Comparison of pain levels developed during intramuscular injections to laterofemoral and ventrogluteal regions in children: a randomized controlled study

SUMMARY OBJECTIVE: The aim of this study was to compare the levels of pain developed during intramuscular injections to the laterofemoral and ventrogluteal regions in children. METHODS: The study population consisted of all children aged between 7 and 12 years who presented to the pediatric emergency clinic of a hospital. The sample consisted of 62 children who met the inclusion criteria and agreed to participate in the study, and the children were randomly assigned to each group (laterofemoral n=31, ventrogluteal n=31). "Buzzy" and "deep breathing" were applied to children in both groups to relieve pain during the procedure. The data were obtained using an Information Form, a visual analog scale, and the Facial Pain Scale-Revised. RESULTS: It was determined that the children in the ventrogluteal group during the intramuscular injections had lower visual analog scale and faces pain scale-revised scores immediately after the procedure compared with the vastus lateralis group, that is, they experienced less pain, and the difference between the two groups was significant (p<0.001). CONCLUSION: In children, it is recommended to choose the less painful ventrogluteal region for intramuscular injection and to inform health professionals about it.

A case of poisoning caused by intramuscular injection of esfenvalerate / 中华劳动卫生职业病杂志

Esfenvalerate is a kind of commonly used highly effective pyrethroid insecticide. It is common for people who are poisoned by contact or misuse, but rarely reported for people who are poisoned by intramuscular injection. This paper reports a case of intramuscular injection of esfenvalerate in the Department of Infection, West China Hospital of Sichuan University in November 2021. The patient was intramuscularly injected with about 20 ml of esfenvalerate, inducing the sense of swelling and tingling, degeneration and necrosis of striated muscle tissue at the injection site, also liver function damage and other manifestations. The patient was discharged from hospital after rehydration, accelerating poison metabolism, anti-infection, liver protection and local puncture.

Administração de medicamentos por via intramuscular: caracterização dos vídeos brasileiros veiculados no YouTube® / Intramuscular drug administration: characterization of Brazilian videos on YouTube®

RESUMO Objetivo caracterizar os vídeos que contém a demonstração do procedimento de administração de medicamentos por via intramuscular em indivíduos adultos. Métodos estudo de corte transversal descritivo, foram selecionados 44 vídeos brasileiros disponíveis no YouTube® que abordavam o procedimento de administração de medicamentos por via intramuscular. Resultados a maioria dos vídeos selecionados é de origem pessoal (86,4%), tem como autor um técnico de Enfermagem (59,1%), adota a região dorsoglútea como local de injeção (54,5%), foi produzido em ambiente de saúde utilizando um paciente para a demonstração do procedimento (52,3%). Nenhum vídeo apresentou a completude do procedimento, sendo identificada grande frequência de erros em todas as etapas do procedimento. Observou-se uma diferença estatisticamente significante entre os testes de confiabilidade e popularidade dos vídeos (p=0,042). Conclusão os vídeos que abordam o procedimento de administração de medicamentos por via intramuscular disponíveis na plataforma YouTube® foram considerados atuais, de pouca relevância, elaborados por fontes não confiáveis, de baixa acurácia e frágil finalidade. Contribuições para a prática os vídeos disponíveis na plataforma YouTube® sobre a administração de medicamentos por via intramuscular não devem ser indicados como material educativo para a formação ou atualização profissional.

ABSTRACT Objective to characterize videos that contain a demonstration of the procedure for administering drugs intramuscularly to adults. Methods a descriptive cross-sectional study, 44 Brazilian videos available on YouTube® were selected which addressed the procedure of intramuscular drug administration. Results the majority of the videos selected are of personal origin (86.4%), were made by a Nursing technician (59.1%), used the dorsal gluteal region as the injection spot (54.5%), and were produced in a healthcare environment using a patient to demonstrate the procedure (52.3%). No video showed the completeness of the procedure, and a high frequency of errors was identified at all stages of the procedure. There was a statistically significant difference between the reliability and popularity tests of the videos (p=0.042). Conclusion the videos on intramuscular drug administration available on the YouTube® platform were considered to be up-to-date, of little relevance, produced by unreliable sources, of low accuracy, and with a weak purpose. Contributions to practice the videos available on the YouTube® platform on intramuscular drug administration should not be used as educational material for professional training or updating.

Intramuscular injection safety without aspiration in the ventro-gluteal region during vaccination: randomized clinical trial / Seguridad de la inyección intramuscular sin aspiración en la región ventroglútea durante la vacunación: ensayo clínico aleatorizado / Segurança da injeção intramuscular sem aspiração na região ventro-glútea durante a vacinação: ensaio clínico randomizado

ABSTRACT Objectives: to compare adverse events after administrating hepatitis A vaccine intramuscularly in the ventro-gluteal region between techniques with and without aspiration. Methods: randomized double-blind clinical trial, using hepatitis A vaccine (inactivated) in the ventro-gluteal region, with a sample of 74 participants in the intervention group, vaccinated with the slow injection technique without aspiration, and 74 participants in the control group undergoing slow injection with aspiration. Daily assessment of participants was carried out in the 72 hours after vaccination, in order to ascertain local, systemic adverse events, local and contralateral temperatures. Results: the occurrence of local and systemic adverse events was homogeneous between the groups in the three days after vaccination (p>0.05). There was no influence of sex, race, pre-existing disease and use of medication. Conclusions: the intramuscular vaccination technique without aspiration in the ventro-gluteal region is safe for adverse events following immunization compared to the conventional technique with aspiration.

