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Injection Period (injection + period)
Selected AbstractsInsulin and glucose profiles during continuous subcutaneous insulin infusion compared with injection of a long-acting insulin in Type 2 diabetes1DIABETIC MEDICINE, Issue 5 2008T. Parkner Abstract Aims To compare insulin and glucose profiles during basal continuous subcutaneous infusion of a rapid-acting insulin analogue and once daily subcutaneous injection of a long-acting insulin analogue in Type 2 diabetes. Methods Twenty-one patients with Type 2 diabetes treated with oral glucose-lowering agents were randomized in this two-period crossover study to an equivalent 24-h dose of continuous subcutaneous infusion of insulin aspart and subsequently once-daily bedtime subcutaneous injection of insulin glargine, or vice versa, for eight consecutive days. Plasma profiles of insulin and glucose were recorded. Results On the last day of each treatment period, the area under the curve (AUC) for glucose was 10% lower on the continuous subcutaneous infusion regimen compared with the insulin injection regimen (P = 0.002). This was accomplished by a flat exogenous insulin infusion profile compared with a peaking profile with injected insulin (AUC was 74% higher after injection compared with pre-injection levels (P = 0.001)). During the last 6 days in each treatment period, the intra-subject variability of exogenous fasting insulin levels in the mornings was 41% lower during insulin infusion compared with insulin injection (P = 0.012). The corresponding intra-subject variability for fasting glucose only showed a tendency to be lower during infusion as compared to the injection regimen (28%; P = 0.104). Thirteen symptomatic-only or minor hypoglycaemic episodes were recorded during the entire infusion period compared with three episodes during the injection period. Conclusions Basal continuous subcutaneous infusion of a rapid-acting insulin analogue improved plasma insulin (more flat insulin profile with a lower variability) and glucose (lower AUC) profiles compared with once-daily subcutaneous injection of a long-acting insulin analogue in Type 2 diabetes. [source] Is improved high speed performance following frusemide administration due to diuresis-induced weight loss or reduced severity of exercise-induced pulmonary haemorrhage?EQUINE VETERINARY JOURNAL, Issue S36 2006X. A. ZAWADZKAS Summary Reasons for performing study: Prerace administration of frusemide to horses has been linked with a significant improvement in racing performance, but the basis for this improvement is unclear. Objective: To test whether improved performance with prerace administration of frusemide is due to the drug's diuresis-induced weight loss rather than its apparent alleviation of exercise-induced pulmonary haemorrhage (EIPH). Methods: Eight thoroughbred horses underwent 3 trials in a random order, 2 or 3 weeks apart: control (C), frusemide/unburdened (FU), and frusemide/burdened (FB). None of the horses were known to have exhibited post-exercise epistaxis or endoscopic evidence of EIPH. Endoscope-guided bronchoalveolar lavages (BALs) were performed before and after each horse completed a standardised exercise test (SET) on an inclined treadmill to assess semi-quantitatively the volume of EIPH. For C, horses received an i.v. saline placebo injection (5 ml) and were unburdened while performing the SET. With FU, horses received frusemide (0.5 mg/kg) and were also unburdened. For FB, horses received frusemide and were burdened with weight equal to that lost during the 4 h post frusemide injection period. Erythrocyte number in BAL fluid, mass specific VO2max, time and distance for the entire SET as well as at maximum speed were recorded. A one-way repeated measures analysis of variance was conducted on all results. Results: Mass specific VO2max was significantly higher for the FU than for FB or C. Mass specific VO2max for FB and C were not different. More RBCs were found in BAL samples after C runs than after both FU and FB trial runs. Horses with the frusemide treatment (either burdened or unburdened) produced less EIPH than in the C trial, but their mass specific VO2max values were higher on the FU trial alone. For FU, horses ran longer at 115% VO2max than under C or FB conditions. Conclusion and potential relevance: Improvement of performance in the furosemide trials was due more to the weight-loss related effects of the drug than its apparent alleviation of EIPH. Further research is warranted with the same or similar project design, but with a larger sample size and with horses known to have more severe EIPH. [source] Treatment of Refractory, Chronic Low Back Pain with Botulinum Neurotoxin A: An Open-Label, Pilot StudyPAIN MEDICINE, Issue 3 2006Bahman Jabbari MD ABSTRACT Objective., To study the short- and long-term effects of botulinum neurotoxin A (BoNT-A, Botox®, Allergan Inc.) on refractory chronic low back pain. Design., The effect of botulinum neurotoxin A on chronic low back pain was prospectively studied in 75 patients with repeated treatments over a period of 14 months. Pain intensity (visual analog scale [VAS]), pain frequency (pain days), and perceived functional status (Oswestry scale) were assessed at baseline, 3 weeks, and at 2, 4, 6, 8, 10, 12, and 14 months. BoNT-A was injected into para-spinal muscles at 4,5 levels (between L1 and S1) unilaterally or bilaterally. The dose per site varied from 40 to 50 units. The total dose per session ranged from 200 to 500 units. Reinjections were performed at 4 months only when pain returned. Results., At 3 weeks, 40 patients (53%) and at 2 months, 39 patients (52%) reported significant pain relief. The change in VAS, Oswestry score, and pain days was significant compared with baseline at 2 months after each injection period (P < 0.005) and remained so over subsequent treatments. Among initial responders, 91% continued responsiveness over the length of the study. Three patients (4%), after the first treatment, had a mild flulike reaction that lasted 2,5 days. Conclusion., Botulinum neurotoxin A may be beneficial in patients with chronic low back pain. A favorable initial response predicts subsequent responsiveness. The treatment is well tolerated, and side effects are mild and transient. [source] Local and systemic effects of intralaryngeal injection of cidofovir in a canine model,THE LARYNGOSCOPE, Issue 11 2003Dinesh K. Chhetri MD Abstract Objective: The safety of intralaryngeal injection of cidofovir remains a concern. Our goal was to evaluate local and systemic effects of intralaryngeal injection of cidofovir. Study Design: Animal study using a canine model. Methods: Two groups of three young beagle dogs (6 vocal folds in each group) were used. Subepithelial vocal fold injections were performed in each group biweekly for 6 months with 0, 2.5, 5, 10, 20, and 37.5 mg cidofovir in a 0.5 mL volume. Direct laryngoscopy was performed at each injection interval. Complete blood cell count and renal parameters were measured at baseline and monthly thereafter. Histopathologic examination of the vocal folds was performed after the 6-month injection period in one group of animals and after an additional 6-month observation period in the second group. Results: Endomysial edema with muscle fiber separation and dose-dependent atrophy and scarring of the vocal folds was present. Onset of atrophy and scarring was observed after 3,7, and 11 injections in the vocal folds injected with 37.5, 20, and 10 mg cidofovir, respectively. After the 6-month observation period, recovery of histologic abnormalities was complete in the low-dose (0, 2.5 mg) vocal folds, near complete in the intermediate-dose (5, 10 mg) vocal folds, and no apparent recovery was seen in the high-dose (20, 37.5 mg) vocal folds. Leukocyte count and renal parameters remained unchanged at up to 4.26 mg/kg body weight of systemic dose of cidofovir. Conclusions: Intralaryngeal cidofovir leads to dose-dependent scarification of the vocal folds that appears irreversible at higher doses. Lower concentrations of this drug should be used in intralesional intralaryngeal use. [source] | ||||||||||