Establishment and comparison of two methods to produce a rat model of mammary gland hyperplasia with hyperprolactinemia

Abstract This study aimed to establish and compare models of mammary gland hyperplasia (MGH) with hyperprolactinemia (HPRL) using two different methods. The models provide information on the relationship between mammary gland hyperplasia and associated hormones. Model A was constructed using intramuscular injections of estradiol benzoate injection (EBI), followed by progesterone (P), and then metoclopramide dihydrochloride (MDI). Model B was designed by administering MDI, follow by EBI, and then P intramuscularly. Model B showed higher MGH progression compared with model A. Notably, increase in estradiol (E2) was negatively correlated with prolactin (PRL) secretion. However, PRL levels in model B were significantly higher compared with the levels in model A. Estrogen (ER), prolactin receptor (PRLR), and progesterone receptor (PR) mRNA and protein expression levels in model B rats were positively correlated with changes in the corresponding hormone levels. However, E2, P, and PRL levels in model A showed no direct relationship with levels of the mRNAs of related hormones and protein expression levels. Our results suggest that model B is an appropriate model of MGH with HPRL that can be used to perform further studies about the interactions of the E2, P, and PRL hormones in this disorder.

(Re)discutindo a técnica de administração de medicamentos pela via intramuscular: revisão sistemática / (Re)discussing the drug administration technique by the intramuscular route: a systematic review / (Re)discutir la técnica de administración de fármacos por vía intramuscular: revisión sistemática

Objetivo: Identificar la producción del conocimiento en enfermería junto la técnica de administración de medicamentos por vía intramuscular, describa las diferencias, congruencias, y la ocurrencia de las complicaciones de la técnica y analizar las recomendaciones formuladas en la literatura con las mejores prácticas y las actualizaciones clínicas en enfermería. Método: Revisión sistemática sin meta-análisis. Búsqueda realizada en las bases de datos LILACS, PUBMED, MEDLINE, DEDALUS, Portal de Evidencia en Salud y Bibliotecas SciELO y Cochrane, en el período de 1993-2012, por un total de 16 estudios. Resultados: Estúdios mostraron diferencias en las variaciones en la demarcación de la región ventral glútea, la realización de la antisepsia y la aplicación de presión antes de la administración intramuscular. Consonancia en la aspiración del contenido de la jeringa después de la inserción de la aguja en el músculo, de ricino secuencias del sitio de aplicación para inyección IM, entre otras. Conclusión: La incorporación de la mejor evidencia permite la ejecución segura de la técnica intramuscular, proporcionando comodidad y la excelencia en la atención al paciente

Objective: The study's purpose has been to identify the production of nursing knowledge related to the medication administration technique by the intramuscular route. It was also aimed to describe the differences, similarities, and occurrence of complications of the technique and to analyze the recommendations described in literature with best practice and clinical updates in the nursing research field. Methods: This is a systematic review without meta-analysis. The research was performed through the following electronic databases, LILACS, PUBMED, MEDLINE, DEDALUS, Health Evidence Portal and Libraries SciELO and Cochrane, during the period from 1993 to 2012, then totaling 16 studies. Results: The findings have shown the different variations in the limit of the ventrogluteal region, conducting antisepsis, and applying pressure before intramuscular administration. They also showed consonances in the aspiration of the contents of the syringe after insertion of needle into the muscle, caster application site during sequences IM injections, among others. Conclusion: The incorporation of best evidence allows safe execution of intramuscular technique, providing comfort and excellence towards the patient care

Objetivo: Identificar a produção do conhecimento da enfermagem atrelado à técnica de administração de medicamentos pela via intramuscular; descrever as divergências, congruências e ocorrência de complicações acerca da técnica; e analisar as recomendações descritas na literatura com as melhores práticas e atualizações clínicas na enfermagem. Método: Revisão sistemática sem meta-análise. Realizada busca nas bases de dados LILACS, PUBMED, MEDLINE, DEDALUS, Portal de Evidência em Saúde e Bibliotecas SciELO e Cochrane, no período de 1993 a 2012, totalizando 16 estudos. Resultados: Os estudos evidenciaram divergências na variações de demarcação da região ventroglútea; realização de antissepsia; e aplicação de pressão antes da administração intramuscular. Consonâncias na aspiração do conteúdo da seringa após inserção da agulha na massa muscular, rodízio do local de aplicação durante sequências de injeções IM, dentre outros. Conclusão: A incorporação das melhores evidências permite a execução segura da técnica intramuscular, gerando conforto ao paciente e excelência na assistência

Pain from intramuscular vaccine injection in adults / Percepción de dolor después de una inyección intramuscular en adultos