RESUMEN Objetivos: comparar eventos adversos después de la administración de la vacuna contra la hepatitis A por vía intramuscular en la región ventroglútea entre técnicas con y sin aspiración. Métodos: ensayo clínico aleatorizado doble ciego utilizando la vacuna Hepatitis A (inactivada) en la región ventroglútea, con una muestra de 74 participantes en el grupo de intervención, vacunados con la técnica de inyección lenta sin aspiración, y 74 participantes del grupo control sometidos a inyección con aspiración. La evaluación diaria de los participantes se llevó a cabo en las 72 horas posteriores a la vacunación, con el fin de conocer los eventos adversos locales, sistémicos, las temperaturas locales y contralaterales. Resultados: la ocurrencia de eventos adversos locales y sistémicos fue homogénea entre los grupos en los tres días posteriores a la vacunación (p>0.05). No hubo influencia de las variables sexo, raza, enfermedad preexistente y uso de medicación. Conclusión: la técnica de vacunación intramuscular sin aspiración en la región ventroglútea es segura para eventos adversos después de la vacunación en comparación con la técnica convencional con aspiración.

RESUMO Objetivos: comparar os eventos adversos após a administração da vacina hepatite A via intramuscular na região ventro-glútea entre as técnicas com e sem aspiração. Métodos: ensaio clínico randomizado duplo-cego, utilizando a vacina hepatite A (inativada) na região ventro-glútea, com amostra de 74 participantes no grupo intervenção, vacinados com a técnica de injeção lenta sem aspiração, e 74 participantes no grupo controle submetidos à injeção lenta com aspiração. Foi realizada avaliação diária dos participantes nas 72 horas pós-vacinação, com intuito de averiguar eventos adversos locais, sistêmicos, temperaturas locais e contralaterais. Resultados: a ocorrência de eventos adversos locais e sistêmicos foi homogênea entre os grupos nos três dias pós-vacinação (p>0,05). Não houve influência das variáveis sexo, raça, doença pré-existente e uso de medicamento. Conclusões: a técnica de vacinação intramuscular sem aspiração na região ventro-glútea é segura quanto aos eventos adversos pós-vacinação em comparação à técnica convencional com aspiração.

Práticas de medicações injetáveis: conduta referida de profissionais de enfermagem / Prácticas de medicaciones inyectables: conducta referida de los profesionales de enfermería / Injectable medications: self-reported practices of nursing professionals

RESUMO Objetivo: Identificar a conduta referida de profissionais da enfermagem, do estado de São Paulo, sobre Práticas de Medicações Injetáveis. Método: Estudo tipo survey que identificou a frequência referida sobre Práticas de Medicações Injetáveis mediante resposta de questionário eletrônico, validado, entre setembro e dezembro de 2017. Resultados: Considerando as 1.295 respostas computadas, foram identificadas inconformidades como compartilhamento de frascos multidoses para dois ou mais pacientes (10,8%), reutilização de insumos de uso único, como seringas para salinização de pacientes diferentes (1,2%) e reencape de agulhas após uso (4,9%). Foram referidas maior adesão ao uso de luvas para administração de injeções endovenosas (80,5%) e falta de treinamento para manipulação de dispositivos de segurança (13%). Dados correlacionais apontaram que, quanto maior a idade, melhor era a conduta referida na prática de injetáveis. Conclusão: Embora a maioria das condutas configure-se dentro das Boas Práticas de Medicações Injetáveis, há relatos de práticas de risco, como compartilhamento de insumos de uso único. O treinamento para uso de dispositivos de segurança ainda não é uma realidade para todos os profissionais, visto que muitos o referiram como raro.

RESUMEN Objetivo: Identificar la conducta de profesionales de enfermería del estado de São Paulo sobre Prácticas de Medicaciones Inyectables. Método: Se trata de un estudio tipo survey, el cual identificó la frecuencia de Prácticas de Medicaciones Inyectables mediante respuesta de un cuestionario electrónico, validado entre septiembre y diciembre de 2017. Resultados: Teniendo en cuenta las 1.295 respuestas computadas, se identificaron inconformidades como el uso de frascos de dosis múltiples para dos o más pacientes (10,8%), la reutilización de insumos de un solo uso, como jeringas para la salinización de diferentes pacientes (1,2%) y el reencapuchado de agujas después de su uso (4,9%). Sobresalió la adhesión al uso de guantes para las inyecciones intravenosas (80,5%) y la falta de capacitación sobre la manipulación de dispositivos de seguridad (13%). Los datos correlativos señalaron que, a mayor edad, mejor la conducta referida en la práctica de los inyectables. Conclusión: Aunque la mayoría de las conductas se configuran dentro de las Buenas Prácticas de Medicaciones Inyectables, se informa sobre la existencia de prácticas de riesgo, como el compartir insumos de un solo uso. La capacitación en el uso de dispositivos de seguridad aún no es una realidad para todos los profesionales y muchos han declarado que raramente se los entrena en esa área.

ABSTRACT Objective: To identify the self-reported injectable medications of nursing professionals in the state of São Paulo. Method: Survey study that assessed the self-reported frequency of injection medications through a validated electronic questionnaire, applied from September to December 2017. Results: The 1,295 computed responses showed non-compliances such as sharing multidose vials for two or more patients (10.8%), reusing single-use supplies, such as use of saline flush syringes for different patients (1.2%) and needle recapping after use (4.9%). Greater adherence to glove use for administration of intravenous injections (80.5%) and lack of training for handling safety devices (13%) were reported. Correlational data showed that, the older the age, the better the self-reported injecting practices. Conclusion: Although most practices are within Safe Injecting practices, there are reports of risky practices, such as sharing single-use supplies. Training for the use of safety devices is not yet a reality for all professionals, since many reported it as rare.

