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Observation on cadavers and through ultrasonography using a 2 mm needle length for intradermal injections

Yi KH, Lee B, Kim MJ, Lee SH, Hidajat IJ, Lim TS, et al.

Skin Res Technol, 2023 Nov;29(11):e13529.
PMID: 38009043 DOI: 10.1111/srt.13529

BACKGROUND: An intradermal injection is a medical procedure that involves administering a small amount of medication or substance into the dermal layer of the skin. This research focused on identifying the most suitable injection needle for precise intradermal administration of skin boosters.
METHODS: The study involved conducting intradermal injections on four cadavers and participants using a 2 mm length, 34-gauge needle (N-Finders, Inc., South Korea). During the cadaveric study, the polynucleotide prefilled syringe was dyed green, and an anatomist performed dissections, removing only the skin layer. Ultrasonographic observations were carried out to ensure accurate intradermal injection placement.
RESULTS: In all four cadavers, the facial injections at the anterior cheek region were precisely administered intradermally at a 30-degree injection angle. However, the 90-degree injection was found just below the dermal layer upon skin layer removal.
DISCUSSION: The findings suggest that using a 2 mm needle length allows for easy and convenient intradermal injections.

Matched MeSH terms: Injections, Intradermal
Fulltext A Case of Herpes Simplex Virus Type 1 (HSV-1) Encephalitis as a Possible Complication of Cosmetic Nasal Dermal Filler Injection

Khoo CS, Tan HJ, Sharis Osman S

Am J Case Rep, 2018 Jul 13;19:825-828.
PMID: 30002360 DOI: 10.12659/AJCR.909883

BACKGROUND Dermal fillers are increasingly used for medical and aesthetic purposes in clinical practice. Common complications following filler injections include bruising, itching, infections, allergic reactions, and tissue necrosis. This case is the first report of Herpes simplex virus type 1 (HSV-1) encephalitis as a possible complication of dermal filler injection. CASE REPORT A 27-year-old woman with no past medical history presented with altered mental state, headaches, and seizures. She had a nasal dermal filler injection for aesthetic purpose five weeks before her acute presentation. A diagnosis of HSV-1 encephalitis was made based on brain imaging with computed tomography and magnetic resonance imaging (MRI) findings that showed bilateral frontotemporal lobe hyperintensity. Analysis of her cerebrospinal fluid (CSF) confirmed the presence of HSV-1 DNA. Despite anti-viral treatment with acyclovir, she developed postencephalitic syndrome. CONCLUSIONS This case report highlights the possibility that among the complications of the use of cosmetic dermal fillers, the transmission of HSV-1 and the development of HSV-1 encephalitis should be recognized.

Matched MeSH terms: Injections, Intradermal/adverse effects
Fulltext Response to intradermal autologous platelet rich plasma injection in refractory dermal melasma: report of two cases

Yew, C.H., Ramasamy, T.S., Amini, F.

JUMMEC, 2015;18(2):1-6.
MyJurnal

Refractory dermal melasma is resistant to conventional treatment. Platelet rich plasma (PRP) may help to reduce the pigmentation of melasma. We present a case report on the clinical outcome of 2 patients with melasma, given PRP, as an adjunct therapy. PRP was administered at a monthly interval for 2 sessions in combination with a monthly Q-switched Nd Yag laser treatment and topical alpha arbutin application. A modified melasma area and severity index (MASI) was evaluated by two dermatologists who were blinded. At the follow up on the 3rd months, the MASI score was reduced by mean 33.5% for case 1 and 20% for case 2. There were no clinical complications for case 1. However recurrence of melasma was noted in case 2 by a worsening of the MASI score mean to 53% at the sixth months follow up. In conclusion, intradermal PRP injection as an adjunct to the conventional treatment of melasma presented with differing results in two cases.