Background: Vaccine use has been increasing worldwide, and adult populations are presented with more opportunities to experience pain from vaccine injection. The insertion of a needle through the skin is the most common source of iatrogenic pain, and needle phobia is a major concern in medical practice. However, it is unclear which factors play major roles in the perception of pain from vaccine injection in adults. Aim: To evaluate the influences of patient characteristics on pain perception due to intramuscular vaccine injection in healthy adult volunteers. Material and Methods: The injection of hepatitis B vaccine using a 24 mm, 24-G needle was performed as a uniform stimulus, and the intensity of injection pain was measured immediately after the injection using a 100-mm visual analogue scale (VAS). The influences of patient characteristics on pain intensity were investigated. Results: One hundred sixty volunteers (65 males, 95 females) were enrolled in this study. The average VAS score was 20.8 ± 17.1 (range 0 to 67) in males and 34.4 ± 19.7 (range 2 to 76) in females (P < 0.001). However, there were no correlations between VAS score and age, body mass index or maximal pain score from previous painful experiences. The VAS score was also not affected by the experience of previous vaccine injections, a history of childbirth in females, or religion. Conclusions: Gender appears to be the only major factor that influences the pain of intramuscular vaccine injection. Therefore, pain-reducing methods will be needed when performing injection procedures, particularly in women.

Antecedentes: La inserción de una aguja para inyecciones es la forma más común de inducción de dolor iatrogénico. No se sabe qué factores afectan la percepción del dolor. Objetivo: Evaluar la influencia de características propias de los pacientes en la percepción de dolor después de una inyección intramuscular. Material y Métodos: Se utilizó como estímulo, la inyección intramuscular de vacuna de hepatitis B, mediante una aguja de 24 mm (24 G). La intensidad del dolor fue evaluada inmediatamente después de la inyección utilizando una escala visual análoga de 100 mm (VAS). Se evaluó la influencia de las características de los pacientes en la intensidad del dolor. Resultados: Participaron 160 voluntarios (65 hombres). El puntaje VAS fue 20,8 ± 17,1 (rango 0 a 67) en hombres y 34,4 ± 19,7 (rango 2 a 76) en mujeres (p < 0,01). No hubo asociación entre el puntaje VAS y edad, índice de masa corporal, haber experimentado previamente dolor, haber dado a luz en mujeres o religión. Conclusiones: El género es la única variable que se asocia con la percepción de dolor después de una inyección intramuscular.

Prediction of Optimal Gluteal Intramuscular Needle Length by Skinfold Thickness Measurements in Korean Adults

PURPOSE: This study was conducted to assess optimal needle length for gluteal intramuscular injections (IM) via simple skinfold thickness (SFT). METHODS: For this study, 190 healthy adults were recruited and grouped into eight groups according to gender and body mass index (BMI) (kg/m2). The Korean Society for the Study of Obesity criteria defines a BMI under 20 as underweight, 20.1-22.9 as normal, 23-24.9 as overweight and over 25 as obese. For each participant, the SFT of dorsoguteal (DG) and ventrogluteal (VG) sites were measured using a caliper. Subcutaneous tissue thickness was acquired through ultrasonic images. RESULTS: For men in the overweight and obese groups at the DG site, for the obese group at the VG site, and for women in the normal weight, overweight and obese groups at both sites, the mean subcutaneous tissue thickness exceeded 1.84 cm, the minimal length for a 1 inch needle used for IM. At the DG site, optimal intramuscular needle length (OINL) was 1.4 times in women and 1.0 times in men compared to SFT. At the VG site, OINL was 1.3 times in women and 0.9 times in men compared to SFT. CONCLUSION: The results of this study suggest that SFT is a reliable index to determine optimal needle length with minimal effort prior to IM.

Toxina botulínica para el tratamiento de las arrugas faciales / Botulin toxin A for the treatment of facial wrinkles

La toxina botulínica (TB) es una excelente alternativa para el tratamiento cosmético de arrugas y surcos faciales secundarios a hiperfunción de los músculos de la mímica. Mediante el bloqueo de la liberación de acetilcolina en la placa neuro-muscular la TB produce la parálisis fláccida y reversible de los músculos tratados. Las principales indicaciones son los surcos glabelares, las "patas de gallo" y las arrugas frontales. La incidencia de efectos adversos es mínima y la toxocidad nula. Junto con otros métodos de implante constituye un eficaz tratamiento para las arrugas faciales.

