subcutaneous route
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2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Yang Bai ◽  
Song Han ◽  
Jing-Yu Guan ◽  
Jun Lin ◽  
Ming-Guang Zhao ◽  
...  

Abstract The previous three decades have witnessed a prosperity of contralateral C7 nerve (CC7) transfer in the treatment of upper-extremity paralysis induced by both brachial plexus avulsion injury and central hemiplegia. From the initial subcutaneous route to the pre-spinal route and the newly-established post-spinal route, this surgical operation underwent a series of innovations and refinements, with the aim of shortening the regeneration distance and even achieving direct neurorrhaphy. Apart from surgical efforts for better peripheral nerve regeneration, brain involvement in functional improvements after CC7 transfer also stimulated scientific interest. This review summarizes recent advances of CC7 transfer in the treatment of upper-extremity paralysis of both peripheral and central causes, which covers the neuroanatomical basis, the evolution of surgical approach, and central mechanisms. In addition, motor cortex stimulation is discussed as a viable rehabilitation treatment in boosting functional recovery after CC7 transfer. This knowledge will be beneficial towards improving clinical effects of CC7 transfer.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12355
Author(s):  
Ariane Zaloszyc ◽  
Claus Peter Schmitt ◽  
Amira Sayeh ◽  
Laetitia Higel ◽  
Catherine-Isabelle Gros ◽  
...  

Background To provide insight into bone turnover, quantitative measurements of bone remodeling are required. Radionuclide studies are widely used in clinical care, but have been rarely used in the exploration of the bone in preclinical studies. We describe a bone planar scintigraphy method for frequent assessment of bone activity in mice across the growing period. Since repeated venous radiotracer injections are hardly feasible in mice, we investigated the subcutaneous route. Methods Repeated 99mTc-hydroxymethylene diphosphonate (HMDP) tracer bone planar scintigraphy studies of the knee region and µCT to measure femur growth rate were performed in eight mice between week 6 and week 27 of life, i.e., during their growth period. Three independent investigators assessed the regions of interest (ROI). An index was calculated based on the counts in knees ROI (normalized by pixels and seconds), corrected for the activity administered, the decay between administration and imaging, and individual weights. Results A total of 93 scintigraphy studies and 85 µCT were performed. Repeated subcutaneous tracer injections were well tolerated and allowed for adequate radionuclide studies. Mean scintigraphic indexes in the knees ROI decreased from 87.4 ± 2.6 × 10−6 counts s−1 pixel−1 MBq−1 g−1 at week 6 to 15.0 ± 3.3 × 10−6 counts s−1 pixel−1 MBq−1 g−1 at week 27. The time constant of the fitted exponential decay was equal to 23.5 days. As control mean femur length assessed by µCT increased from 12.2 ± 0.8 mm at week 6 to 15.8 ± 0.2 mm at week 22. The time constant of the fitted Gompertz law was equal to 26.7 days. A correlation index of −0.97 was found between femur growth and decrease of bone tracer activity count between week 6 and 24. Conclusion This methodological study demonstrates the potential of repeated bone planar scintigraphy in growing mice, with subcutaneous route for tracer administration, for quantitative assessment of bone remodeling.


Author(s):  
Maria Gabriela Figueiredo ◽  
Thiago Gagliano-Jucá ◽  
Shehzad Basaria

Abstract Context Injections with intramuscular testosterone esters have been available for almost 8 decades and not only result in predictable serum testosterone levels but are also the most inexpensive modality. However, they are difficult to self-administer and associated with some discomfort. Recently, subcutaneous administration of testosterone esters has gained popularity, as self-administration is easier with this route. Available data, though limited, support the feasibility of this route. Here we review the pharmacokinetics and safety of subcutaneous testosterone therapy with both long- and ultralong-acting testosterone esters. In addition, we provide guidance for clinicians on how to counsel and manage their patients who opt for the subcutaneous route. Evidence Acquisition Systematic review of available literature on subcutaneous testosterone administration including clinical trials, case series and case reports. We also review the pharmacology of testosterone absorption after subcutaneous administration. Evidence Synthesis Available evidence, though limited, suggests that subcutaneous testosterone therapy in doses similar to those given via intramuscular route results in comparable pharmacokinetics and mean serum testosterone levels. With appropriate training, patients should be able to safely self-administer testosterone esters subcutaneously with relative ease and less discomfort compared with the intramuscular route. Conclusion Although studies directly comparing the safety of subcutaneous vs intramuscular administration of testosterone esters are desirable, clinicians should consider discussing the subcutaneous route with their patients, as it is easier to self-administer and has the potential to improve patient adherence.


2021 ◽  
Vol 3 ◽  
Author(s):  
Alessandro Conforti ◽  
Luigi Carbone ◽  
Giuseppe Gabriele Iorio ◽  
Federica Cariati ◽  
Francesca Bagnulo ◽  
...  