Clinical effect of acupoint injection of salmon calcitonin in the treatment of senile osteoporosis / 中国基层医药

Objective To observe the clinical effect of acupoint injection of salmon calcitonin in the treatment of senile osteoporosis. Methods From February 2016 to July 2017,136 elderly patients with osteoporosis admitted to Wenzhou Hospital of Traditional Chinese Medicine were included. The patients were randomly divided into two groups,with 68 cases in each group. The acupoint－injection group was given 50IU salmon calcitonin on day 1, day 2 100IU, one time per day, continuously used for 15 days for a course of treatment, and with an interval of 90 days,and repeat the course of treatment. The patients were given 0. 9% sodium chloride diluted to 2mL,inject 0. 5mL into bilateral Shenshu and Zusanli these two points. The intramuscular injection group was given the same dose of salmon calcitonin gluteus maximus injected intramuscularly. At the same time,both two groups were given calcium Erqi D tablets one tablet a day,alendronate once a week,each time 70mg fasting taken orally. The type Ⅰ collagen β－CTx,PINP,NBAP,femoral neck,femur trochanter,lumbar (L1 －L4) lumbar BMD and osteoporosis symptom score before and after treatment were compared. Results After treatment,the NBAP and BMD of the two groups were significantly higher than those before treatment (all P＜0. 05),and the β－CTx,PINP and symptoms scores were lower than before treatment (P＜0. 05). After treatment,NBAP in the acupoint injection group was (32. 36 ± 3. 03)μg/L, which was higher than (29. 66 ± 3. 20) μg/L in the intramuscular injection group(t =10. 477,P ＜0. 05). The β－CTx and PINP in the acupoint injection group were decreased to (0. 10 ± 0. 05)μg/L and (28. 78 ± 5. 23)μg/L, which were significantly lower than those in the intramuscular injection group[β－CTx(0. 20 ± 0. 05)μg/L,PINP (35.77 ±6. 49)μg/L(t =5. 983,2. 662,all P ＜0. 05)]. After treatment,the BMD of the femoral neck,femur trochanter and lumbar vertebra (L1 －L4) in the acupoint injection group were (0. 690 ± 0. 032)g/m2,(0. 620 ± 0. 010)g/m2and (0. 822 ± 0. 012)g/m2,respectively,which were higher than those in the intramuscular injection group[(0.652 ±0.012)g/m2,(0.572 ±0.022)g/m2and (0.801 ±0.011)g/m2(t=5.055,6.133,1.956,all P＜0. 05)]. After treatment,the improvements of TCM syndromes such as weakness in the waist and knees,tinnitus and deafness,loss of appetite,release of teeth,relaxation of two feet,weak tongue,weak pulse in the acupoint injection group were better than those in the intramuscular injection group (all P＜0. 05). Conclusion The acupoint injection of salmon calcitonin at Zusanli and Shenshu points is more effective than the intramuscular injection in the treatment of senile osteoporosis. It can significantly increase the serum NBAP,decrease the serum β－CTx,PINP,improve the BMD and improve the patients＇clinical symptoms,which means acupoint injection is a safe and effective way to treat senile osteoporosis.

Ensaio clínico randomizado e unicego comparando a aplicação de toxina onabotulínica intradérmica versus intramuscular na região frontal / Randomized, single-blind clinical study comparing the application of intradermal versus intramuscular onabotulinum toxin in the frontal region

Introdução: A aplicação-padrão da toxina botulínica para linhas frontais é feita no plano intramuscular. Alguns autores têm sugerido que a combinação com pontos intradérmicos pode trazer resultado mais natural, evitando o efeito muito paralisante do uso apenas intramuscular. Objetivo: Estabelecer se o efeito paralisante da toxina onabotulínica tipo A na fronte, aplicada de forma intradérmica, é tão efetivo quanto o da mesma toxina aplicada de forma intramuscular após: 48 horas, uma, duas, quatro, oito e 12 semanas para o tratamento de linhas frontais. Materiais e métodos: 16 pacientes com rugas frontais foram randomizadas para receber toxina onabotulínica intramuscular ou intradérmica e foram reavaliadas em 48 horas, uma e duas semanas, um, dois, e três meses. Resultados: Foram coletados dados de 16 pacientes. A média de idade foi 33 anos (desvio-padrão 5,96). Em duas semanas a paralisia ocorreu em 93,3% no lado intramuscular e em 53,5% no lado intradérmico (p = 0,07). A nota mediana de dor foi 2,69 no lado intramuscular e 4 no lado intradérmico (p = 0,072). Conclusões: apesar da mais alta frequência da presença de paralisia no lado intramuscular em todas as avaliações, não houve diferença estatisticamente significativa entre os lados.

Introduction: The standard application of botulinum toxin for frontal wrinkles is at the intramuscular level. Some authors have suggested that the combination with intradermal application can bring about a more natural result, avoiding the paralyzing effect of the intramuscular application only. Objective: Establish if the paralyzing effect of type A onabotulinum toxin in the forehead, applied intradermally, is as effective as of the same toxin applied intramuscularly after: 48 hours, one, two, four, eight and 12 weeks for the treatment of frontal wrinkles. Material and Methods: Sixteen patients with frontal wrinkles were randomized to receive intramuscular or intradermal onabotulinum toxin and were reevaluated after 48 hours, one and two weeks, one, two and three months. Results: Data were collected from 16 patients. Mean age was 33 years (standard deviation 5.96). Paralysis occurred in 93.3% in the intramuscular side and in 53.5% in the intradermal side in two weeks (p= 0.07). Median pain grade was 2.69 in the intramuscular side and 4 in the intradermal side (p=0.072). Conclusions: Despite the highest frequency of the presence of paralysis in the intramuscular side in all evaluations, there was no statistically significant difference between the sides.

