinal vein occlusion (CRVO). Methods:, Seventeen pseudophakic or aphakic eyes of 17 patients (10 male, seven female) with macular oedema caused by CRVO received a repeat injection of 4 mg IVTA, 16 weeks after the first injection of the same dose. The examination included measurements of best-corrected visual acuity (BCVA) for distance and central foveal thickness (CFT) by optical coherence tomography (OCT), preoperatively and 1, 2, 3 and 4 months postoperatively. The values were compared by paired- t test. Side-effects were monitored. Results:, BCVA and CFT were not significantly different before initial and repeat injections. Transient improvements of BCVA and CFT were achieved after both injections. At the end of follow-up, BCVA and CFT were significantly different compared to pre-injection values in the same group (P = 0.032, 0.049 in the initial-injection group and P = 0.001, 0.008 in the repeat-injection group, respectively). However, compared to the initial injection, BCVA measurements were significantly worse at each time-point (P = 0.043, 0.011, 0.010 and 0.012, respectively) after the repeat injection, as were CFT at 1, 2 and 3 months post-injection (P = 0.040, 0.015 and 0.025, respectively). The achieved maximum mean intraocular pressures were 20.00 [standard deviation (SD) 2.06] mmHg and 18.56 (SD 3.65) mmHg after the first and repeat injections, respectively. These values were not significantly different (P = 0.467). No other significant adverse events were noted during the study. Conclusion:, A repeat injection of 4 mg IVTA may not be as effective as an initial injection for the treatment of macular oedema caused by CRVO. [source] An audit of peribulbar blockade using 15 mm, 25 mm and 37.5 mm needles, and sub-Tenon's injection,ANAESTHESIA, Issue 8 2004A. A. Van Den Berg Summary The efficacy of peribulbar anaesthesia performed with short, medium and long needles, with sub-Tenon's injection as a control, was audited. Two hundred patients undergoing cataract surgery underwent peribulbar injection using 25G needles of the following lengths: 15 mm, 25 mm or 37.5 mm. Sub-Tenon's injections were performed with a curved 25-mm sub-Tenon anaesthesia cannula. The injection technique, ocular akinesia and analgesia scoring system, and supplementary injection protocols were standardised. After initial injections of local anaesthetic via the sub-Tenon's cannula or with 37.5 mm, 25 mm and 15 mm needles, supplementation was required in one (2%), 13 (26%), 22 (44%) and 32 (64%) of patients, respectively; the total number of supplementary injections required were 1, 16, 35 and 47, respectively. It is concluded that the efficacy of peribulbar anaesthesia depends upon the proximity of the deposition of local anaesthetic solution either to the globe or orbital apex. These data justify the classification of peribulbar anaesthesia into: circum-ocular (sub-Tenon's, episcleral), peri-ocular (anterior, superficial); peri-conal (posterior, deep) and apical (ultra-deep) for teaching purposes. [source] | ||||||||||