Luteal phase support (LPS) is crucial in assisted reproductive technology (ART) cycles when the luteal phase has been found to be defective. Such deficiency is most likely related to the supraphysiological steroid levels that usually occurr in stimulated cycles which, in turn, could severely affect luteinizing hormone (LH) secretion and function, thereby negatively influencing the luteal phase. A number of different medications and routes have been successfully used for LPS in ART. Although an optimal protocol has not yet been identified, the existing plethora of medications offer the opportunity to personalize LPS according to individual needs. Subcutaneous administration progesterone has been proposed for LPS and could represent an alternative to a vaginal and intramuscular route. The aim of the present systematic review is to summarize the evidence found in the literature concerning the application of subcutaneous progesterone in ARTs, highlighting the benefits and limits of this novel strategy. With this aim in mind, we carried out systematic research in the Medline, ISI Web of Knowledge, and Embase databases from their inception through to November 2020. Randomized controlled trials (RCTs) were preferred by the authors in the elaboration of this article, although case-control and cohort studies have also been considered. According to our findings, evidence exists which supports that, in women with a good prognosis undergoing a fresh in vitro fertilization (IVF) cycle, subcutaneous Pg is not inferior to vaginal products. In the Frozen-thawed embryo transfer (FET) cycle, data concerning efficacy is mixed with an increased miscarriage rate in women undergoing a subcutaneous route in oocyte donor recipients. Data concerning the acceptance of the subcutaneous route versus the vaginal route are encouraging despite the different scales and questionnaires which were used. In addition, a cost-effective analysis has not yet been conducted.


2021 ◽  
Vol 18 ◽  
Author(s):  
Rohini Bhattacharya ◽  
Asha P. Johnson ◽  
Shailesh T. ◽  
Mohamed Rahamathulla ◽  
Gangadharappa H. V.

: Diabetes mellitus is found to be among the most suffered and lethal diseases for mankind. Diabetes mellitus type-1 is caused by the demolition of pancreatic islets responsible for the secretion of insulin. Insulin is the peptide hormone (anabolic] that regulates the metabolism of carbohydrates, fats, and proteins. Upon the breakdown of the natural process of metabolism, the condition leads to hyperglycemia (increased blood glucose levels]. Hyperglycemia demands outsourcing of insulin. The subcutaneous route was found to be the most stable route of insulin administration but faces patient compliance problems. Oral Insulin delivery systems are the patient-centered and innovative novel drug delivery system, eliminating the pain caused by the subcutaneous route of administration. Insulin comes in contact across various barriers in the gastrointestinal tract, which has been discussed in detail in this review. The review describes about the different bioengineered formulations, including microcarriers, nanocarriers, Self-Microemulsifying drug delivery systems (SMEDDs), Self-Nanoemulsifying drug delivery systems (SNEDDs), polymeric micelles, cochleates, etc. Surface modification of the carriers is also possible by developing ligand anchored bioconjugates. A study on evaluation has shown that the carrier systems facilitate drug encapsulation without tampering the properties of insulin. Carrier-mediated transport by the use of natural, semi-synthetic, and synthetic polymers have shown efficient results in drug delivery by protecting insulin from harmful environment. This makes the formulation readily acceptable for a variety of populations. The present review focuses on the properties, barriers present in the GI tract, overcome the barriers, strategies to formulate oral insulin formulation by enhancing the stability and bioavailability of insulin.


Author(s):  
Ranjodh Jeet Singh

Migraine is one form of disorder affecting the quality of life of patient. The term chronic migraine refers to a clinical condition summarized by migraines headache on fifteen days usually per monthly episode. Most commonly patients on pharmacotherapy of migraine include Ergot derivatives, Opioids, and Analgesics for a period range of ten days per month. The CGRP is involved in pathology and physiology of origin of neurovascular headaches via migraine at both peripheral and central levels. The CGRP is highly expressed in trigeminal neurons (small myelinated Ad and unmyelinated C fibers) co-localized with other neuropeptides (e.g., substance P). The CGRP levels are increased into external jugular venous blood ipsilateral to pain during headache phase of migraine attack. Also the saliva and serum CGRP levels are increased during migraine and interracially in patients with CM. Scope: Erenumab-aooe, CGRPr antagonist, being the latest approved drug administered via subcutaneous route as 70 mg per month for prophylactic regime of migraine in adult patients, the results documented as per clinical trials data are very promising and thus Erenumab-aooe is an emerging hope to improve quality of life. Conclusion: CM is not fully treated as the pharmacotherapy response is at the poor level and also limited pharmacotherapy is available, however the emergence of Erenumab- aooe, CGRPr antagonist as the one of the latest drug approval for the prophylaxis of migraine in adults.


2021 ◽  
Vol Volume 15 ◽  
pp. 1679-1680
Author(s):  
Eric Senbel ◽  
Sonia Tropé ◽  
Hélène Herman-Demars ◽  
Elena Zinovieva ◽  
Agnès Courbeyrette ◽  
...  

2021 ◽  
Vol Volume 15 ◽  
pp. 751-760
Author(s):  
Eric Senbel ◽  
Sonia Tropé ◽  
Hélène Herman-Demars ◽  
Elena Zinovieva ◽  
Agnès Courbeyrette ◽  
...  

2021 ◽  
Vol 77 (10) ◽  
pp. 6582-2021
Author(s):  
GULSEN GONCAGUL ◽  
ELCİN GUNAYDİN ◽  
OZLEM KARDOGAN ◽  
YAVUZ COKAL ◽  
EMSAL SİNEM OZDEMİR SALCİ

Brucellosis in sheep and goats has a major economic and zoonotic importance, and implementation of strategies for its control and eradication is essential in endemic areas. In this study, the enhanced abortion cases in small ruminants after conjunctival Rev-1 vaccine administration was examined by PCR in terms of probability of vaccine induced abort cases. Of the examined 77 cotyledons from the aborted fetuses belonging to 68 sheep and 9 goats, 70 (90.90%) were found to harbour Brucella spp. DNA. In the first, second and third trimester of gestation, the rate of 100%, 40% and 42.85% positive results were determined from the cotyledons of the small ruminants, respectively. In conclusion, the conjunctival route of Rev-1 vaccine administration was safe during field vaccination, compatible with the serological tests and induces less abortion compared with the subcutaneous route as long as the period of pregnancy is taken into consideration during the vaccination period.


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