Analysis of gluteal subcutaneous and muscle thickness in infants and children for application to intramuscular injection, autologous fat grafting, and gluteal artery perforator flaps

BACKGROUND: To achieve improvements in intramuscular injection, autologous fat grafting, and gluteal artery perforator flaps in infants and children, the relationships of computed tomography (CT)-determined gluteal muscle thickness (MT) and subcutaneous tissue thickness (SCT) with age and body mass index (BMI) were analyzed. METHODS: Gluteal SCT and MT at ventrogluteal (VG) and dorsogluteal (DG) sites were measured in a standardized manner in 350 patients aged 0 to 6 years who had visited a tertiary hospital and had undergone abdominopelvic CT between January 2005 and December 2016. Recorded measurements were analyzed using one-way analysis of variance and stepwise multiple regression to identify the factors that were most closely related to MT and SCT. RESULTS: Subcutaneous tissue at VG sites was thinner than at DG sites, but not significantly so in any age group. Muscles tended to be thinner at VG sites in 4 to 7-year-old, but thicker at VG sites in 1 to 3-year-old, though the differences were not significant. MT in the VG and DG regions was found to be related to age, and SCT in these regions to be related to age and BMI. CONCLUSIONS: The VG and DG sites should be considered as alternatives for intramuscular injection in infants and children when the anterolateral site is problematic. In addition, considering the gluteal MT and SCT of infants and children should help produce good results in autologous fat grafting and gluteal artery perforator flap harvesting.

Effects of Single Vitamin D₃ Injection (200,000 Units) on Serum Fibroblast Growth Factor 23 and Sclerostin Levels in Subjects with Vitamin D Deficiency

BACKGROUND: Vitamin D deficiency remains common in all age groups and affects skeletal and non-skeletal health. Fibroblast growth factor 23 is a bone-derived hormone that regulates phosphate and 1,25-dihydroxyvitamin D homeostasis as a counter regulatory factor. 1,25-Dihydroxyvitamin D stimulates fibroblast growth factor 23 synthesis in bone, while fibroblast growth factor 23 suppresses 1,25-dihydroxyvitamin D production in the kidney. The aim of this study was to evaluate the effects of vitamin D₃ intramuscular injection therapy on serum fibroblast growth factor 23 concentrations, and several other parameters associated with bone metabolism such as sclerostin, dickkopf-1, and parathyroid hormone. METHODS: A total of 34 subjects with vitamin D deficiency (defined by serum 25-hydroxyvitamin D levels below 20 ng/mL) were randomly assigned to either the vitamin D injection group (200,000 units) or placebo treatment group. Serum calcium, phosphate, urine calcium/creatinine, serum 25-hydroxyvitamin D, fibroblast growth factor 23, sclerostin, parathyroid hormone, and dickkopf-1 levels were serially measured after treatment. RESULTS: Comparing the vitamin D injection group with the placebo group, no significant changes were observed in serum fibroblast growth factor 23, parathyroid hormone, or dickkopf-1 levels. Serum sclerostin concentrations transiently increased at week 4 in the vitamin D group. However, these elevated levels declined later and there were no statistically significant differences as compared with baseline levels. CONCLUSION: Serum fibroblast factor 23, sclerostin, parathyroid hormone, and dickkopf-1 levels were not affected significantly by single intramuscular injection of vitamin D₃.

Influences of improved intramuscular injection on quality of benzathine benzylpenicillin medication / 中华护理杂志

Objective To explore influences of improved intramuscular injection on quality of benzathine benzylpenicillin medication.Methods The cluster random sampling was adopted to select 178 patients who needed injection of 240U benzathine benzylpenicillin.A self-control study design was used,and benzathine benzylpenicillin was injected in both sides with each of 1 200 000 units.The left side was injected via routine method,while the right side was injected by an improved intramuscular injection.One-time success rate,degree and duration of pain during and after injection were recorded.Results The differences of one-time success rate,pain during injection,pain after injection,duration of pain after injection and incidence of induration after injection between two groups were statistically significant(P＜0.01).Conclusion The improved intramuscular injection can improve one-time success rate of benzathine benzylpenicillin,reduce pain during injection and local pain after injection,shorten duration of pain and decrease incidence of induration after injection.

Post-injection embolia cutis medicamentosa - Nicolau Syndrome: case report and literature review / Embolia cutis medicamentosa pós-injeção - Síndrome de Nicolau: relato de caso e revisão de literatura

We report on the case of a 40-year-old male who was admitted to the clinic with a large ulcer on his left buttock, 3 days after an intramuscular benzathine penicillin injection. The patient was diagnosed with Nicolau syndrome, a rare vascular complication in which a lesion develops after intramuscular injection. Symptoms are intense pain at the injection site, erythema, and livedoid dermatitis, which leads to necrosis of skin, subcutaneous tissue and muscle tissue. It was described by Nicolau after intramuscular injections of bismuth salt for syphillis therapy. Nicolau syndrome is rare, but its symptoms are devastating and healthcare professionals must be aware of this clinical entity, since intramuscular injections are common procedures for administration of drugs.