Manifestaciones de incomodidad en la aplicación de inyecciones intramusculares con técnica rar y convencional en pacientes adultos, H.R.H.D. 1995

El presente estudio de investigación se llevó a cabo en el consultorio de inyectables del Hospital Regional Honorio Delgado siendo el objetivo: Determinar el grado de incomodidad que produce la aplicación de inyecciones intramusculares mediante la tecnica RAR en comparación con la técnica convencional, región dorsoglútea, utilizando el método cuasi experimental. La población en estudio estuvo constituida por 164 pacientes que acudieron al consultorio de inyectables durante los dos meses de ejecución; los cuales fueron distribuidos aleatoriamente: 50 pacientes para el grupo experimental y 50 para el grupo control. El método usado fue la observación, la técnica de entrevista y los instrumentos utilizados fueron el formulario y guía de observación que se realizó durante la aplicación de las técnicas (1era. consulta, 2da. consulta al día siguiente) y la guía de entrevista para corroborar las reacciones que se observaron en los pacientes. Para la comprobación de la hipótesis se utilizó la prueba estadística de Ji cuadrado a fin de establecer la significancia de los resultados, demostrándose que: A los pacientes a quienes se les administró inyecciones intramusculares mediante la técnica intramuscular RAR no presentaron ligeras manifestaciones de incomodidad, mientras que a los pacientes que se les administró con la técnica convencional presentaron demasiadas manifestaciones de incomodad.

Optimum needle length for DPT inoculation of Indian infants.

Correct placement of the injected DPT vaccine into the deep muscular layers decreases the local reactions, including the sterile abscess formation. However, recommendations on size of the needle to be used and the angle of injection are not easily available, are not uniform and are based on case reports. The only study based on scientific data of ultrasonographic measurement of fat layer and muscle layer thickness of thigh of only 24 infants of 4 months age covers only American children. (Hick et al, Pediatrics 1989; 84: 136-37). In the present study, we have produced similar data on 215 Indian children belonging to all those age groups in which DPT vaccinations are given. Mean thickness of skin + fat layer in the middle one-third of the anterolateral aspect of thigh was 1.03 +/- 0.23 cm, 1.04 +/- 0.21 cm, 0.95 +/- 0.19 cm and 1.06 +/- 0.27 cm in the age groups of 6-12 weeks (Groups I), 13-18 weeks (Group II), 19-24 weeks (Groups III) and 18 +/- 1 month (Group IV) respectively. These age groups correspond to the timings of first 3 primary doses and the first booster dose of the DPT vaccine in our immunization clinic. Mean thickness of all the soft tissues together at the same site were 1.87 +/- 0.35, 2.17 +/- 0.38, 2.07 +/- 0.39 and 2.07 +/- 0.26 cm respectively for the groups I to IV.(ABSTRACT TRUNCATED AT 250 WORDS)

Growth hormone therapy with a new delivery system.

Until recently the general regimen for treatment of growth hormone deficient (GHD) children consisted of 2 to 3 intramuscular (i.m.) injections per week using conventional syringes and vials. However, studies within the last 5-10 year have shown that by dividing the same total weekly dosage into daily subcutaneous (s.c.) injections it is possible to achieve a significantly increased growth rate. To make it more feasible for the patients and the parents to cope with this increased number of injections, an injection pen system (Nordiject) for administration of B-hGH has been developed. The Nordiject pen has been investigated both with respect to patient acceptance and bioavailability of the B-hGH (Norditropin) injected with the device. Twenty-seven children with growth retardation were included in a study. The patients had no problems with the handling of the pen and approximately 2/3 of them experienced less injection pain with the pen compared to the syringe. Those patients who had previously been using conventional syringes strongly preferred the pen, and all wished to continue using the device. Fourteen adult GHD patients were included in a randomized cross-over study for investigation of bioavailability. Two separate s.c. injections of 4 IU of B-hGH (Norditropin) each were administered in random order by means of either syringe (4IU/ml) or injection pen (Nordiject) (12 IU/ml). On the basis of this study it was concluded that the bioavailability of B-hGH, measured as AUC, Cmax, and tmax, is equal following injection with the pen to that of injection by syringe.

Reaçöes locais e níveis de antitoxina circulante decorrentes de administraçäo do toxóide tetânico: estudo comparativo entre ped-o-jet e seringa hipodérmica / Local reactions and antitoxin circulating levels induced by the administration of tetanus toxoid: comparative study between ped-o-jet and hypodermic syringe

Com o objetivo de comparar reaçöes locais e conversäo sorológica apresentadas por adultos que receberam o toxóide tetânico através de Ped-o-Jet (via subcutânea) ou de seringa hipodérmica (via intramuscular), o toxóide foi administrado a 472 recrutas do Exército. Em observaçöes realizadas 4 a 24 horas após a vacinaçäo verificou-se que as reaçöes locais dos indivíduos vacinados com Ped-o-Jet eram significativamente mais frequentes e mais intensas do que aquelas dos vacinados com seringa hipodérmica, näo tendo ocorrido, entretanto, reaçöes graves. A conversäo sorológica dos näo imunes vacinados com Ped-oJet ocorreu numa frequencia maior do que nos indivíduos vacinados com seringa hipodérmica. Conclui-se portanto, que o Ped-o-Jet pode ser utilizado em campanhas de vacinaçäo em massa contra o tétano, embora a via de administraçäo preferencial, até o momento, seja a intramuscular