Matched MeSH terms: Injections, Intradermal
Allergic contact dermatitis caused by polymethylmethacrylate following intradermal filler injection

Shah V, Chaubal TV, Bapat RA, Shetty D

Contact Derm., 2017 Dec;77(6):407-408.
PMID: 29164691 DOI: 10.1111/cod.12779
Matched MeSH terms: Injections, Intradermal
Fulltext Effects of repeated comparative intradermal tuberculin testing on test results: a longitudinal study in TB-free red deer

Che-Amat A, Risalde MÁ, González-Barrio D, Ortíz JA, Gortázar C

BMC Vet Res, 2016 Sep 05;12(1):184.
PMID: 27596591 DOI: 10.1186/s12917-016-0825-2

Diagnosing tuberculosis (TB) in farmed red deer (Cervus elaphus) is challenging and might require combining cellular and humoral diagnostic tests. Repeated skin-testing with mycobacterial purified protein derivatives (PPDs) might sensitize or desensitize the subjects to both kinds of diagnostic tools. We evaluated the effect of repeated (every 6 months) comparative tuberculin skin testing on skin test and ELISA responsiveness in farmed red deer hinds from a TB-free herd. Eighteen 8-month old hinds were inoculated with bovine and avian PPDs and the mitogen phytohaemagglutinin (PHA), as positive control and concurrently tested by ELISA for antibodies against avian (avian PPD, aPPD and protoplasmatic antigen 3, PPA3) and bovine antigens (bPPD and MPB70). Blood serum was also sampled three weeks after each skin testing round and tested for antibodies against aPPD and bPPD, in order to detect eventual antibody level boosts. Testing took place every six months from winter 2012 until winter 2015.

Matched MeSH terms: Injections, Intradermal
Mechanical, bioadhesive strength and biological evaluations of chitosan films for wound dressing

Peh K, Khan T, Ch'ng H

J Pharm Pharm Sci, 2000 Sep-Dec;3(3):303-11.
PMID: 11177648

To investigate the suitability of chitosan films prepared using two different solvents, acetic acid (Chitosan-AA) and lactic acid (Chitosan-LA), for wound dressing, in comparison with a commercial preparation, Omiderm.

Matched MeSH terms: Injections, Intradermal
Fulltext Development of enhanced antibody response toward dual delivery of nano-adjuvant adsorbed human Enterovirus-71 vaccine encapsulated carrier

Saeed MI, Omar AR, Hussein MZ, Elkhidir IM, Sekawi Z

Hum Vaccin Immunother, 2015;11(10):2414-24.
PMID: 26186664 DOI: 10.1080/21645515.2015.1052918

This study introduces a new approach for enhancing immunity toward mucosal vaccines. HEV71 killed vaccine that is formulated with nanosize calcium phosphate adjuvant and encapsulated onto chitosan and alginate delivery carriers was examined for eliciting antibody responses in serum and saliva collected at weeks 0, 1, 3, 5, 7 and 9 for viral-specific IgA & IgG levels and viral neutralizing antibody titers. The antibody responses induced in rabbits by the different formulations delivered by a single (buccal) route were compared to those of dual immunization (intradermal / mucosal) and un-immunized control. Chitosan-loaded vaccine adjuvant induced elevated IgA antibody, while Alginate-adjuvant irreversible bonding sequestered the vaccine and markedly reduced immunogenicity. The induced mucosal and parenteral antibody profiles appeared in an inverse manner of enhanced mucosal IgA antibody accompanied by lower systemic IgG following a single oral immunization route. The combined intradermal and oral dual-immunized group developed an elevated salivary IgA, systemic IgG, and virus neutralizing response. A reduced salivary neutralizing antibody titer was observed and attributed to the continual secretion exchanges in saliva. Designing a successful mucosal delivery formulation needs to take into account the vaccine delivery site, dosage, adjuvant and carrier particle size, charge, and the reversibility of component interactions. The dual immunization seems superior and is a important approach for modulating the antibody response and boosting mucosal protection against HEV71 and similar pathogens based on their transmission mode, tissue tropism and shedding sites. Finally, the study has highlighted the significant role of dual immunization for simultaneous inducing and modulating the systemic and mucosal immune responses to EV71.

Matched MeSH terms: Injections, Intradermal