Relatamos o caso de um homem de 40 anos apresentando uma grande úlcera na nádega esquerda 3 dias após receber injeção intramuscular de penicilina benzatina. O paciente foi diagnosticado com síndrome de Nicolau, uma rara complicação vascular com lesão após injeções intramusculares. Os sintomas incluem dor intensa no local da injeção, eritema e dermatite livedoide, o que leva a necrose da pele, do tecido subcutâneo e do tecido muscular. Foi descrita por Nicolau após injeções intramusculares de sal de bismuto para o tratamento de sífilis. A síndrome de Nicolau é incomum, mas seus sintomas são devastadores. Portanto, os profissionais de saúde precisam conhecer essa entidade clínica, uma vez que as injeções intramusculares são procedimentos comuns para a administração de drogas.

Ensaio clínico controlado randomizado: região ventro glútea, local alternativo para aplicação da benzilpenicilina benzatina G / Ventrogluteal region, an alternative location to apply benzathine penicillin

O objetivo deste estudo foi comparar o nível de dor relacionada à administração da Benzilpenicilina Benzatina G nas regiões ventro glútea (VG) e dorso glútea (DG). Ensaio clínico controlado randomizado. Participaram do estudo 61 pessoas, 31 do grupo de intervenção (região VG) e 30 do grupo controle (região DG). O teste de qui-quadrado e Mann­ Whitney foram utilizados para testar diferenças entre proporções e comparar tendências centrais entre os grupos, respectivamente. Valores de p ˂ 0,05 foram considerados estatisticamente significantes. Nos três momentos avaliados, a média do escore de dor foi maior quando a aplicação do fármaco ocorreu na região VG vs. DG. No primeiro e terceiro minuto a diferença foi estatisticamente significativa. Estes resultados ratificam a região VG como local alternativo com menor reação local para aplicação de injeções intramusculares.

The objective of this study was to compare the pain level related to the administration of benzathine penicillin on the ventrogluteal (VG) and dorsogluteal (DG) region. A randomized controlled trial. Sixty-one people participated in the study, 31 on the intervention group (VG region), and 30 on the control (DG region). The Chi-Squared and Mann-Whitney tests were used to test differences of proportions and to compare central tendencies between groups, respectively. Values of p <0.05 were considered statistically significant. At the three assessed moments, the mean score of pain was higher when the application of the drug was on the VG region vs. DG. At the first and third minute, the difference was statistically significant. These results confirm the VG region as alternative place with less local reaction to apply intra- muscular injections.

Prevalência e fatores associados ao doping cosmético entre frequentadores de academias / Prevalence and associated factors to the cosmetic doping among fitness-centers customers

INTRODUÇÃO: O crescente culto ao corpo na sociedade atual tem levado diversos frequentadores de academia à prática sistemática de injetar óleos por via intramuscular, procedimento denominado doping cosmético. Assim, o presente estudo teve como objetivo verificar a prevalência de doping cosmético na região do Vale do São Francisco, buscando estabelecer os perfis sociodemográfico e clínico desse grupo de indivíduos. RELATO DE CASO: Trata-se de um estudo retrospectivo e documental, com análise dos registros de 346 frequentadores de academias de ginástica, dos quais sete relataram utilização de doping cosmético. Destes registros, foram coletados dados sociodemográficos, cineantropométricos, hemodinâmicos, história patológica pessoal e familiar pregressa e de consumo de drogas lícitas e ilícitas. A prevalência de doping cosmético foi 2,0% (IC95% 0,8–4,1), e a maioria dos usuários são adultos jovens com segundo grau completo, trabalhadores de classe média, sendo considerados ativos com baixo percentual de gordura. Eles utilizam suplementos alimentares, esteroides anabolizantes e outras drogas ilícitas. CONCLUSÃO: Os achados contribuem na determinação do perfil dessa população, demonstrando que os usuários de doping cosmético são adultos jovens preocupados com a estética corporal. As características sociodemográficas encontradas diferem de estudos prévios quanto ao nível de escolaridade, renda e ocupação. Nesse sentido, ações voltadas para a conscientização dessa população quanto aos riscos e perigos da utilização do doping cosmético devem ser apoiadas o mais breve possível.

INTRODUCTION: The rise in the cult of the body in modern society has led many fitness-centers customers to the systematic practice of intramuscular oil injections, procedure called cosmetic doping. Therefore, this study aimed to determine the prevalence of cosmetic doping in the São Francisco Valley region, in order to establish the sociodemographic and clinical profiles of this group of individuals. CASE REPORT: This is a retrospective documentary study with analysis of 346 records from fitness-centers customers, of which 7 reported use of cosmetic doping. Sociodemographic, kinanthropometric, hemodynamic, personal and family past medical history and the consumption of licit and illicit drug data were collected from these records. The prevalence of cosmetic doping was 2.0% (95%CI 0.8–4.1), and most of the users are young adults with high school graduates, middle-class workers, and are considered physically active with low body fat mass. They use concomitantly dietary supplements, anabolic steroids and other illicit drug. CONCLUSION: The findings of the study contribute in determining the profile of this population, demonstrating that users of cosmetic doping are young adults concerned with aesthetic body. The sociodemographic characteristics found in this study differ from previous studies in the level of education, income and occupation. In this sense, actions to raise awareness of this population about the risks and dangers of the cosmetic doping should be supported as soon as possible.

