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At least 577 records · Page 32Linked to original sources
PubMed1983

Severe local reactions to live measles virus vaccine following an immunization program.

A cluster of nine severe local reactions occurred in a Pennsylvania school district following a mass measles immunization program in February 1981. A case-control study showed that the nine cases had a statistically significant increased history of having received killed measles vaccine previously (p less than .001, Fisher's exact test) and a statistically significant higher geometric mean measles antibody titer (p less than .01, Student's t test) than controls, suggesting that previous receipt of killed measles vaccine was the underlying cause of these reactions.

Adolescent↗
PubMed2004

Evolving strategies for insulin delivery and therapy.

It has now been conclusively proven that adequate control of blood glucose delays or prevents the progression of diabetic complications. In order to achieve the suggested targets for glycaemic control necessary to reduce the incidence of diabetic complications, it has been established that a more intensive insulin regimen requiring multiple insulin injections is required for patients with type 1 diabetes mellitus. For patients with type 2 diabetes, oral antidiabetic therapy is generally used initially, but given the natural history of type 2 diabetes and the need to achieve improved glycaemic control, earlier use of insulin has been promoted. However, the use of insulin in more intensive regimens for the patient with type 1 diabetes or for earlier treatment of the patient with type 2 diabetes is not routine. Many factors are responsible for this observation. Nevertheless, available device options such as insulin pens or insulin pumps are routinely available for implementation of intensive insulin therapy. However, a major limitation for advancing to intensive insulin therapy is that the only viable way to administer insulin is through injection. Delivery options that use dermal, nasal and oral approaches have been explored. The oral approach may include gastrointestinal, buccal or pulmonary uptake. Recent evidence shows that delivery of insulin via the oral cavity with uptake occurring in the pulmonary alveoli may be the most viable clinical option in the future.

Administration, Oral↗
PubMedDate not supplied

Continuous subcutaneous insulin infusion (Mill-Hill Infuser) versus multiple injections (Medi-Jector) in the treatment of insulin-dependent diabetes mellitus and the effect of metabolic control on microangiopathy.

The present study was designed to compare continuous subcutaneous insulin infusion (CSII) using the Mill-Hill Infuser (Muirhead Medical Products Ltd., London, England) with multiple injections (MI) using the Medi-Jector (Derata Corporation, Minneapolis, Minnesota) in the treatment of insulin-dependent diabetes mellitus (IDDM), and to assess the effect of glucose control on diabetes complications. Twelve diabetic subjects were treated 3 mo with CSII and 3 mo with MI (bedtime ultralente and premeal boluses of regular insulin) in a randomized fashion. Prestudy preprandial/postprandial glucose levels were 147-215 mg/dl and improved to 108-138 mg/dl during CSII, and to 115-139 mg/dl during MI with glycosylated hemoglobin of 12.9%, 9.1%, and 8.7%, respectively. This improved glucose control with either CSII or MI was associated with an increase in sural nerve conductivity from 42.9 to 45 m/s and a decrease in proteinuria from 1.9 to 0.5 g/24 h. The 24-h insulin dose consisted of 45 U before the study, 44 U during CSII, and 56 U during MI. After the study, seven patients opted to continue with the Mill-Hill Infuser, and five with the Medi-Jector. We conclude the following: (1) treatment with both the Mill-Hill Infuser and the Medi-Jector was well accepted by the patients and resulted in similar improvement in measured blood glucose and glycosylated hemoglobin; (2) this improved metabolic control was associated with an increased nerve conductivity and a decreased protein excretion; and (3) MI required 20% more insulin than CSII to achieve similar glycemic control.

Adult↗
PubMed1998

Waterjet dissection of the brain: experimental and first clinical results. Technical note.

Control of bleeding during dissection is a problem that is still not completely resolved in neurosurgical procedures. To overcome this problem in some settings, the authors, in close collaboration with their institution, developed a new device for blunt dissection of brain tumors that is based on a waterjet technique. This report describes their first experimental and clinical experience with this new method. Numerous cutting experiments were performed in porcine cadaver brains. The best results were obtained using pressures from 4 to 6 bars with a 100-microm tip, which produced very small, precise cuts. Histological evaluation showed no disruption or vacuolization of the surrounding tissue. The authors have used the new device in nine patients (seven with gliomas and two undergoing temporal lobe resections for epilepsy), and no complications have been observed. The waterjet device allowed dissection of the brain tissue while even small exposed vessels were spared injury. The instrument was found to be easy to use. Future investigations will concentrate on adapting this new method to endoscopic surgery and evaluating fluids with low surface tension to avoid foaming and bubbling during open surgery.

Animals↗
PubMed1975

Reactions to injected influenza vaccine.

Almost 6,000 healthy adults inoculated with influenza vaccine were asked to record daily for 5 days the presence or absence of defined local and general symptoms; 70 percent completed and returned the record. The overall incidence of subjective reactions derived in this way was high; approximately 50 percent complained of local pain and 40 percent of general symptoms. Only about one-third of vaccinees recorded no symptoms. The incidence of subjective local reactions was about 8 percent higher in women than men. Among 5,600 vaccinees a total of 63 days sickness absence was attributed to reaction in the week of immunization (1.1 days per 100 employees). Almost all the absences were of less than 3 days duration, unsupported by a doctor's certificate. In the week of vaccination sickness absence among vaccinees was not higher than that of non-vaccinees. Although the incidence of subjective reaction was found to be high and vaccination might itself cause some sickness absence, most of the reactions appear to be trivial. Among 700 employees who were interviewed 1 or 2 days after vaccination in 1973, the incidence of what was judged to be significant local pain and erythema was about 5 percent. Nevertheless,the reactions appear to have an important effect on acceptance of influenza vaccination. From the answers given to a questionnaire 30 percent of employees who refused vaccination did so either because they previously had symptoms after vaccination, or because others had told them of their occurrence. In approximately 16,500 injections, only 2 patients had an acute reaction resembling anaphylaxis.

Adult↗