Acceptance of multiple injectable vaccines in a single immunization visit in The Gambia pre and post introduction of inactivated polio vaccine

BackgroundAs the World Health Organization (WHO) currently recommends that children be protected against 11 different pathogens, it is becoming increasingly necessary to administer multiple injectable vaccines during a single immunization visit. In this study we assess Gambian healthcare providers’ and infant caregivers’ attitudes and practices related to the administration of multiple injectable vaccines to a child at a single immunization visit before and after the 2015 introduction of inactivated polio vaccine (IPV). IPV introduction increased the number of injectable vaccines recommended for the 4-month immunization visit from two to three in The Gambia.MethodsWe conducted a cross-sectional questionnaire-based survey before and after the introduction of IPV at 4 months of age in a representative sample of all health facilities providing immunizations in The Gambia. Healthcare providers who administer vaccines at the selected health facilities and caregivers who brought infants for their 4 month immunization visit were surveyed.FindingsPrior to IPV introduction, 9.9% of healthcare providers and 35.7% of infant caregivers expressed concern about a child receiving more than 2 injections in a single visit. Nevertheless, 98.8% and 90.9% of infants received all required vaccinations for the visit before and after IPV introduction, respectively. The only reason why vaccines were not received was vaccine stock-outs. Infant caregivers generally agreed that vaccinators could be trusted to provide accurate information regarding the number of vaccines that a child needed.ConclusionHealthcare providers and infant caregivers in this resource limited setting accepted an increase in the number of injectable vaccines administered at a single visit even though some expressed concerns about the increase.     

Review of long-term adverse effects associated with the use of chemically-modified animal and nonanimal source hyaluronic acid dermal fillers

Although only recently introduced, chemically-modified hyaluronic acid dermal fillers have gained widespread acceptance as “redefining” dermal fillers in the fields of dermatology and cosmetic facial surgery. Although hyaluronic acid-based dermal fillers have a low overall incidence of long term side effects, occasional adverse outcomes, ranging from chronic lymphoplasmacytic inflammatory reactions to classic foreign body-type granulomatous reactions have been documented. These long-term adverse events are reviewed.     

哺乳妇女单次注射迪波盖司通~长效避孕针后血清和乳液中MPA浓度变化

目的:探讨中国妇女哺乳期使用迪波盖司通后血清和乳液醋酸甲羟孕酮(MPA)浓度变化。方法:10名产后哺乳妇女单次注射迪波盖司通(含MPA150mg),在注射后的第1、2、4、6、8、10和12周采集血样和乳液样本,用放射免疫方法测定MPA。结果:血清MPA浓度于注射后第1周最高,到第2、4周时下降明显,第4周后浓度下降趋势逐渐缓慢。乳液MPA浓度在第1周为最高,第2周比第1周降低了约1/2,之后10周平均浓度变化波动在5.09-8.15ng/ml之间。观察期间乳液/血清MPA浓度比值和曲线下浓度面积比值均为0.55。对象之间和同一对象不同时间点乳液/血清MPA浓度存在明显个体差异。结论:哺乳期使用迪波盖司通,将导致血液和乳液中含有一定量的MPA。     

Use of sclera and liquid collagen in the camouflage of superior sulcus deformities

The cosmetic deformities following enucleation are often unavoidable. Loss of orbital volume and atrophy of orbital fat create significant enophthalmos. The literature is filled with numerous procedures that add to the orbital volume of the anophthalmic socket. An outline of three procedures to the upper eyelid to camouflage an enophthalmic appearance are presented. These can be used alone or in conjunction with an "orbital volume increasing" procedure. Two procedures can be used in an office setting to alleviate small deformities; 19 patients have been treated in this manner with a follow-up period of up to 26 months.     

耐高压注射型双腔PICC导管在头颈部肿瘤患者中的应用与护理

目的探讨耐高压注射型双腔PICC导管在头颈部肿瘤患者中的应用与护理。方法回顾性分析158例置入耐高压注射型双腔PICC导管患者在头颈部肿瘤患者中的应用效果。结果158例患者中导管堵塞及皮肤过敏样改变发生率为34．8％及13．2％，导管相关感染及导管脱出发生率各为4．4％，穿刺点渗液发生率为5．0％．静脉炎和静脉血栓发生率为0％及1．2％。结论耐高压注射型双腔PICC导管与普通PICC导管相比，可以同时满足两路静脉输液的需要、可注射造影剂，值得在临床上推广应用。     