Contracepção injetável trimestral / Progestin-only injectable contraception

Os contraceptivos injetáveis trimestrais representam métodos de longo prazo muito utilizados, sendo acessíveis a grande contingente de pacientes. São altamente eficazes e com fácil posologia, colaborando com eficiente planejamento familiar. Suas taxas de gravidez oscilam entre 0,0 e 0,7/100 mulheres por ano. É método contraceptivo interessante para pacientes que não desejam ingestão de comprimidos, que apresentam contraindicações ao uso de estrogênios, que optam por amenorreia e para as adolescentes. No Brasil, é comercializado com a formulação de 150 mg de Acetato de Medroxiprogesterona de depósito (AMPD). Injeções intramusculares são capazes de inibir a ovulação e, também, alterarem o muco cervical e o endométrio. Seus efeitos adversos são reduzidos, destacando-se ganho de peso, dor abdominal, cefaleia, mudança de humor e diminuição do desejo sexual. Estudos atuais não demonstram maior risco de fraturas, apesar de haver discreta diminuição na densidade óssea. Apresenta benefícios relevantes como diminuição no risco de câncer endometrial, de câncer ovariano, de doença inflamatória pélvica e pode apresentar efeito benéfico nos sintomas da endometriose. Os autores realizaram revisão sobre o contraceptivo injetável trimestral priorizando seu modo de uso, efeitos benéficos, efeitos adversos e critérios de elegibilidade para sua prescrição.(AU)

The progestin-only injectable contraceptives are long-term methods widely used. They are accessible to large numbers of patients and are highly effective and easy to use. This collaborate with effective family planning. The pregnancy rates range between 0.0 and 0.7/100 women per years. They are a good alternative for contraception to patients who do not wish intake of pills, have contraindications to the use of estrogens, choose to amenorrhea and are adolescents. In Brazil it is marketed with the formulation of 150 mg of medroxyprogesterone acetate depot (DMPA). Intramuscular injections are able to inhibit ovulation and also modifies the cervical mucus and endometrium. Its adverse effects are few, especially weight gain, abdominal pain, headache, mood swings and decreased sexual desire. Current studies show no increased risk of fractures, although there is a slight decrease in bone density. It offers significant benefits such as reduced risk of endometrial cancer, ovarian cancer, pelvic inflammatory disease and may have beneficial effect on the symptoms of endometriosis. The authors conducted a review of the progestin-only injectable contraceptive focusing on its manner of use, benefits, side effects and eligibility criteria for prescription.(AU)

Human umbilical cord mesenchymal stem cells via intramuscular injection influence the expression of cytokines related to dilated cardiomyopathy in rats / 中国组织工程研究

BACKGROUND:Studies have shown that intramuscular transplantation of xenogeneic umbilical cord mesenchymal stem cel s in a certain dose range is safe and reliable, and it also confirm that this approach is equal y safe and effective for heart failure in rats with dilated cardiomyopathy. OBJECTIVE:To explore the effect of human umbilical cord mesenchymal stem cel s through intramuscular injection on the cytokine expression in adriamycin-induced dilated cardiomyopathy (DCM) rats. METHODS:Total y 160 rats were randomly divided into control group (n=20) and DCM group (n=140). Rats in the DCM group were administered adriamycin intraperitoneal y to establish DCM model. The DCM rats were randomly subdivided into model control group (served as model group), cel supernatant group, the low-dose mesenchymal stem cel group (served as low-dose group), the middle-dose mesenchymal stem cel group (served as middle-dose group), and the high-dose mesenchymal stem cel s group (served as high-dose group). Secondary injection was performed at 4 weeks after first injection. RESULTS AND CONCLUSION:The ELISA test showed that the serum levels of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), leukemia inhibitor factor (LIF) and granulocyte macrophage colony stimulating factor (GM-CSF) were higher in the model group than the control group before and after intramuscular injection (P0.05). Both the immunohistochemical and RT-PCR results showed that the expressions of insulin-like growth factor-1, VEGF and HGF were increased in al the DCM rats as compared with the control group, which were increased most in the middle-dose group. These findings indicate that low-dose and middle-dose human umbilical cord mesenchymal stem cel s intramuscular injection can increase the serum levels of HGF, LIF, GM-CSF, VEGF and the expressions of IGF-1, HGF and VEGF in the myocardium of DCM rats.

Development and assessment of learning objects about intramuscular medication administration / Desenvolvimento e avaliação de objetos de aprendizagem sobre administração de medicamentos por via intramuscular / Desarrollo y evaluación de objetos de aprendizaje sobre administración de medicamentos por vía intramuscular

OBJECTIVES: to develop and assess a learning object about intramuscular medication administration for nursing undergraduates and nurses. METHOD: a random, intentional and non-probabilistic sample was selected of nurses from a Brazilian social network of nursing and students from the Undergraduate Program at the University of São Paulo School of Nursing to serve as research subjects and assess the object. RESULTS: the participants, 8 nurses and 8 students, studied the object and answered an assessment instrument that included the following criteria: educational aspects (relevance of the theme, objectives and texts/hypertexts), interface of the environment (navigation, accessibility and screen design) and didactic resources (interactivity and presentation of resources). In total, 128 significant answers were obtained, 124 (97%) of which were positive, assessed as excellent and satisfactory, considered as a flexible, dynamic, objective resources that is appropriate to the nursing learning process. CONCLUSION: the educational technology shows a clear and easily understandable language and the teaching method could be applied in other themes, contributing to the education and training of nursing professionals, positively affecting nursing teaching, stimulating the knowledge, autonomous and independent learning, aligned with the new professional education requirements. .

