There are 12 billion injections given worldwide every year. For many injections, the intramuscular route is favoured over the subcutaneous route due to the increased vascularity of muscle tissue and the corresponding ...There are 12 billion injections given worldwide every year. For many injections, the intramuscular route is favoured over the subcutaneous route due to the increased vascularity of muscle tissue and the corresponding increase in the bioavailability of drugs when administered intramuscularly. This paper is a review of the variables that affect the success of intramuscular injections and the implications that these success rates have in psychiatry and general medicine. Studies have shown that the success rates of intended intramuscular injections vary between 32 and 52%, with the rest potentially resulting in inadvertent subcutaneous drug deposition. These rates are found to be even lower for certain at-risk populations, such as obese patients and those on antipsychotic medications. The variables associated with an increased risk of injection failure include female sex, obesity, site of injection, and subcutaneous fat depth. New guidelines and methods are needed in order to address this challenge and ensure that patients receive optimum care. Looking forward, the best way to improve the delivery of intramuscular injections worldwide is to develop uniform algorithms or innovative medical devices to confirm or guarantee successful delivery at the bedside.展开更多
AIM： To introduce a bioimpedance gastric motility mea- surement method based on an electrical-mechanical composite concept and a preliminary clinical application. METHODS： A noninvasive gastric motility measure- men...AIM： To introduce a bioimpedance gastric motility mea- surement method based on an electrical-mechanical composite concept and a preliminary clinical application. METHODS： A noninvasive gastric motility measure- ment method combining electrogastrograrn （EGG） and impedance gastric motility （IGM） test was used. Prelim- inary clinical application studies of patients with func- tional dyspepsia （FD） and gastritis, as well as healthy controls, were carried out. Twenty-eight FD patients （mean age 40.9±9.7 years） and 40 healthy volun- teers （mean age 30.9±7.9 years） were involved. IGM spectrum was measured for both the healthy subjects and FD patients, and outcomes were compared in the FD patients before treatment and 1 wk and 3 wk after treatment. IGM parameters were obtained from 30 erosive gastritis patients （mean age 50.5±13.0 years） and 40 healthy adults, and IGM and EGG results were compared in the gastritis patients before treatment and 1 wk after treatment.RESULTS： There were significant differences in the IGM parameters between the FD patients and healthy subjects, and FD patients had a poorer gastric motility [percentage of normal frequency （PNF） 70.8±25.5 in healthy subjects and 28.3 =t= 16.9 in FD patients, P 〈 0.01]. After 1 wk administration of domperidone 10 mg, tid, the gastric motility of FD patients was not im- proved, although the EGG of the patients had returned to normal. After 3 wk of treatment, the IGM rhythm of the FD patients became normal. There was a significant difference in IGM parameters between the two groups （PNF 70.4：1：25.5 for healthy subjects and 36.1 4- 21.8 for gastritis patients, P 〈 0.05）. The EGG rhythm of the gastritis patients returned to normal （frequency insta- bility coefficient 2.22±0.43 before treatment and 1.77 ：t： 0.19 one wk after treatment, P 〈 0.05） after 1 wk of treatment with sodium rabeprazole tablets, 10 mg, qd, po, qm, while some IGM parameters showed a tenden- cy toward improvement but had not reached statistical significance. CONCLUSION： The electrical-mechanical composite measurement method showed an attractive clinical appli- cation prospect in gastric motility research and evaluation.展开更多
文摘There are 12 billion injections given worldwide every year. For many injections, the intramuscular route is favoured over the subcutaneous route due to the increased vascularity of muscle tissue and the corresponding increase in the bioavailability of drugs when administered intramuscularly. This paper is a review of the variables that affect the success of intramuscular injections and the implications that these success rates have in psychiatry and general medicine. Studies have shown that the success rates of intended intramuscular injections vary between 32 and 52%, with the rest potentially resulting in inadvertent subcutaneous drug deposition. These rates are found to be even lower for certain at-risk populations, such as obese patients and those on antipsychotic medications. The variables associated with an increased risk of injection failure include female sex, obesity, site of injection, and subcutaneous fat depth. New guidelines and methods are needed in order to address this challenge and ensure that patients receive optimum care. Looking forward, the best way to improve the delivery of intramuscular injections worldwide is to develop uniform algorithms or innovative medical devices to confirm or guarantee successful delivery at the bedside.
基金Supported by The National Natural Science Foundation of China, No. 60471041 and 60901045
文摘AIM： To introduce a bioimpedance gastric motility mea- surement method based on an electrical-mechanical composite concept and a preliminary clinical application. METHODS： A noninvasive gastric motility measure- ment method combining electrogastrograrn （EGG） and impedance gastric motility （IGM） test was used. Prelim- inary clinical application studies of patients with func- tional dyspepsia （FD） and gastritis, as well as healthy controls, were carried out. Twenty-eight FD patients （mean age 40.9±9.7 years） and 40 healthy volun- teers （mean age 30.9±7.9 years） were involved. IGM spectrum was measured for both the healthy subjects and FD patients, and outcomes were compared in the FD patients before treatment and 1 wk and 3 wk after treatment. IGM parameters were obtained from 30 erosive gastritis patients （mean age 50.5±13.0 years） and 40 healthy adults, and IGM and EGG results were compared in the gastritis patients before treatment and 1 wk after treatment.RESULTS： There were significant differences in the IGM parameters between the FD patients and healthy subjects, and FD patients had a poorer gastric motility [percentage of normal frequency （PNF） 70.8±25.5 in healthy subjects and 28.3 =t= 16.9 in FD patients, P 〈 0.01]. After 1 wk administration of domperidone 10 mg, tid, the gastric motility of FD patients was not im- proved, although the EGG of the patients had returned to normal. After 3 wk of treatment, the IGM rhythm of the FD patients became normal. There was a significant difference in IGM parameters between the two groups （PNF 70.4：1：25.5 for healthy subjects and 36.1 4- 21.8 for gastritis patients, P 〈 0.05）. The EGG rhythm of the gastritis patients returned to normal （frequency insta- bility coefficient 2.22±0.43 before treatment and 1.77 ：t： 0.19 one wk after treatment, P 〈 0.05） after 1 wk of treatment with sodium rabeprazole tablets, 10 mg, qd, po, qm, while some IGM parameters showed a tenden- cy toward improvement but had not reached statistical significance. CONCLUSION： The electrical-mechanical composite measurement method showed an attractive clinical appli- cation prospect in gastric motility research and evaluation.