耐高压注射型PICC导管在神经外科患者中的应用及护理

目的 探讨耐高压注射型PICC导管在神经外科患者中的应用及护理。方法 对符合PICC适应症的50例神经外科患者在超声引导下运用改良塞丁格技术置入耐高压注射型PICC导管,置管后注意导管的维护及并发症的观察。结果50例患者置管成功率100%。其中发生4例堵管、1例脱管、1例机械性静脉炎,除外均顺利完成治疗,效果良好。结论 耐高压注射型PICC导管用于神经外科患者,不仅能让患者避免反复穿刺带来的痛苦及伤害,保护外周静脉,且“一管多用”能解决患者众多的静脉治疗难题,“一针式”完成患者静脉治疗需求。     

Antibacterial‐nanocomposite bone filler based on silver nanoparticles and polysaccharides

Injectable bone fillers represent an attractive strategy for the treatment of bone defects. These injectable materials should be biocompatible, capable of supporting cell growth and possibly able to exert antibacterial effects. In this work, nanocomposite microbeads based on alginate, chitlac, hydroxyapatite and silver nanoparticles were prepared and characterized. The dried microbeads displayed a rapid swelling in contact with simulated body fluid and maintained their integrity for more than 30 days. The evaluation of silver leakage from the microbeads showed that the antibacterial metal is slowly released in saline solution, with less than 6% of silver released after 1 week. Antibacterial tests proved that the microbeads displayed bactericidal effects toward Staphylococcus aureus, Pseudomonas aeruginosa and Staphylococcus epidermidis, and were also able to damage pre‐formed bacterial biofilms. On the other hand, the microbeads did not exert any cytotoxic effect towards osteoblast‐like cells. After characterization of the microbeads bioactivity, a possible means to embed them in a fluid medium was explored in order to obtain an injectable paste. Upon suspension of the particles in alginate solution or alginate/hyaluronic acid mixtures, a homogenous and time‐stable paste was obtained. Mechanical tests enabled to quantify the extrusion forces from surgical syringes, pointing out the proper injectability of the material. This novel antibacterial bone filler appears as a promising material for the treatment of bone defects, in particular when possible infections could compromise the bone‐healing process. Copyright © 2016 John Wiley & Sons, Ltd.     

Bioactive injectable aggregates with nanofibrous microspheres and human dental pulp stem cells: A translational strategy in dental endodontics

Regeneration of the pulp–dentin complex with stem cells is a potential alternative to conventional root canal treatments. Human dental pulp stem cells (hDPSCs) have been extensively studied because of their ability to proliferate and differentiate into mineralized dental and non‐dental tissues. Here we combined hDPSCs with two types of injectable poly‐l ‐lactic acid (PLLA) microsphere with a nanofibrous or smooth surface to form bioactive injectable aggregates, and examined their ability to promote pulp regeneration in the root canal in an in vivo model. We investigated the biocompatibility, biosafety and odontogenic potential of fibrous (F‐BIM) and smooth bioactive injectable microspheres (S‐BIM) in vitro and in vivo. Our results demonstrated that PLLA microspheres and hDPSCs were able to form bioactive injectable aggregates that promoted dentin regeneration in both in vitro and in vivo models. Our results suggest that F‐BIM and S‐BIM may induce dentinogenesis upon in vivo grafting, and propose that the potential usefulness of the microsphere–hDPSC aggregates described here should be evaluated in clinical settings. Copyright © 2017 John Wiley & Sons, Ltd.     

The potential of DBP gels containing intervertebral disc cells for annulus fibrosus supplementation:in vivo

Demineralized bone particle (DBP), which is widely used as a biomaterial in the field of tissue engineering, contains various bioactive molecules, such as cytokines. For this reason, in this study we investigated the effects of injectable DBP gels on cell proliferation, inflammation and maintenance of the shape of DBP gels as a scaffold able to substitute for intervertebral discs (IVDs) in vivo. DBP gels were fabricated with different percentages (5% and 10%) of DBP powder and 3% acetic acid, including 0.02% pepsin. DBP gels with 1 × 10⁶ annulus fibrosus (AF) cells were implanted into the dorsal subcutaneous region of BALB/C‐nu mice for 1, 2 and 3 weeks. Cell proliferation was measured by MTT assay. The effect of DBP gels on the inflammatory response was analysed by measuring the amount of tumour necrosis factor‐alpha (TNFα) released. Also, histological methods were carried out to analyse the response of DBP gels in vivo. This study demonstrated that injectable DBP gels are able to provide physical scaffolds for growing IVD cells in vivo. Copyright © 2013 John Wiley & Sons, Ltd.