OBJETIVOS: desenvolver e avaliar um objeto de aprendizagem sobre administração de medicamentos por via intramuscular para graduandos de enfermagem e enfermeiros. MÉTODO: foram selecionados, de forma aleatória, intencional e não probabilística, enfermeiros de uma rede social brasileira de enfermagem e alunos do curso de Graduação da Escola de Enfermagem da Universidade de São Paulo, para serem sujeitos da pesquisa e avaliadores do objeto. RESULTADOS: os participantes, oito enfermeiros e oito graduandos, estudaram o objeto e responderam a um instrumento de avaliação composto pelos critérios: aspectos educacionais (relevância do tema, objetivos e textos/hipertextos), interface do ambiente (navegabilidade, acessibilidade e design das telas) e recursos didáticos (interatividade e apresentação dos recursos). Obteve-se o total de 128 respostas significativas, sendo 124 (97%) respostas positivas, tendo sido o instrumento avaliado como excelente e satisfatório, considerado como um recurso flexível, dinâmico, objetivo e adequado ao processo de aprendizagem da enfermagem. CONCLUSÃO: a tecnologia educacional apresenta linguagem clara, de fácil compreensão, e o método de ensino poderia ser aplicado em outros temas, contribuindo para a formação e capacitação dos profissionais de enfermagem, impactando positivamente o ensino de enfermagem, estimulando o conhecimento, aprendizado autônomo e independente, alinhado às novas exigências de formação profissional. .

OBJETIVOS: desarrollar y evaluar un objeto de aprendizaje sobre administración de medicamentos por vía intramuscular para estudiantes de enfermería y enfermeros. MÉTODO: fueron seleccionados, de forma aleatoria, intencional y no probabilística, enfermeros de una red social brasileña de enfermería y alumnos del curso de Graduación de la Escuela de Enfermería de la Universidad de Sao Paulo, para ser sujetos de la investigación y evaluadores del objeto. RESULTADOS: los participantes, 8 enfermeros y 8 estudiantes, estudiaron el objeto y respondieron a un instrumento de evaluación compuesto por los criterios: aspectos educacionales (relevancia del tema, objetivos y textos/hipertextos), interfaz del ambiente (navegabilidad, accesibilidad y design de las pantallas) y recursos didácticos (interactividad y presentación de los recursos). Se obtuvo un total de 128 respuestas significativas, siendo 124 (97%) propuestas positivas; fue evaluado como excelente y satisfactorio, considerado como un recurso flexible, dinámico, objetivo y adecuado al proceso de aprendizaje de la enfermería. CONCLUSIÓN: la tecnología educacional presenta un lenguaje claro, de fácil comprensión y el método de enseñanza podría ser aplicado en otros temas, contribuyendo para la formación y capacitación de los profesionales de enfermería, impactando positivamente en la enseñanza de enfermería, estimulando: conocimiento, aprendizaje autónomo e independiente y en concordancia con las nuevas exigencias de formación profesional. .

Security of heterogeneous umbilical cord mesenchymal stem cells via intramuscular injection in Wistar rats / 中国组织工程研究

BACKGROUND:So far, the short-term changes of various organs after injection of umbilical cord mesenchymal stem cells have been reported, but there are few studies on the long-term changes of various organs in healthy rats after repeated intramuscular injection of umbilical cord mesenchymal stem cells. OBJECTIVE:To observe the security of intramuscular injection of heterogeneous umbilical cord mesenchymal stem cells. METHODS:Sixty male SPF Wistar rats were divided into six groups randomly:normal group (suspension liquid of umbilical cord mesenchymal stem cells);control group with culture solution;supernatant group (supernatant of human umbilical cord mesenchymal stem cells);low concentration group (0.25×105 human umbilical cord mesenchymal stem cells);moderate concentration group (1.0×105 human umbilical cord mesenchymal stem cells);high concentration group (4.0×105 human umbilical cord mesenchymal stem cells). Each rat was injected 0.8 mL liquid in muscle, 0.2 mL in each limb, twice at weeks 1 and 4. Biochemical tests were conducted before and after injection. At the end of 8 weeks, al the rats were kil ed and hematoxylin-eosin staining was done with the liver, spleen, lung, kidney, brain and muscle. RESULTS AND CONCLUSION:There was no abnormal change about biochemical tests and hematoxylin-eosin staining after the intramuscular injection of heterogeneous umbilical cord mesenchymal stem cells. No significant alteration was observed in the liver, spleen, lung, kidney, brain, and muscle of the limb after the injection of heterogeneous umbilical cord mesenchymal stem cells under suitable concentration. These findings indicate intramuscular injection of heterogeneous umbilical cord mesenchymal stem cells at certain concentrations is safe and reliable.

Effects of human umbilical cord mesenchymal stem cells via intramuscular injection on the myocardial ki-67, phh3 and cTnT expression in normal rats / 中国组织工程研究

BACKGROUND:It is unclear whether intramuscular injection of human umbilical cord mesenchymal stem cells wil increase regeneration of normal myocardial cells and play adverse effects on normal myocardium. OBJECTIVE:To observe the effects of intramuscular injection of human umbilical cord mesenchymal stem cells on expression of the myocardial ki-67, phh3 and cTnT in normal Wistar rats. METHODS:A total of 60 male Wistar rats were divided into six groups randomly:normal group, solution group, supernatant group, low concentration group, moderate concentration group, and high concentration group. These groups were intramuscularly injected different liquid, respectively, as fol ows:PBS, DMEM, the supernatant of human umbilical cord mesenchymal stem cells, human umbilical cord mesenchymal stem cells with amount of 0.25×105, human umbilical cord mesenchymal stem cells with amount of 1.0×105, human umbilical cord mesenchymal stem cells with amount of 4.0×105 . After 4 weeks, each rats received the second same intramuscular injections of human umbilical cord mesenchymal stem cells. Four weeks after the second injection, al rates were kil ed to obtain myocardial tissues which were fixed, embedded and sectioned. Final y, the ki-67, phh3 and cTnT expressions of the myocardium were detected by immunohistochemical technique. RESULTS AND CONCLUSION:In the normal group, negative expression of the ki-67 was observed in the caryon of myocardial cells, weak positive expression of the phh3 was observed in the caryon of myocardial cells, and positive expression of the cTnT was observed in the caryon of myocardial cells. Compared with the normal group, the expression of the ki-67, phh3 and cTnT in the myocardium had no significant difference among the other groups (F=1.076, 0.167, 0.300;P>0.05). Human umbilical cord mesenchymal stem cells or the supernatant of human umbilical cord mesenchymal stem cells via intramuscular injection have no effects on the expression of the ki-67, phh3 and cTnT in normal Wistar rats.

