The strengthening of chronically strained ankle ligaments with injections of sodium psylliate.
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OBJECTIVE: The objective was to determine the composition of three available solutions of sodium tetradecyl sulfate from compounding pharmacies in comparison to pharmaceutical-grade sodium tetradecyl sulfate, Fibrovein (STD Pharmaceuticals, Ltd.). METHODS: Solutions of 3% sodium tetradecyl sulfate were obtained from three compounding pharmacies. An analysis of their composition was performed. RESULTS: All samples of 3% sodium tetradecyl sulfate obtained had a different concentration of sodium tetradecyl sulfate than that stated on the bottle (range, 2.59%-3.39%). Significant concentrations of the contaminant carbitol were present in samples from all three sources (0.33%-4.18%). CONCLUSION: The production of 3% sodium tetradecyl sulfate by these three compounding pharmacies appears to occur by simple dilution of a 27% industrial detergent solution that is not manufactured for use in humans. Physicians need to be aware that the stated concentration may not be correct and that along with sodium tetradecyl sulfate, potentially harmful contaminants may be present in the solution.
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Over a period of 10 months, we conducted a prospective randomized controlled trial of endoscopic injection for the arrest of peptic ulcer hemorrhage in 84 patients. We injected pure alcohol (PA, 99.8%), 50% glucose in water (G/W), 3% NaCl solution, and normal saline solution (N/S, controls) to stop bleeding. The ultimate success rates in the four groups were: 81% (17/21) in the PA group, 80% (16/20) in the 50% G/W group, 65.2% (15/23) in the 3% NaCl group, and 80% (16/20) in the N/S group (p greater than 0.05). The volume of blood transfusion (mean +/- s. e. m.) for each patient was 1,200 ml +/- 433 ml in the PA group, 1,130 +/- 356 ml in the 50% G/W group, 1,704 +/- 330 ml in the 3% NaCl group, 1,400 +/- 548 ml in the N/S group (p greater than 0.05). The duration of hospitalization (mean +/- s. e. m.) was 5.7 +/- 1.5 days in the PA group, 3 +/- 1.3 days in the 50% G/W group, 6.1 +/- 1.1 days in the 3% NaCl group, and 5 +/- 1.1 days in the N/S group (p greater than 0.05). No complication of perforation or aspiration pneumonia was observed during hospitalization. We suggest that endoscopic injection with the above solutions be used as the first line of therapeutic endoscopy for arrest of peptic ulcer hemorrhage.
The authors describe an experimental study in man, using electron microscopy to study the effect of sclerosing injections on the great saphenous vein, in particular concerning the initial phases of the process. Results may be summarised as follows: The endothelial lesion develops immediately and is visible only by electron microscopy during the first 15 minutes. It involves necrotic changes with subendothelial edema and, finally, detachment of the endothelial cells. This process is complete on average 2 hours and 30 minutes after the injection. The first deposits of fibrin, which are not abundant, englobe blood cells and loosen already within the first 15 minutes. The first lamellar platelet microclot forms on average 2 hours and a half after the injection but this involves a microclot and not a thrombosis which will become organised. The first massive thrombosis seen occurred between the second and third day after injection and involved a recent thrombus.
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Benzyl alcohol produced an allergic contact dermatitis in a 46-year-old woman. The dermatitis was characterized by erythema, palpable edema, and raised borders. It had occurred after the use of sodium tetradecyl sulfate, a sclerosing agent used for the treatment of varicose veins. This article reviews the widespread use of this preservative in a variety of injectable agents.
PURPOSE: To determine the efficacy of percutaneous sclerotherapy with an alcoholic solution of zein in lymphangiomas in pediatric patients. MATERIALS AND METHODS: Fourteen patients with macrocystic and mixed lymphangiomas were treated with use of Ethibloc as a sclerosing agent. The procedure was performed with ultrasonographic and/or fluoroscopic guidance. Follow-up clinical and sequential computed tomographic examinations were performed to evaluate regression of the lesion. RESULTS: Regression was excellent in nine (64%) of the 14 lesions: Regression was complete in four lymphangiomas and was to less than 5% of the initial volume in five. Satisfactory results were obtained in the remaining five (36%) of 14 lesions. The most frequent complication was leakage of Ethibloc without important sequelae in 10 of the 14 lymphangiomas. CONCLUSION: Percutaneous sclerotherapy with Ethibloc was a safe and effective procedure in the treatment of macrocystic and mixed lymphangiomas.
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