Comparison between the anesthetic induction times in the first and second surgery in rabbits / Comparação entre os tempos de indução anestésica no primeiro e segundo atos operatórios em coelhos

PURPOSE: To compare the anesthetic induction time (IT) in the first and second surgery in rabbits. METHODS: Eighteen rabbits, weighing between 1.825 and 2.980kg. The anesthetic protocol consisted of premedication of ketamine and xylazine intramuscularly. The rabbits were anesthetized and the induction time was evaluated by compressing the animal's ear every 30 seconds. The IT was measure and than a saphenous vein surgery was made on the rabbit. Seven days after the first procedure, the same anesthetic protocol was performed and measuring the second IT. RESULTS: It was observed an increase of 50 seconds on the average value of second IT in relation to the average value of first. The IT variation between the first and second anesthetic procedure was between 0 and eight minutes for each animal. In 94.4% of the animals, there was variation greater than 30 seconds between the IT. CONCLUSION: There was difference between the first and second induction time in almost animals. There was an increase on the average value of second IT in relation to the average value of first.

OBJETIVO: Comparar os tempos de indução anestésica (TIA) no primeiro e segundo atos operatórios em coelhos. MÉTODOS: Foram utilizados 18 coelhos de peso entre 1,825 e 2,980kg. O protocolo anestésico consistiu de pré-medicação de ketamina e xilazina por via intramuscular. Os coelhos foram anestesiados e o tempo de indução anestésica foi avaliado por meio da compressão da orelha do animal a cada 30 segundos. O TIA foi medido e em seguida foi realizada cirurgia na veia safena do coelho. Depois de sete dias do primeiro procedimento, o mesmo protocolo anestésico foi realizado e o segundo TIA foi medido. RESULTADOS: Foi observado um aumento de 50 segundos na média dos tempos de indução anestésica da segunda medida em comparação com a média do primeiro. A variação do TIA entre o primeiro e segundo protocolo anestésico foi de 0 a oito minutos. Em 94,4% dos animais a variação entre os tempos foi maior que 30 segundos. CONCLUSÃO: Houve diferença entre o primeiro e o segundo tempo de indução anestésica em todos os animais. Houve aumento na media dos valores do segundo TIA em relação ao primeiro TIA.

Bupivacaine and botulinum toxin to treat comitant strabismus / Bupivacaína e toxina botulínica para tratamento de estrabismo comitante

PURPOSE: To evaluate the change in ocular motility and muscle thickness measured with ultrasonography after intramuscular injection of bupivacaine and botulinum toxin A. METHODS: Eight patients (five female) were enrolled to measure ocular motility prior and 1, 7, 30 and 180 days after one injection of 2 ml of 1.5% bupivacaine and 2.5 U of botulinum toxin A in agonist and antagonist muscles, respectively, of eight amblyopic eyes. Muscle thickness was measured prior and on days 1, 7 and 30 after injection using 10-MHz ultrasonography (eyelid technique). RESULTS: Mean change in alignment was 10 prism diopters after 180 days (n=6). An average increase of 1.01 mm in muscle thickness was observed after 30 days of bupivacaine injection and 0.28 mm increase was observed after botulinum toxin A injection, as measured by ultrasonography. Lateral rectus muscles injected with bupivacaine had a mean increase of 1.5 mm in muscle thickness. CONCLUSION: In this study, a change in ocular motility was observed after 180 days of intramuscular injection of bupivacaine and botulinum toxin in horizontal extraocular muscles. Overall, there was an increase of muscle thickness in both botulinum toxinum A and bupivacaine injected muscles after 30 days of injection when measured by ultrasonography. This change was more pronounced on lateral rectus muscles after bupivacaine injection.

OBJETIVO: Avaliar a mudança na motilidade ocular e espessura dos músculos medida por ultrassonografia após injeção intramuscular de bupivacaína e toxina botulínica tipo A. MÉTODOS: Oito pacientes (5 mulheres) foram incluidos para avaliar a mudança na motilidade ocular antes e após 1, 7, 30 e 180 dias da injeção de 2 ml de bupivacaína 1,5% e 2,5 U de toxina botulínica tipo A nos músculos agonista e antagonista, respectivamente, de 8 olhos amblíopes. A espessura muscular foi medida antes após 1, 7, 30 dias da injeção através de ultrassonografia ocular 10-MHz (técnica palpebral). RESULTADOS: A média de mudança no alinhamento ocular foi igual a 10 dioptrias prismáticas após 180 dias (n=6). Foi observado um aumento médio de 1,01 mm na espessura muscular após 30 dias da injeção de bupivacaína e 0,28 mm após a injeção de toxina botulínica A medido pela ultrassonografia. Os músculos reto laterais injetados com bupivacaína tiveram um aumento médio de 1,5 mm na sua espessura. CONCLUSÃO: Neste estudo, observou-se uma mudança no alinhamento ocular após 180 dias de injeção intramuscular de bupivacaína e toxina botulínica A. Em geral, houve um aumento da espessura muscular de ambos os grupos de músculos injetados com toxina botulínica A e com bupivacaína após 30 dias da injeção. Essa mudança foi mais pronunciada nos músculos retos laterais após a injeção de bupivacaína.